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Sleep-Disordered Breathing in Children

October 1, 2023

Learn about the six independent red flags for sleep-disordered breathing in children as Orthodontist Rebecca Bockow continues to educate and inform on important sleep and airway issues troubling our kids today.

Dr. Rebecca Bockow is a dual-trained board-certified orthodontist and periodontist – one of only a handful in the country. She lectures nationally on periodontics, orthodontics, interdisciplinary orthodontics, airway, and skeletal growth and development.

”This group, published 2021, they asked the question, "If we..." They said, "Let's look at a lot of different parameters for children, and can we come up with a screening tool that if a patient has a 'Yes' to a certain number of these questions, they have a high likelihood of having sleep-disordered breathing."

”And so I'll share with you their findings. They looked at these six factors after looking at all of their data. These six factors were independent red flags for sleep-disordered breathing, and if you had more than one, the likelihood of having sleep-disordered breathing in a child went up.

”So function: mouth breathing - unable to breathe through their nose with lip sealed for more than three minutes. Mentalis strain, lip incompetence, tonsil hypertrophy, ankyloglossia (tongue tie, and we'll talk about that definition), dental wear, grinding (grinding in children is a sign of an airway issue), and maxillary constriction and narrow palate, looking at inner canine distance and intermolar distance.

”And so looking at their findings, if you had more than one of these six red flags, so to speak, the likelihood of a child having sleep-disordered breathing goes way up. So what were their six? We'll go through these and look at what this looks like clinically.

”So mouth breathing, this is a five-year-old that came to the practice, and he cannot breathe through his nose. So he's always mouth breathing, and mouth breathing is positively associated with gummy smiles. And so we're starting to see that here in this young man already at five.

”Mentalis strain, inability to close lips secondary to the position of the lower jaw and jaw growth. Tonsil hypertrophy, looking at the swollen tissue in the back of the throat identifying this in young kids because they will compensate, they'll mouth breath.

”They'll do other things which can lead to poor poor sleep, poor breathing, poor growth. And tongue ties - looking for anterior and posterior tongue ties. Dental wear and narrow palate - this patient has both, so grinding looking at those flattened cusp tips, looking for dentin exposure.”

Dr. Bockow loves to create beautiful smiles for her patients, setting them up for a lifetime of dental and airway health.

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