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颅面睡眠医学:牙科医疗人员在儿童睡眠呼吸障碍的检测与治疗中的重要作用。

Craniofacial Sleep Medicine: The Important Role of Dental Providers in Detecting and Treating Sleep Disordered Breathing in Children.

作者信息

Heit Tammarie, Tablizo Bea Janine, Salud Martina, Mo Fan, Kang Mandip, Tablizo Mary Anne, Witmans Manisha

机构信息

Avalon Dental, Edmonton, AB T6B 3T7, Canada.

Department of Pediatrics, Philippine General Hospital, Taft Avenue, Manila 1000, Philippines.

出版信息

Children (Basel). 2022 Jul 15;9(7):1057. doi: 10.3390/children9071057.

Abstract

Obstructive sleep apnea (OSA) is a clinical disorder within the spectrum of sleep-related breathing disorders (SRDB) which is used to describe abnormal breathing during sleep resulting in gas exchange abnormalities and/or sleep disruption. OSA is a highly prevalent disorder with associated sequelae across multiple physical domains, overlapping with other chronic diseases, affecting development in children as well as increased health care utilization. More precise and personalized approaches are required to treat the complex constellation of symptoms with its associated comorbidities since not all children are cured by surgery (removal of the adenoids and tonsils). Given that dentists manage the teeth throughout the lifespan and have an important understanding of the anatomy and physiology involved with the airway from a dental perspective, it seems reasonable that better understanding and management from their field will give the opportunity to provide better integrated and optimized outcomes for children affected by OSA. With the emergence of therapies such as mandibular advancement devices and maxillary expansion, etc., dentists can be involved in providing care for OSA along with sleep medicine doctors. Furthermore, the evolving role of myofunctional therapy may also be indicated as adjunctive therapy in the management of children with OSA. The objective of this article is to discuss the important role of dentists and the collaborative approach between dentists, allied dental professionals such as myofunctional therapists, and sleep medicine specialists for identifying and managing children with OSA. Prevention and anticipatory guidance will also be addressed.

摘要

阻塞性睡眠呼吸暂停(OSA)是睡眠相关呼吸障碍(SRDB)范围内的一种临床疾病,用于描述睡眠期间的异常呼吸,导致气体交换异常和/或睡眠中断。OSA是一种高度普遍的疾病,在多个身体领域伴有相关后遗症,与其他慢性疾病重叠,影响儿童发育,并增加医疗保健利用率。由于并非所有儿童都能通过手术(切除腺样体和扁桃体)治愈,因此需要更精确和个性化的方法来治疗伴有相关合并症的复杂症状群。鉴于牙医在整个生命周期中管理牙齿,并且从牙科角度对气道的解剖学和生理学有重要的了解,他们领域更好的理解和管理似乎有理由为受OSA影响的儿童提供更好的综合和优化结果。随着下颌前移装置和上颌扩弓等治疗方法的出现,牙医可以与睡眠医学医生一起参与为OSA患者提供护理。此外,肌功能治疗不断演变的作用也可能被用作OSA儿童管理中的辅助治疗。本文的目的是讨论牙医的重要作用以及牙医、肌功能治疗师等牙科相关专业人员和睡眠医学专家在识别和管理OSA儿童方面的协作方法。还将讨论预防和预期指导。

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