Author: Mayoor Patel, DDS
The Journal of Dental Sleep Medicine recently published an article about the prevalence of pediatric dentists who screen for sleep apnea. Pediatric obstructive sleep apnea (OSA) is characterized by repeated episodes of upper airway obstruction during sleep that lasts for more than two usual respiratory cycles. As a result, children experience breathing pauses, shallow breathing and respiratory effort-related arousals, leading to interruptions in sleep.
OSA most commonly affects children between the ages of two and seven years old–this is an especially critical time for growth and development. As a result, the consequences of untreated OSA in children remains long, including failure to thrive, attention-deficit disorder, and poor academic performance. It also places a burden on the cardiovascular system due to acute increases in blood pressure and arrhythmias associated with apneas and intermittent hypoxia, said the article.
What we know is that screening children for OSA is absolutely necessary and very critical to the maintenance of their overall health. It has been estimated that between 82 percent and 93 percent of adults with OSA remain undiagnosed. Similarly, OSA has been recognized as one of the most underdiagnosed chronic childhood diseases. And with the alarming increase in childhood obesity over the past few decades, it continues to influence OSA.
A Pediatric Dentist’s Role in OSA
Pediatric dentists and child dentistry as a whole play a very important role in the screening of OSA. Because adenotonsillar hypertrophy is the most common etiology, the recognition and documentation of the size of the tonsils during a head and neck examination can lead to a referral to a patient’s primary care physician or sleep specialist. It has been shown that there is a delay of up to 23 months between identification and referral to a sleep clinic, which is why it is so important for pediatric dentists to screen their patients.
The results from the study showed that less than 30 percent of pediatric dentists do not routinely screen their patients for OSA, which is a significant portion of the pediatric population. Of those that do screen for OSA in their patients, only 40 percent report screening all of their patients. In fact, only an average of 66 percent were actually screened–that isn’t enough. And when asked how confident they feel about screening for OSA, 72 percent of pediatric dentists stated that they felt uncomfortable.
What Can You Do?
As a pediatric dentist, it is important to take the next steps toward educating not only yourself and your team, but your patients as well. In this case, it would be to further educate your patients’ parents so they can better care for their children too.
There are a number of continuing education courses and conferences available for dentists to attend to become better trained in screening and treating children with OSA. Dental students and residents should consult their school’s programs to see what options are available for them to learn more as well.
While many do screen for OSA, not all are efficient in doing so. We need to continue to screen our pediatric patients to ensure they live healthy, happy lives.
Contact us today to learn more about OSA in children and how you can further improve your knowledge and services for your dental practice.