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Pediatric Sleep Medicine


A Problem Seeking a Solution

pediatric-sleep-medicine-new-jersey-njMost people I talk to now know what Sleep Apnea is, and everyone understands snoring.  It's a disease of older fat men, right?

Not quite.  Did you know that a significant number of children have Sleep Disordered Breathing (SDB) now that can become the full blown Sleep Breathing Disorders of adulthood?

Did you also know that a sleep breathing disorder - like snoring - in an infant can lead to behavior and attention deficit issues by ages 4-7?(Bonuck, 2012)  It affects the way oxygen gets to all parts of our body, including the brain. 

The issue is now important enough that the American Academy of Pediatrics has issued guidelines on treatment of children with SDB and Obstructive Sleep Apea.  (see here for a copy) For instance, if your child has swollen tonsils and adenoids that are preventing easy nighttime breathing, they should be removed even if there are no recurrent ear infections.  (Finally!...)

But there is something as yet missing from these guidelines that is only alluded to in their report.  That is, it is the shape of the face, the jaws, and the back of the nose and throat that makes it easier for breathing to become stopped up.  Even moderate sized tonsils in a small throat can cause trouble.

Integrative Orthodontics can provide relief.

myofunctional-orthodontics-new-jersey-njMFO deals directly with helping the face, jaws and mouth grow to their proper proportions.  That means the back of the throat as well.  And if the back of the throat enlarges, it will not clog up so easily.  In fact, physics tells us that even a small amount of increase can make a huge difference in breathing

Orthodontists have known for years that palatal expansion can help a child breath better.  Since the palate is not only the roof of the mouth but also the floor of the nose, this makes perfect sense.

Now that we can bring both jaws FORWARD (see Biobloc Orthotropics), we can help the children even more, perhaps setting them up with a lifetime of better breathing. 

Has your child had a sleep study?

sleep-study-pediatric-new-jersey-njIf your child has trouble breathing, snoring, restlessness, bedwetting, nightmares, or a whole host of other nighttime symptoms, it may be time to talk to your pediatrician or a myofunctional orthodontist about doing a sleep study.  Even if the results are negative at first, it will serve as an important baseline if things get worse as they age (like from mouth breathing habits).

If they have had positive results, PLEASE see your myofunctional orthodontist before you begin more extreme measures such as CPAP, throat surgery and the like.  We can help! 



What to do if you suspect a problem

Here are two forms you can use to screen your child for a Sleep Breathing Disorder.

  • Pediatric Daytime Sleepiness Scale (link)
  • Symptoms of Pediatric Sleep Disordered Breathing

If you need some help interpreting what you find, please request an appointment.


orthodontist-clifton-nj-new-jerseyWe thank our patients for the trust they have put in our orthodontics practice the past 30 years (60 years if you include my Dad and Elaine).
I hope this website earns their trust again.

Barry Raphael, DMD

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