A Review of Pediatric Obstructive Sleep Apnea and the Role of the Dentist

Abstract

Pediatric obstructive sleep apnea (POSA), considered most severe in the spectrum of sleep-disordered breathing (SDB), is highly prevalent and affects up to 1% to 4% of all children. Approximately 7 to 9 million children experience POSA, prompting the medical and dental communities to improve awareness for proper screening, diagnosis, and earlier treatment. According to the American Academy of Pediatric Dentistry (AAPD), signs of untreated POSA in school-aged children can include neurocognitive dysfunction such as aggressive behavior, symptoms that resemble attention deficit hyperactivity disorder, deteriorating school performance, bedwetting, developmental delay, and reduced quality of life. Various surgical and nonsurgical techniques are currently being used in the treatment of POSA. Although it often improves symptoms, adenotonsillectomy (AT), the first line of therapy, may not be entirely curative in children with POSA. Further, recurrence of POSA is frequent even after AT is performed. Although dentists play critical roles in both screening and referral of children with symptoms of POSA, the dentist’s role has recently evolved to include participation through a multidisciplinary approach in the management of children in whom POSA has been diagnosed. In this review, the etiology, epidemiology, and treatment considerations of POSA will be summarized with special emphasis on the dental provider’s role in identifying and treating POSA.