Dental clues to your child's sleep troubles — Nurul Zeety Azizi and Lau May Nak

Malay Mail

8 hours ago

JULY 7 — Your child snores loudly at night or consistently breathes through their mouth while sleeping. Perhaps they struggle to concentrate in school or wake up feeling tired despite what seems like a full night's rest. Do these scenarios sound familiar? If so, your child may be experiencing a condition known as Obstructive Sleep Apnoea (OSA).
While OSA is increasingly recognised and discussed among adults, a critical blind spot remains: many people are unaware that this debilitating condition can significantly affect children as well. Often dismissed as just 'loud snoring,' OSA in children presents unique challenges and carries serious long-term health and developmental risks that are frequently overlooked. As we approach July 10th, World Airway Disorders Day, it's crucial to shine a light on conditions like paediatric OSA and their profound impact on a child's overall well-being. This day serves as an important reminder of the need for greater awareness and early intervention for all airway-related issues.
At its core, OSA arises when sleep is disrupted by intermittent pauses or reductions in breathing, caused by a partial or complete obstruction of the upper airway. In children, common culprits are enlarged tonsils or adenoids. Other contributing factors can include obesity, craniofacial abnormalities, allergic rhinitis, or even certain dental issues.
Often dismissed as just 'loud snoring,' OSA in children presents unique challenges and carries serious long-term health and developmental risks that are frequently overlooked. — Unsplash pic
Surprisingly, many parents remain unaware that dental factors can play a significant role in contributing to OSA. In numerous cases, it is often the dental professional who first identifies critical warning signs during routine dental check-ups and subsequently refers the child to an ENT specialist for further evaluation. This crucial connection stems from the fact that the very shape and structure of a child's mouth and jaw are intrinsically linked to their airway function.
Indeed, dentists, particularly paediatric dental specialists and orthodontists, receive specialised training to identify structural issues that can severely impact breathing. These include a narrow or high-arched palate, a receded lower or upper jaw, tongue thrusting habits, or an anterior open bite — all of which can dramatically reduce essential airway space and significantly contribute to OSA symptoms.
Understanding the potential link between dental health and a child's breathing during sleep is the first step. For parents seeking to protect their child's well-being, here are some practical tips that are important to note:
Tip No. 1: Prioritise early and regular dental check-ups for your child
One of the most impactful steps parents can take for their child's potential OSA concerns is to schedule early and regular dental check-ups. These visits are a critical opportunity for the early detection of subtle signs of OSA. Prompt identification can lead to timely referral and effective management, especially since many effective interventions are most successful when applied during a child's developmental years. For instance, some dental treatments for OSA leverage 'growth modification' — using specific appliances to gently widen the upper jaw, thereby improving the airway and enhancing nasal airflow. Other functional appliances are designed to encourage proper jaw growth, guiding the upper or lower jaw into a healthier forward position. Furthermore, it's worth exploring the potential benefits of myofunctional therapy, an increasingly popular non-invasive approach that uses targeted exercises to strengthen the tongue and facial muscles, often complementing other OSA treatments.
Tip No. 2: Observe your child's breathing and sleep habits
Parents are often the first to notice subtle changes in their child. For potential OSA, it's vital to closely observe your child's sleep, noting any unusual snoring patterns or habitual mouth breathing. Don't dismiss loud, frequent snoring, especially if it includes gasping, choking, or silent pauses in breathing, as these can be critical indicators. Persistent mouth breathing, even during waking hours, should also raise a red flag. Make it a point to communicate these observations clearly with both your dentist and family doctor. These 'detective' findings are incredibly important for healthcare professionals to piece together a comprehensive picture, guiding them toward the most appropriate evaluation and interventions for your child's well-being.
Tip No. 3: Monitor for daytime behavioural and developmental clues
Many parents might attribute their child's daytime hyperactivity, difficulty focusing, or irritability to personality traits or other conditions. However, it's vital to recognise that these, along with poor academic performance or even unexplained growth issues, can be significant indicators of fragmented sleep due to OSA. Children don't always present with classic adult sleepiness; instead, their bodies often react with compensatory behaviours. Share any such behavioural or developmental concerns with your healthcare provider, as they could be silent calls for help from a sleep-deprived body.
In conclusion, parents play a vital role in recognising potential red flags early. Establishing regular dental visits from a young age not only promotes healthy teeth but can also be key in identifying and managing conditions like OSA before they affect a child's long-term health and development.
* Dr Nurul Zeety Azizi and Associate Professor Dr Lau May Nak are dental professionals based at Universiti Malaya. They can be contacted via email at [email protected]
** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.