Respiratory disorders in paediatric age: orthodontic diagnosis and treatment in dysmetabolic obese children and allergic slim children.

ABSTRACT

AIM: Obesity and allergic susceptibility are worsening problems in the most industrialised countries. With different mechanisms, they both lead to a deterioration of children's life quality because they affect the respiratory system, leading to asthma and respiratory disorders such as mouth breathing and obstructive sleep apnoea. The latter are related to specific types of malocclusions that require an early diagnosis and specific multidisciplinary treatment. The purpose of this work is to show the characteristic signs and symptoms of these disorders in children of the two phenotypes (allergic and slim, obese and dysmetabolic). Intercepting such issues allows both pediatricians and paediatric dentists to refer the child to a multidisciplinary team of specialists able to deal, in a holistic way, with both the physical and behavioural causes, and also with the consequences on systemic and craniofacial development in particular. MATERIALS AND METHODS: The literature available on this topic in the years between 1997 and 2011 was reviewed, paying special attention to prevention, paediatric visits, diagnostic tools and treatment options for each of the two conditions. CONCLUSION: Dysmetabolic obese children and allergic slim children have specific respiratory problems during rest and exercise. Mouth breathing and obstructive sleep apnoea are due to an abnormal craniofacial development and can cause serious systemic problems in adulthood. Intercepting early signs of pathognomonic symptoms of sleep aponea and mouth breathing permits to treat children with an early multidisciplinary approach, and allows for proper physical and psychological development of the child.