Better Faces - Less Braces

A Spreecast Webinar by

Dr. Barry RaphaelOf the

Raphael Center for Integrative Orthodontics

November 13, 2013

The link between crooked teeth, sleep and ADHD

Snoring 8-10%

NormalPrevalence:

OSAS 1-3%

UARS ?

3

Spectrum of SDB

Anatomic Determinants of SleepDisordered Breathing Across the Spectrum of Clinical and Nonclinical Male Subjects*

•Apnea occurs due to craniofacial morphology and obesity, each with their contributions

•The single most important cephalometric variable in predicting AHI severity was the horizontal dimension of the maxilla (ie, porion vertical to supradentale [PV-A] distance).

•SDB increased five- to seven-fold in non-obese subjects and threefold in obese subjects

CHEST September 2002 vol. 122no. 3 840-851

Jerome A. Dempsey, PhD; James B. Skatrud, MD; Anthony J. Jacques, BS;Stanley J. Ewanowski, PhD; B. Tucker Woodson, MD;

Pamela R. Hanson, DDS, MS; and Brian Goodman, PhD

Airway Size Matters

Which is easier to breath through?

Which would you rather have?

Pharyngeal Airspace

Mouthbreathers have significantly smaller airway space.

(measurements PAS-OccL, PAS-UP, airway volume, area and minimum axial area)

Mouth breather Nasal breather

Nighttime symptoms of SDB in kids

•Abnormal sleeping position•Bruxism•Chronic, heavy snoring•Delayed sleep onset•Difficulty breathing•Difficulty waking up in AM•Drooling•Enuresis•Frequent awakenings•Insomnia

•Mouth breathing•Nocturnal migraine•Nocturnal sweating•Periodic Limb movement•Restless sleep•Sleep talking•Sleep terror•Sleep walking•Witnessed apnea

Daytime symptoms of SDB in kids

•Morning headache•Mouthbreathing•Morning thirst•Excessive fatigue•Abnormal shyness, withdrawn, and depressive presentation

•Behavioral problems

•ADHD pattern•Aggressiveness•Irritability•Poor concentration•Learning difficulties•Memory impairment•Poor academic performance

Sleep Monitor

SQI = 7.3

SQI = .41

AirwayProblems

• Open Mouth habit• Mouth breathing• Snoring• Apnea/Hypopnea• Flexed Head• Gasping for Air• Stridor• Bruxism• Restless Sleep• Bed wetting• Tired and cranky

In the News, March 2012