Orthotown October 2017 - 43

continuing education

Fig. 4

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Fig. 5

Awakening with a dry mouth or sore
throat.
Difficulty staying asleep.
Attention problems.
Mouth breathing.
Restlessness.
Bed-wetting.
Poor school performance.
Aggression.
Developmental delay.

Questionnaire for OSA
during screening
During our routine screenings, a series
of questions for the parent or care provider
can be helpful in our diagnosis.
1. Does your child snore at night? On a
scale of 1-10, how loud is it?
2. Does your child have any habits, like
thumb- or finger-sucking, to help
comfort him to sleep?
3. Does your child wet the bed
frequently?
4. Is it hard to wake your child in the
morning?
5. Does your child breathe through her
mouth during the day?
6. Does your child fall asleep in school?
7. Does your child have difficulty
paying attention or focusing?
8. Has your child been diagnosed with
ADHD?
9. Has your child had a sleep study?

10. This lack of restorative sleep and
resultant behavioral changes has
sometimes been misdiagnosed as
attention deficit hyperactive disorder
(ADHD).8 When we see this as a
possibility in our patients, we probe
further.

OSA and rapid palatal expansion
In an article from 2008 by Carla Evans,
et al., there was a direct correlation found
between rapid palatal expansion, nasal
cavity size and a subjective decrease in
airway resistance.9 This article and others
found a 100 percent increase in nasal cavity
volume, with decreased airway resistance
and subjective improvement in 60 percent
of people studied (Figs. 4 and 5).
In our practice, we subscribe to the idea
that the ENT clears the contents and the
orthodontist enlarges the container. Our
clinical fi ndings are that rapid maxillary
expansion plays a key role in improving the
lives of our patients, both from an orthodontic perspective-reducing crowding,
aiding eruption of teeth, and increasing
arch width, resulting in fuller smiles-as
well as decreasing airway resistance.

Case study
This patient came to us with a history
of snoring, ADHD diagnosed, general
sleepiness and an AHI score of 7.2. Her
orthotown.com \\ OCTOBER 2017

43



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Table of Contents for the Digital Edition of Orthotown October 2017

Orthotown October 2017 - Intro
Orthotown October 2017 - Cover1
Orthotown October 2017 - Cover2
Orthotown October 2017 - 1
Orthotown October 2017 - 2
Orthotown October 2017 - 3
Orthotown October 2017 - 4
Orthotown October 2017 - 5
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