WESTCHESTER, Ill. — According to new research that will receive the Graduate Student Research Award on Saturday, June 5, at the 19th Annual Meeting of the American Academy of Dental Sleep Medicine, questionnaires can help dentists screen for sleep-disordered breathing (SDB) in a pediatric population. SDB includes obstructive sleep apnea (OSA), upper-airway resistance syndrome, and snoring.
The researchers evaluated two SDB questionnaires in children undergoing orthodontic treatment in the undergraduate program at the University of British Columbia.
The study included 189 children, of which 48.2 percent were male. The patients ranged from seven to 15 years of age.
Craniofacial abnormalities, such as small jaw, narrow upper arch, or high palatal, are considered a common cause of SDB in children. Each child underwent a routine orthodontic examination of the upper, lower and total face height, hyoid position, soft palate length, mandibular length, vertical airway length, overjet and overbite to determine craniofacial characteristics.
Each parent or guardian completed two sets of questions for his or her child: the OSA 18 and the Pediatric Sleep Questionnaire (PSQ). Both questionnaires evaluated SDB symptoms.
Questions on the OSA 18 were divided into five domains: sleep disturbance, physical symptoms, emotional symptoms, daytime functions and caregiver concerns. Scores greater than 60 indicated a greater probability of SDB and/or a reduced quality of life. The PSQ questionnaire included 22 “yes, no, or don’t know” type questions. If the number of “yes” responses surpassed eight, it indicated a high risk of SDB.
The OSA 18 suggested that two children were at risk for SDB while the PSQ suggested that 11 children were at risk. Twenty percent of the subjects reported snoring, which is a common symptom of SDB.
Lead author Hiroko Tsuda, DDS, PhD, explained that dentists have more opportunity than physicians to detect pediatric SDB because they see patients on a regular basis.
“Based on this study, family dentists may find the preliminary risks of SDB by using simple questionnaires,” said Tsuda.
Tsuda emphasized that SDB must be properly diagnosed by a sleep specialist.
This research was supported by the MITACS Accelerate BC Internship.
The AADSM Annual Meeting will bring together almost 700 international clinical and research leaders in dental sleep medicine to present and discuss new findings and developments related to sleep-related breathing disorders. The three-day scientific meeting will be held in conjunction with SLEEP 2010, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society in San Antonio, Texas. Learn more at www.aadsm.org.
Abstract Title: A Correlation between Two Pediatric Sleep Disordered Breathing Questionnaires and Craniofacial Morphology in Children
Presentation Date: Saturday, June 5, 2010
Category: Graduate Student Research Award
Abstract ID: 004
Dentistry in Canada is available to those who can afford it. Hence, the suggestion that dentists would have a better opportunity than family physicians to screen children they see regularly for sleep-disordered breathing is certainly plausible, but not convincing. It is likely that those children who are socio-economically advantaged and whose parents can afford dental care may be screened by dentists for sleep-disorders; and then only likely if dentists can charge for this service and patients are willing to pay.
We know that segments of the population that are less advantaged are denied comprehensive dental care in Canada. Oral health related problems remain a large unmet healthcare need, and a frequent reason for children missing school, and parents missing work, particularly among low-income groups. There seems to be little interest among policy makers and dental organizations to include dentistry as a healthcare benefit within the publicly-funded health system in Canada.
Dentists are well aware of the damage that poor oral health inflicts on children, yet programs for children in low-income families are less than adequate, if they exist at all. What’s most alarming is that many dentists tend to resist universal dental care in Canada, favoring instead a a free market system. As long as dentists limit the provision of oral healthcare to those who are privilged, physicians under a universally accessible healthcare system in Canada will likely always have a better opportunity and accept the social responsibility to screen for issues related to oral health.
Shafik Dharamsi
Department of Family Practice
UBC Faculty of Medicine
UBC Faculty of Medicine