Screening for paediatric sleep disordered breathing in the dental setting: a scoping review

Abstract

Background: Sleep-disordered breathing (SDB) is under-recognised and under-diagnosed in children. Therefore, SDB screening during routine dental appointments may be considered a scalable approach to identifying at-risk children and guiding referrals to sleep specialists. This scoping review aims to explore the literature on paediatric SDB screening in dental settings and identify knowledge gaps. Methods: A scoping review was conducted using Medline, Embase, and PubMed. The inclusion criteria were: studies conducted in dental settings that describe SDB screening in non-syndromic patients aged 18 or younger, without previous surgical management for OSA. Results: Thirty-four studies were included, most of which were observational descriptive studies (n = 32). Eleven screening tools were used across studies: the most common being the Paediatric Sleep Questionnaire (n = 23). Numerous studies (n = 16) have reported the prevalence of positive SDB screening outcomes among the paediatric population, while others explored associations with sociodemographic factors (n = 7), craniofacial features (n = 11), medical conditions (n = 9), orthodontic treatment (n = 6), and oral health outcomes (n = 4). Two studies developed novel screening measures. A small number of studies discussed referral pathways (n = 7), and only one study documented referral outcomes. Conclusions: This review highlights the need for further validation of paediatric sleep questionnaires within dental settings. However, additional validation of clinical assessment tools in this context may offer limited incremental benefit. Furthermore, none of the included studies examined how screening protocols integrate within routine dental workflows or explored perceptions of children, caregivers, and dental practitioners. Lastly, there is a paucity of evidence concerning referral pathways and follow-up outcomes subsequent to screening.