The interface between dentistry and respiratory sleep disorders in children.

OBJECTIVE: To study the incidence of mouth breathing and its association with sleep disorders, dental caries, malocclusion and deleterious oral habits, in children. MATERIAL AND METHODS: 152 children (6 to 9 years), of both genders, were invited to perform clinical evaluation of the oral cavity and the application of the OSA-18. RESULTS: 89 presented mouth breathing (MB), being 45% with malocclusion, 56% with dental caries, 38% with tooth loss, 51% with bruxism and 52% with the habit of sucking finger or pacifier, compared to 40%, 40%, 21%, 27% and 43%, respectively, in the 63 children with nasal breathing (NB). 35 MB showed moderate to high risk for OSAS, while only 8 of the children showed moderate risk. The average score of OSA-18 was 50 (MB:57/NB:40), with 29 (19%) children showing moderate risk. Among these, 74% presented mouth breathing, 26% malocclusion, 61% dental caries, 35% tooth loss, 42% bruxism and 55% sucked finger or pacifier, and in the 14 (9%) with high risk, they were 100%, 75%, 58%, 50%, 67% and 67%, respectively. CONCLUSION: High frequencies of respiratory disorders with sleep repercussions associated with oral alterations were observed, reinforcing the correlation between mouth breathing and changes in stomatognathic system.

Rapid Maxillary Expansion Increases Internal Nasal Dimensions of Children With Bilateral Cleft Lip and Palate.

OBJECTIVE: The transverse maxillary deficiency frequently observed in patients with cleft lip and palate (CLP) is usually treated by rapid maxillary expansion (RME). Considering that RME causes a significant increase of the internal nasal dimensions in children with unilateral CLP (UCLP), this study aimed to characterize the internal nasal geometry of children with bilateral CLP (BCLP) and transverse maxillary deficiency using acoustic rhinometry. The study also aimed to analyze changes caused by RME. DESIGN: Cross-sectional prospective study. SETTING: Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil. PARTICIPANTS: Fifteen children with repaired BCLP of both genders, aged 8 to 15 years, referred for RME, were prospectively analyzed. INTERVENTIONS: Subjects underwent acoustic rhinometry before the expander installation and after the active phase of expansion. Cross-sectional areas (CSA) and volumes (V) of the nasal valve regions (CSA1 and V1) and turbinates (CSA2, CSA3, and V2), were measured after nasal decongestion. MAIN OUTCOME MEASURES: In the majority of the subjects, an increase of internal nasal dimensions was observed. RESULTS: Percent changes of CSA1, CSA2, CSA3, V1, and V2 were: +25%, +11%, +9%, 20%, and +12%, respectively. Differences were significant for all variables studied, except CSA3 (P < .05). CONCLUSIONS: RME promotes an increase in the internal nasal dimensions of children with BCLP, suggesting that RME is capable of substantially improving nasal patency in this population.