ortho - the international C.E. magazine of orthodontics

I 21ortho 1_2014 technique_ sleep apnea I whenitcomestoaskingpatientsaboutpossibleOSAS issues. • Some sleep apnea is linked with aging. The natural loss of muscle tone that happens as the years go by can lead to the development of airway obstructions. • Smoking and alcohol use may not cause sleep apnea, but both can aggravate the condition. •Inrecentdecades,increasingattentionhasbeen paidtoOSAScaseslinkedwithabnormalitiesinoral- facial development among non-obese children. A review of the evidence supporting this hypoth- esiswaspublishedlastyearinFrontiersinNeurology. Co-author Christian Guilleminault is a pioneering sleep scientist at the Stanford School of Medicine whohelpedtodiscoverandnamethesyndromeback in the 1970s. The paper identifies several facial characteristics associated with OSAS in non-obese patients, includ- ing the narrowing of dental arches, a decrease in maxillary arch length and an increase in anterior facial height. What causes these developmental abnormali- ties is uncertain; the paper speculates that they are sparkedbysomethingthathappensinutero.Theyare also common among premature births. Harry Legan, the chairman of orthodontics at the Vanderbilt University School of Medicine, noted these characteristics in a 2008 presentation before the Pacific Coast Society of Orthodontics and added acoupleofotherstothemix,includingalargetongue and an inferiorly positioned hyoid bone. The list made it clear, Legan said, that “the ortho- dontistisuniquelysuitedtorecognizethesymptoms of[obsessivesleepapnea],makeatentativediagnosis and make the necessary referral to coordinate treat- ment options.” _The orthodontist and pediatric OSAS Early diagnosis and successful treatment can make a huge difference in the lives of young sleep apnea patients. Among the outcomes cited in an August 2013 paper in the journal JSM Dentistry by developmental dentist Zheng Xu of the University of Texas Health Science Center are improved cogni- tive development, better academic outcomes and improved social skills. The treatment of pediatric OSAS generally in- volvesamultidisciplinaryteamthatcanincludesleep specialists, weight-loss experts and pediatricians, as well as dentists and orthodontists. The participation of orthodontists seems poised to increase, given a growing body of evidence that rapidmaxillaryexpansion(RME)isaneffectivetreat- ment. RME has been around for more than a century now, but its usage in disordered sleep patterns is a relatively recent phenomenon. The treatment in- volves the placement of an expandable brace on the (Illustrations/Provided by www.shutterstock.com)

ortho - the international C.E. magazine of orthodontics

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