journal article·2024-12-26Open access

Sleep Breathing Disorders’ Screening Among Children Approaching Orthodontic Evaluation: A Preliminary Study

Marco Storari, Francesca Stramandinoli, Maurizio Ledda, Alberto Verlato, Alessio Verdecchia, Enrico Spinas

Applied Sciences· Volume 15· Issue 1

Abstract

Background: The orthodontist can play an important role in the early detection of sleep-disordered breathing (SDB), aiding in the prevention of dentoskeletal complications and systemic issues. Early intervention supports proper pediatric development, emphasizing the need for SDB screening in orthodontics. SDB involves abnormal breathing during sleep, with obstructive sleep apnea (OSA) in children presenting unique diagnostic challenges compared to adults. Aim: This study aimed to identify children at risk for SDB through a validated screening questionnaire during orthodontic evaluations. Methods: This prospective study recruited children under 12 years of age between July 2023 and July 2024. The Sleep Clinical Record was used to screen for SDB indicators. Results: Among the 48 participants (31 females, 17 males) aged 5–12 years, 69% were identified as being at risk for SDB. Risk factors included oral breathing, nasal obstruction, tonsillar hypertrophy, malocclusion, high Friedman scores, narrow palates, and positive Brouillette phenotypes, all showing significant correlations (p < 0.05). Conclusion: The findings underline the critical importance of early SDB screening in orthodontic settings. These preliminary results encourage further research on larger cohorts to refine diagnostic tools and interventions. Early recognition and management of SDB can significantly enhance systemic health and craniofacial outcomes in pediatric patients.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Obstructive Sleep Apnea Research · Neuroscience of respiration and sleep · Infant Health and Development

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Surgical Sciences, Postgraduate School in Orthodontics, University of Cagliari, 09124 Cagliari, Italy

Renal Unit, Department of Medicine, University Hospital of Verona, 37126 Verona, Italy

References (46)

Show source-provided references
1. Faverio, P., Zanini, U., Monzani, A., Parati, G., Luppi, F., Lombardi, C., and Perger, E. (2023). Sleep-Disordered Breathing and Chronic Respiratory Infections: A Narrative Review in Adult and Pediatric Population. Int. J. Mol. Sci., 24.10.3390/ijms24065504 ↗
2. The role of the dentist in the diagnosis and management of pediatric obstructive sleep apnea10.1016/j.sdentj.2021.02.001 ↗
3. Visual scoring of sleep: A comparison between the Rechtschaffen and Kales criteria and the American Academy of Sleep Medicine criteria in a pediatric population with obstructive sleep apnea syndrome10.1016/j.clinph.2009.09.016 ↗
4. Class II correction improves nocturnal breathing in adolescents10.2319/052710-233.1 ↗
5. Pediatric obstructive sleep apnea10.1016/j.anclin.2013.10.012 ↗
6. Caliendo, C., Femiano, R., Umano, G.R., Martina, S., Nucci, L., Perillo, L., and Grassia, V. (2023). Effect of Obesity on the Respiratory Parameters in Children with Obstructive Sleep Apnea Syndrome. Children, 10.10.20944/preprints202310.0095.v1 ↗
7. Snoring but not BMI influences aggressive behavior and concentration problems in children10.5604/00306657.1182622 ↗
8. Craniofacial and upper airway morphology in pediatric sleep-disordered breathing: Systematic review and meta-analysis10.1016/j.ajodo.2012.08.021 ↗
9. Cephalometric, muscular and swallowing changes in patients with OSAS10.1111/joor.12666 ↗
10. Obstructive sleep apnea: From simple upper airway obstruction to systemic inflammation10.4103/0256-4947.75770 ↗
11. Pediatric obstructive sleep apnea-Dental professionals can play a crucial role10.1002/ppul.25291 ↗
12. Kim, K.A., Kim, S.J., and Yoon, A. (2024). Craniofacial anatomical determinants of pediatric sleep-disordered breathing: A comprehensive review. J. Prosthodont.10.1111/jopr.13984 ↗
13. Neurocognitive impairment in obstructive sleep apnea10.1378/chest.11-2214 ↗
14. Prevalence of obstructive sleep apnea (OSA) among preschool aged children in the general population: A systematic review10.1016/j.smrv.2023.101871 ↗
15. Sleep-disordered breathing in children seeking orthodontic care—An Australian perspective10.1111/adj.12945 ↗
16. Pediatric sleep-disordered breathing in the orthodontic population: Prevalence of positive risk and associations10.1016/j.ajodo.2019.05.015 ↗
17. Sleep-disordered breathing among Saudi children seeking orthodontic treatment10.4103/jfmpc.jfmpc_1918_20 ↗
18. Obstructive Sleep Disordered Breathing in 2- to 18-Year-Old Children: Diagnosis and Management10.1183/13993003.00385-2015 ↗
19. Borrelli, M., Corcione, A., Cimbalo, C., Annunziata, A., Basilicata, S., Fiorentino, G., and Santamaria, F. (2023). Diagnosis of Paediatric Obstructive Sleep-Disordered Breathing beyond Polysomnography. Children, 10.10.3390/children10081331 ↗
20. Obstructive sleep apnea syndrome in the pediatric age: The role of the dentist
21. The role of fluoride tablets in the prophylaxis of dental caries. A literature review
22. Screening for obstructive sleep apnea (OSA) in children and adolescents with obesity: A scoping review of national and international pediatric obesity and pediatric OSA management guidelines10.1111/obr.13712 ↗
23. Preventive treatment of post-traumatic dental infraocclusion: Study on the knowledge of dental decoronation in a sample of Italian dental students and dentists
24. The Declaration of Helsinki10.1136/bmj.39339.610000.BE ↗
25. Sleep clinical record: An aid to rapid and accurate diagnosis of paediatric sleep disordered breathing10.1183/09031936.00215411 ↗
26. High Mallampati score and nasal obstruction are associated risk factors for obstructive sleep apnoea10.1183/09031936.03.00292403 ↗
27. Staging of obstructive sleep apnea/hypopnea syndrome: A guide to appropriate treatment10.1097/00005537-200403000-00013 ↗
28. A Diagnostic Approach to Suspected Obstructive Sleep Apnea in Children10.1016/S0022-3476(84)80348-0 ↗
29. Una scala di facile uso per la rilevazione dei comportamenti problematici dei bambini con Deficit di Attenzione e Iperattività
30. Pediatric sleep questionnaire (PSQ): Validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems10.1016/S1389-9457(99)00009-X ↗
31. Combs, D., Goodwin, J.L., Quan, S.F., Morgan, W.J., and Parthasarathy, S. (2015). Modified STOP-Bang Tool for Stratifying Obstructive Sleep Apnea Risk in Adolescent Children. PLoS ONE, 10.10.1371/journal.pone.0142242 ↗
32. Diagnosis of sleep disorders in child healthcare settings10.1016/j.sleep.2024.04.023 ↗
33. Risk Factors of Obstructive Sleep Apnea (OSA) in Pediatric Patients: A Systematic Review and Meta-analysis10.1016/j.pedhc.2024.05.008 ↗
34. Pediatric polysomnography: The patient and family perspective10.5664/jcsm.28045 ↗
35. Breastfeeding and sleep-disordered breathing in children: Systematic review and proposal of underlying interaction models
36. OSAS in developing age: Screening of a Southern Italy population
37. Di Carlo, G., Zara, F., Rocchetti, M., Venturini, A., Ortiz-Ruiz, A.J., Luzzi, V., Cattaneo, P.M., Polimeni, A., and Vozza, I. (2020). Prevalence of Sleep-Disordered Breathing in Children Referring for First Dental Examination A Multicenter Cross-Sectional Study Using Pediatric Sleep Questionnaire. Int. J. Environ. Res. Public Health, 17.10.3390/ijerph17228460 ↗
38. Association among craniofacial morphology, ethnicity, and risk of pediatric sleep-related breathing disorders: A multicenter study10.1016/j.ajodo.2023.10.015 ↗
39. Is there an association between various aspects of oral health in Southern Italy children? An epidemiological study assessing dental decays, periodontal status, malocclusions and temporomandibular joint function
40. Geiger, Z., and Gupta, N. (2023, December 20). Adenoid Hypertrophy, StatPearls, Available online: https://www.ncbi.nlm.nih.gov/books/NBK536984/.
41. The critical age and dentocraniofacial morphologic deviation in mouth breathing patients
42. Cenzato, N., Nobili, A., and Maspero, C. (2021). Prevalence of Dental Malocclusions in Different Geographical Areas: Scoping Review. Dent. J., 9.10.3390/dj9100117 ↗
43. Craniofacial morphology in patients with obstructive sleep apnea: Cephalometric evaluation10.1016/j.bjorl.2020.05.026 ↗
44. Something to consider: Rapid palatal expansion for treatment of obstructive sleep apnea in pediatric patients10.1097/MOP.0000000000001287 ↗
45. Pharyngeal airway in children with sleep- disordered breathing in relation to head posture
46. Orthodontics treatments for managing obstructive sleep apnea syndrome in children: A systematic review and meta-analysis10.1016/j.smrv.2015.02.002 ↗