Determinants of Sleep-Disordered Breathing During the Mixed Dentition: Development of a Functional Airway Evaluation...

The purpose of this study was to identify patterns of functional, extraoral, and intraoral examination characteristics that correlate with increased risk of sleep disturbances and develop a functional airway screening tool to help clinicians for early diagnosis of pediatric sleep-disordered breathing. From March 2018 until March 2019, a cross-sectional study was conducted of 96 mixed dentition children during dental examinations at the UCLA pediatric dental clinic. Outcome measures included a sleep index score by the Sleep Disturbance Scale for Children (SDSC) completed by parents. Clinical assessment tool measurements assessing functional, extraoral, intraoral soft tissue, and intraoral hard tissue determinants were recorded during a routine dental examination by pediatric dental residents. The mean age was 8.9 years (±1.9 years standard deviation), with 46 males and 50 females participating. Mouth-breathing (functional), mentalis strain (extra-oral), tonsillar hypertrophy and ankyloglossia (intraoral soft tissue), dental wear, and narrow palate (intraoral hard tissue) were found to be the most clinically deterministic of higher SDSC scores (P<0.01). A clinical assessment tool for sleep-disordered breathing in pediatric dental patients (FAIREST-6) was developed, comprising these six clinical factors. The FAIREST-6 is a concise and validated clinical assessment tool that may aid in early diagnosis and intervention of pediatric sleep-disordered breathing.