Associations between sleep-disordered breathing symptoms and facial and dental morphometry, assessed with screening examinations

Am J Orthod Dentofacial Orthop. 2011 Dec;140(6):762-70. doi: 10.1016/j.ajodo.2011.03.023.

Abstract

Introduction: Chronic snoring is considered abnormal in a pediatric population. This disorder is often attributed to enlarged tonsils and adenoids, but multiple anatomic obstructions should also be considered. Facial and dental morphometry associations with various sleep-disordered breathing symptoms were investigated at an orthodontic clinic.

Methods: Parents or guardians were asked to complete a 4-part questionnaire on behalf of their children (n = 604; <18 years of age), including medical and dental history, bruxism and temporomandibular disorder habits, sleep and daytime behavior, and sleep duration and quality. All subjects underwent a clinical screening assessment by the same orthodontist to identify standard dental, skeletal, functional, and esthetic factors.

Results: In contrast to sleep-disordered breathing or sleep apnea in adults, which is predominantly associated with obesity, sleep-disordered breathing symptoms in this pediatric cohort were primarily associated with adenotonsillar hypertrophy, morphologic features related to a long and narrow face (dolichofacial, high mandibular plane angle, narrow palate, and severe crowding in the maxilla and the mandible), allergies, frequent colds, and habitual mouth breathing.

Conclusions: Because of the recognized impact of pediatric snoring on children's health, the determination of these good predictors can help in preventing and managing sleep-disordered breathing. If a health professional notices signs and symptoms of sleep-disordered breathing, the young patient should be referred to a sleep medicine specialist in conjunction with an orthodontist if there are dentoskeletal abnormalities.

MeSH terms

  • Adenoids / pathology*
  • Adolescent
  • Bruxism / complications
  • Chi-Square Distribution
  • Child
  • Cross-Sectional Studies
  • Face / anatomy & histology*
  • Female
  • Humans
  • Hypertrophy / complications
  • Male
  • Malocclusion / complications*
  • Mandible / anatomy & histology
  • Mass Screening
  • Mouth Breathing / etiology*
  • Nasal Obstruction / complications
  • Odds Ratio
  • Palate, Hard / pathology
  • Palatine Tonsil / pathology*
  • Sleep Apnea Syndromes / etiology*
  • Snoring / etiology*
  • Surveys and Questionnaires
  • Vertical Dimension