Dental Sleep Medicine Insider March 2015 | Page 15

Staci: Dr. Rouse, you lecture
extensively on the topic of
Sleep Disordered Breathing
(SDB) in children, a topic with
increasing
awareness
amongst the dental
community & the public in
general. Why is this so
w do you screen these patients?

re is a growing body of literature on
mostly focused on the low
ese, older child with a series of
. Screening for SDB rather than
more challenging, given that we
tative rather than reactive.
have used more sophisticated
s during PSGs and found
ps. For example, the links
DHD and airway disturbances in
ng apparent. The problem for
e monitors are not widely
use other clues based on signs
of the signs in children are
ntist should be very comfortable

will revolve around three areas:
ime sleepiness, and attention.
questions concentrating on
bitual is 3x a week or more.
ir mouths, snoring and witnessng are points of discussion. Next,
to be sleepy during the day or
morning? Teachers are usually a
questions. Finally, does the child
ng on tasks, easily distracted, or

includes a craniofacial and
come to believe that children
dental crowding or
Whether the airway caused the
ersa is not important. They have
y. Bruxism, GI erosion,
nd decay, especially on maxillary
be signs of a collapsible airway.
udes a nasal and oropharyngeal
ther elements:
ling (CPC) screening and
mage. Home sleep monitoring in
e CPC is a single line EKG that
nd heart rate variability signals
It monitors the amount of time
pathetic (healing sleep) and
light). It is approved for children
Children should have a 4:1 ratio
sympathetic sleep to gain the
mages are taken because the

adenoids are the point of airway obstruction in
almost 90% of children. You cannot readily visualize
the adenoids in a dental exam.

#2

Staci: I saw one of your
lectures on this issue & the
bruxism/OSA connection is
a hot topic with people
supporting/opposing this
conclusion. Where do you
weigh in?

Dr. Rouse:

I believe that bruxism has an airway
connection in children and adults. The problem as I
see it is that the main group suggesting only a minor
correlation never analyses respiratory effort related
arousals. They only look for connections with apnea/
hypopnea. To break free of an apnea event, you have
to breathe, not brux. After the event, you need to
create a stable, toned airway so that the next breath
is normal.
Bruxism can assist in creating that tone. However, I
think that the most important thing bruxism achieves
is protection. As the airway begins to close, children
react and move their jaw to prevent continued
closure. The conclusion of a study from Tufts on 50
bruxing children mirrors my belief...childhood
bruxism can be used as a marker for SDB

#3

Staci: These are fairly new &
somewhat controversial
topics. How do you broach
these subjects in your l
ectures?

Dr. Rouse:

I am a prosthodontist so my dental
world was built around occlusion and bruxism. I
began a research project in the office in 2007
centered on sleep bruxism and have t