Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, Canada.
Pediatr Pulmonol. 2022 Aug;57(8):1860-1868. doi: 10.1002/ppul.25291. Epub 2021 Mar 1.
The significant contribution of dental professionals to the management of selected adult obstructive sleep apnea (OSA) cases is understood. Among children, it has also been suggested that dental professionals may also help screen and manage this morbidity in selected cases. It has also been noted that our understanding of pediatric OSA lags significantly behind adult OSA. During the screening process for potential pediatric OSA cases, dental professionals may be quite helpful as specific craniofacial abnormalities have been previously associated with pediatric OSA, including Class II malocclusion, vertical facial growth and maxillary transversal deficiency. As dental professionals assess children more frequently than physicians, they can help screen sleep-disordered breathing signs and symptoms using validated questionnaires. In more advanced cases, orthodontists may be leading contributors to the management of selected cases where a craniofacial involvement is suspected. Rapid maxillary expansion and mandibular or maxillary anterior repositioning devices have been proposed as managing alternatives. So far, there is no substantial evidence if these approaches can be adopted to treat OSA fully or if the reported OSA signs and symptoms improvements observed in a selected group of patients are stable long-term. Nevertheless, dentists and orthodontists' integration into a transdisciplinary team should be encouraged to play a significant role. This review discusses dentists or orthodontists' potential contribution to screen and manage selective pediatric OSA patients as part of a transdisciplinary team.
牙科专业人员在管理某些成人阻塞性睡眠呼吸暂停（OSA）病例方面的重要贡献是可以理解的。在儿童中，也有人认为牙科专业人员也可以帮助筛选和管理某些病例中的这种发病率。此外，我们对儿科 OSA 的理解明显落后于成人 OSA。在潜在儿科 OSA 病例的筛查过程中，牙科专业人员可能会非常有帮助，因为以前已经有特定的颅面异常与儿科 OSA 相关，包括 II 类错颌、垂直面型生长和上颌横向不足。由于牙科专业人员比医生更频繁地评估儿童，因此他们可以使用经过验证的问卷帮助筛查睡眠呼吸障碍的体征和症状。在更严重的情况下，正畸医生可能是管理疑似颅面受累的特定病例的主要贡献者。已经提出快速上颌扩张和下颌或上颌前移位装置作为管理替代方案。到目前为止，还没有充分的证据表明这些方法是否可以完全用于治疗 OSA，或者在一组选定的患者中观察到的报告的 OSA 体征和症状改善是否稳定长期。尽管如此，还是应该鼓励牙医和正畸医生融入跨学科团队，发挥重要作用。这篇综述讨论了牙医或正畸医生作为跨学科团队的一部分筛选和管理选择性儿科 OSA 患者的潜在贡献。
