Orthotown October 2017 - 41

continuing education

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One Airg airway resistance
and reducin

The American Association of Orthodontists recommends that we begin screening
patients at age 7 for orthodontic treatment.
As orthodontists, we have the potential to
influence the lives of our patients for a longer
term if we are aware of the questions to ask and
how to diagnose and treatment-plan certain
conditions. How many young observation
patients do we see who may have that may
have underlying medical conditions? This
may be because we didn't ask the appropriate
questions and parents are not aware of the
scope of what we can do if informed.
The purpose of this article is to show
how proper airway assessment and airway
management using rapid maxillary expansion
can change the scope of influence we have
on developing patients. As a result, care
provided in our orthodontic practice becomes
much more valuable in the total health of
the patients that we treat.

Pediatric obstructive sleep apnea
In 2016, the American Academy of
Pediatric Dentistry (A APD) released a
policy that recognizes obstructive sleep
apnea (Fig. 1) in the pediatric population.1
The policy encourages health care professionals to routinely screen for obstructive
sleep apnea (OSA) and, when indicated, to
refer to appropriate medical professionals,
such as sleep medicine physicians or ear,
nose and throat specialists.

Cycle of Obstructive Sleep Apnea
Sleep
Onset
Snoring

Sleep
Disrupted

Airway
Collapses

Breathing
Stops
Fig. 2

OSA is characterized by prolonged partial
upper airway obstruction or intermittent
complete obstruction that disrupts normal
sleep ventilation, resulting in loss in the
patterns of normal sleep.2 It's seen in up to
5 percent of children, commonly between
the ages of 2 and 7.3
Obstructive sleep apnea occurs when
muscles in the back of the throat relax,
causing the airway to narrow and increase
resistance during inspiration. This is believed
to lower the oxygen saturation in the blood,
which alerts the brain and causes the person
to awaken and subsequently inhale in an
effort to replace oxygen. This disrupted
cycle occurs multiple times throughout the
night, which prevents the individual from
obtaining deep, restorative sleep (Fig. 2).

by Dr. Manjari Kulkarni
Dr. Manjari Kulkarni
is a native of
Pittsburgh, where
she earned both
her Doctor of
Dental Medicine
and a master's
in orthodontics
at the University of Pittsburgh. After
completing her orthodontics training,
Kulkarni spent eight years in Manhattan
practicing orthodontics in the New York/
New Jersey area before returning home
with her husband and two daughters. She
has served on the University of Pittsburgh
Orthodontics faculty for six years, and
believes in sharing her skills with both her
students and patients with love. Kulkarni
practices alongside Dr. John Grady at GKG
Orthodontics, where there is a special
emphasis on comprehensive care along
with excellent customer service.

Disclosure:
The author declares that neither she nor any member of her family has a financial arrangement or affiliation with any corporate organization
offering financial support or grant monies for this continuing dental education program.

orthotown.com \\ OCTOBER 2017

http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown October 2017