Snoring & Bruxism in children

Kate Sahafi, DDS
Article by
Orange County Cosmetic Dentist

Sleep disordered breathing (SDB) is a common problem affecting the health of children. Studies show upwards of 20% of all children exhibit snoring and severe tooth grinding (sleep bruxism). Of the group of snorers about 20% will have the more severe forms of Obstructive Sleep Apnea (OSA). Children with even the mildest forms of this problem will experience frequent nighttime arousals, with disrupted sleep architecture and altered daytime functioning. Parents often will seek medical and/or dental attention after observing heavy mouth breathing, teeth grinding, snoring, and breathing stoppages. More often than not, severity of the problem will be in directly related to the enlargement of the adenoid and tonsillar tissue and the amount of fatty tissue lining the upper airway. With the upward trends of obesity in this country we are see more kids at risk than ever before for more severe forms of OSA.
Clinical symptoms of untreated SDB may include excessive daytime sleepiness, failure to thrive, bed wetting, behavioral
Snoring and Bruxism in Children:
It is not All Just Noise!
problems and in more advanced cases, cardiac complications (cor pulmonale). If untreated these cardiac issues can follow into adulthood.
Dental signs of SDB are extreme wear on the dentition, evidence of cheek biting; Craniofacial abnormalities (retrognathism), narrow arch development and abnormal tongue swallow patterns.
As a public health concern, there are an increasing number of children with behavioral problems that are diagnosed as Attention Deficit Hyperactivity Disorder (ADHD). As shown in many studies, a large number of children with ADHD or inattentive behaviors were later shown to have an underlying sleep disordered breathing problem. It is a distinct possibility that if more attention were paid to the underlying sleep issues there would be less reliance on stimulant medication to manage their behavior.
The dentist and primary care pediatrician can play a critical role in screening for this problem by asking a series of question (see below) and doing a thorough dental examination including inspection of the tissues in the back of the throat. Close attention needs to be paid to the relation of the tonsils to the lateral dimension of the available airway.
Dentists involved with management of patients with SDB may use other useful tools such as the Phayngometer (Ecco
Does your child/patient have any of the following symptoms?
• Continuous loud snoring
• Episodes of not breathing at night (apnea)
• Failure to thrive (weight loss or poor weight gain)
• Chronic Mouth breathing
• Enlarged tonsils and adenoids (with frequent sore throat infections)
• Problems sleeping, bed wetting and restless sleep (including sleep walking)
• Excessive daytime sleepiness
• Frequent headaches
• Daytime cognitive and behavior problems, including problems paying attention, aggressive behavior and hyperactivity, which can lead to problems at school.