[Pediatric obstructive sleep apnea--an orthodontic perspective]

Sleep disturbed breathing in children, is a general term describing a wide range of respiratory disorders that occur during sleep, ranging from snoring to Obstructive Sleep apnea syndrome (OSAS). In recent years, the role of OSAS in a vast range of morbidities has been recognized, namely metabolic, neuro-cognitive and cardio-vascular disorders, thus emphasizing the importance of early detection. The recommended initial treatment for pediatric OSAS consists of surgical removal of adenoids and tonsils. However, today it is clear that there are other factors involved in the etiology of the syndrome. An association is believed to exist between the airway and craniofacial development and vice versa. The structure of the face and jaws has been shown to play an important role in the pathophysiology of OSAS, thus, the orthodontist plays a substantial role in the diagnosis and treatment of these children. Moreover, OSAS is believed to have a direct and indirect effect on oral health. Obstructive Sleep apnea syndrome is also common in adults, but is defined as a separate entity being different in terms of pathophysiology, clinical presentation and treatment. This paper reviews the pathophysiology, diagnosis, clinical implications and available treatment options for pediatric OSAS. Moreover, we will review the impact of the condition on the structures of the face, jaws, mouth and teeth and discuss the dentist's critical role in identifying and treating these problems.