loud mouth breathing and what seem to be obvious signs of airway dysfunction. But indeed, often chil-dren only exhibit one or two symp-toms, and they may be symptoms like behavioral problems, bedwet-ting, and/or bruxism. Your referral can change the course of that child’s life. Whether the symptoms are typical or atypical, huge or tiny, know it is possible your referral to a competent, developmentally knowl-edgeable ENT specialist may give the child his or her future. The AAP reports that T &A is the first line treatment of the airway pathologic child. Less frequently there are enlarged turbinates that may require surgery. The recom-mended treatments may be surgical, or may be medical – decongestants, allergy treatments, etc. And, if there is not medical or surgical treatment to be done, know that you as the dentist can still offer palatal expan-sion. In a child with airway patho-physiology, expansion should be rapid and just short of buccal cross-bite, to open the airway as much as possible. Donald Timms reports the amazing increase in athletic prowess, in enjoyment of life, and in happiness following expansion. This is due to oxygenation. Add the airway questions to your health history. If you would like, you can utilize those from my health history which are on my website, www.drchrisbaker.com. Start asking questions, diagnose and refer these patients. It’s your opportunity. Transform lives – those of your patients and your own. Apnea Syndrome PEDIATRICS Vol. 109 No. 4 April 2002, pp. e69-e69 Basciftci, FA et al. Does the timing and method of rapid maxillary expansion have an effect on the changes in nasal dimensions? Angle Orthod 72(2) 202. 118-123. Ceylan, Ismail. The effect of rapid maxillary expansion on conductive hearing loss. The Angle Orthodontist. 66#4: 1996, 301-308. Farber JM. and others, in Letters to the Editor: Clinical practice guideline: diag-nosis and management of childhood obstructive sleep apnea. Pediatrics. 2002 Dec; 110(6) 1255-7. Friedlander et al. Diagnosing and Comanag-ing Patients with Obstructive Sleep Apnea Syndrome. JADA. 131: August 2000, 1178. Gozal, D. Gozal, LK, Bhattacharjee, R, and Spruyt, K. Neurocognitive and Endothe-lial Dysfunction in Children With Obstructive Sleep Apnea. PEDIATRICS Vol. 126 No. 5 November 2010, pp. e1161-e1167. Gozal D. Sleep-Disordered Breathing and School Performance in Children. Pedi-atrics (1998; 102: 616-620). Gray, Lindsay P., Rapid Maxillary Expansion and Impaired Nasal Respiration; Ear Nose Throat J. 1987.66:248-1. Guray E., Karaman Al. Effects of adenoidec-tomy on dentofacial structures: a 6-year longitudinal study. World Journal of Orthod. 3(1) 2002. 73-81. Hyman, Mark . Autism: Is it all in the head? Alternative Therapies, Nov/Dec 2008. 14.(6). Hyman, Mark. The Five Forces of Wellness: The Ultraprevention System for Living an Active, Age-Defying, Disease-Free Life. Nightingale-Conant. Linder-Aronson, S. Adenoids: their effect on mode of breathing and nasal airflow and their relationship to characteristics of the facial skeleton and the dentition. Acta Oto-Larnygologica 1970. Supp. 265. Linder-Aronson, S. et al. Mandibular growth direction following adenoidectomy. American J. of Orthod. 89 #4: April 1986, 273-284. Linder-Aronson, S. Respiratory function….British J Ortho 6. 1979. 59-71. Linder-Aronson. Relationship of Airway Obstruction and Dentofacial Develop-ment. 1960, 3, 70, 2, 3, 5, 7, 9, 9, 83, 6. Marks, MB. Bruxism in allergic children. Abstract. Am J Orthod 1980 Jan:779(1):48-59. McNamara, JA. Influence of respiratory pattern on craniofacial growth. Angle Orthod. Oct 1981. 51:4. 269-273. McNamara, JA. (ed): Naso-Respiratory Func-tion and Craniofacial Growth, Center for Human Growth and Development, Ann Arbor, MI 1979. Meredith, George M., The Airway and Dento-facial Development, Ear Nose Throat J. 1987, 66:209-211. Miller, Stacey. Studies Link Sleep Apnea and ADHD, Advance in Respiratory Care and Sleep Medicine. Vol. 18,Issue 7,p15. Nowak KC,, Weider DJ. Pediatric nocturnal enuresis secondary to airway obstruction from cleft palate repair. Clin Pediatr (Phila). 1998 Nov;37(11):653-7. Oral Health in American: A Report of the Surgeon General. 2000. Petit, Henri, Upper Airway Problems and Pre-Orthodontic Orthopedic; Ear Nose Throat J. 1987, 66:228-36. Pantino DA. Letter to the editor: Sleep disor-dered breathing. JADA 131: November 2000. Richter, Harry J., Obstruction off the Pedi-atric Upper Airway, Ear Nose Throat J. 1987, 66:209-211. Schulhof, Robert J. Consideration of Airway in Orthodontics. JCO 8: June 1978. Shapiro, G. (M.D.), Shapiro, P. (D.D.S., M.S.D.) The Effects of Nasal Obstruction on Facial Development and Orthodontic Treatment. Office of Continuing Educa-tion, Baylor College 1987. Subtelny, J.D. Effect of disease of tonsils and adenoids on dentofacial morphology. Ann. Otol. Rhinol. Laryngol. Mar-Apr 1975. (pt2 suppl 19) 84. Timms, Donald J. Rapid maxillary expansion in the treatment of nocturnal enuresis. The Angle Orthodontist. 60 #3: Nov 1989, 229. Tran KD, Nguyen CD, Weedon J, Goldstein NA. Arch Otolaryngol Head Neck Surg. 2005 Jan;131(1):52-7.Child behavior and quality of life in pediatric obstructive sleep apnea. Vargervik, K, Harvold, EP. Experiments on the interaction between orofacial func-tion and morphology. Ear, Nose and Throat J. May, 1987. 66. 201-208. Weider DJ, Baker GL, Salvatoriello FW, Dental malocclusion and upper airway obstruction, an otolaryngologist’s perspective. Int J Pediatr Otorhinolaryn-gol. 2003 Apr;67(4): 323-31. Weider DJ, Hauri PJ. Nocturnal enuresis in children with upper airway obstruction. Int J Pediatr Otorhinolaryngol. 1985 Jul;9(2):173-82. Weider DJ, Sateia MJ, West RP. Nocturnal enuresis in children with upper airway obstruction. Otolaryngol Head Neck Surg. 1991 Sep;105(3):427-32. Weider DJ, Sulzner SE. Inferior turbinate reduction surgery in children. Ear Nose Throat J. 1998 Apr;77(4):304-6, 311-2, 314-5. Weimart, T. Evaluation of the Upper Airway, Ear Nose Throat J. 1987, 66:196-200. Woodside, Donald et al. Mandibular and maxillary growth after changed mode of breathing. American J. of Orthod. And Dentofacial Orthopedics. 100 #1: July 1991, 1-18. “To know even one life has breathed easier because you have lived – this is to have succeeded.” -Ralph Waldo Emerson Bibliography American Academy of Pediatrics: Clinical Practice Guideline: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome PEDIATRICS Vol. 109 No. 4 April 2002, pp. 704-712. Schechter, Michael S. Schechter, and Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome Technical Report: Diagnosis and Manage-ment of Childhood Obstructive Sleep www.orthodontics.com March/April 2011 29
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