Obstructive Sleep Apnea Syndrome
Introduction :
The field of dentistry in general and orthodontics in particular is expanding more and more and is no longer limited to treatments of teeth and the oral cavity, but our action includes an increasingly MEDICAL component .
This syndrome, which is not very well known in the profession and whose prevalence , according to specialists, is greatly underestimated, can constitute a serious handicap in adulthood.
1-Definition:
OSAS is defined by the repetitive occurrence, during sleep, of complete or partial obstruction of the upper airways causing apnea or hypopnea .
2- Signs of SAOS:
1- Daytime signs:
- drowsiness
- Morning headaches
- Memory disorder
- Difficulty concentrating
- Behavioral disorders
- Traffic accidents
2-Night signs:
- Snoring
- Apnea
- Restless sleep
- Heavy sweating
- Startled awakenings with a feeling of suffocation
- Nocturia
- Bedwetting
- sleepwalking
3- consequences of SAOS:
- Breathing problems
- Significant sleep fragmentation
- Growth hormone secretion deficiency
- Cardiovascular disorders
4- The role of the Dentist: screening
1- examination of soft tissues:
– of a voluminous language,
– a large soft palate and uvula,
– large tonsils.
2-on examination of hard tissues:
– retromandibular disease,
-a retromaxilla,
-upper maxillary endognathism;
3-at the dental examination:
– extractions of premolars with
Orthodontic treatment;
5- Role of the orthodontist:
- preventive:
A-By increasing the upper airways:
- Stimulation of mandibular advancement:
Besides the aesthetic roundness and profile improvement, one of the most important benefits we can obtain from the mandibular advancement by activator generally associated with an FEO is the increase in the volume of the VAS.
2-Stimulation of maxillary advancement:
Stimulation of maxillary growth and anterior development with the Delaire orthopedic face mask can increase the volume of the VAS at the nasopharynx.
3-Maxillary disjunction: restores space in the nasal cavities. Therefore, satisfactory nasal ventilation and better sleep which
Prevents the development of OSA in children in adulthood.
Obstructive Sleep Apnea Syndrome
B- By avoiding narrowing the upper airways:
Inhibition of maxillary growth :
– Inhibition of maxillary growth (class II)
Contributes to the reduction of the nasopharynx and therefore to
the appearance of SAOS in children who snore or present symptoms
apnea
Tongue space and extractions : Tooth extraction
Decrease in the perimeter of the dental arch
Decrease in tongue box
Projection towards the back of the tongue
Reduction of VAS volume
Conclusion
- The orthodontist, by optimizing the growth of the jaw and nasal cavity from early childhood through appropriate orthopedic treatment, can reduce the severity of OSA in adulthood or even prevent its occurrence.
- We want to encourage dentists in general and orthodontists in particular to be more vigilant about this syndrome, and above all not to ignore its signs.