Craniofacial changes and symptoms of sleep-disordered breathing in healthy children

Dental Press J Orthod. 2015 May-Jun;20(3):80-7. doi: 10.1590/2176-9451.20.3.080-087.oar.

Abstract

Introduction: The main cause of mouth breathing and sleep-disordered breathing (SDB) in childhood is associated with upper airway narrowing to varying degrees.

Objective: The aim of this study was to assess the prevalence of morphological and functional craniofacial changes and the main clinical symptoms of SDB in healthy children.

Methods: A cross-sectional observational study was conducted. A sample comprising 687 healthy schoolchildren, aged 7-12 years old and attending public schools, was assessed by medical history, clinical medical and dental examination, and respiratory tests. The self-perceived quality of life of mouth breathing children was obtained by a validated questionnaire.

Results: Out of the total sample, 520 children were nose breathers (NB) while 167 (24.3%) were mouth breathers (MB); 32.5% had severe hypertrophy of the palatine tonsils, 18% had a Mallampati score of III or IV, 26.1% had excessive overjet and 17.7% had anterior open bite malocclusion. Among the MB, 53.9% had atresic palate, 35.9% had lip incompetence, 33.5% reported sleepiness during the day, 32.2% often sneezed, 32.2% had a stuffy nose, 19.6% snored, and 9.4% reported having the feeling to stop breathing while asleep. However, the self-perception of their quality of life was considered good.

Conclusion: High prevalence of facial changes as well as signs and symptoms of mouth breathing were found among health children, requiring early diagnosis and treatment to reduce the risk of SDB.

INTRODUÇÃO:: a principal causa da respiração bucal e dos distúrbios respiratórios do sono (DRS) está associada ao estreitamento das vias aéreas superiores, em diferentes graus.

OBJETIVO:: avaliar a prevalência de alterações morfológicas e funcionais da face e os principais sintomas clínicos de DRS em crianças saudáveis.

MÉTODOS:: estudo transversal, observacional, com amostra de 687 escolares saudáveis, provenientes de escolas públicas, com idades entre 7 e 12 anos. Foram avaliados pela história clínica, exame clínico médico e odontológico e testes respiratórios. A autopercepção da qualidade de vida dos escolares com respiração bucal foi obtida por meio de um questionário validado.

RESULTADOS:: na amostra total, 520 crianças eram respiradoras nasais (RN) e 167 (24,3%) eram respiradoras bucais (RB); 32,5% tinham hipertrofia das amígdalas palatinas, 18% tinham índice Mallampati obstrutivo (III e IV); 26,1% tinham overjet exagerado e 17,7%, mordida aberta anterior. Entre os RB, 53,9% tinham palato atrésico; 35,9% com ausência de selamento labial; 33,5% relataram sonolência diurna; 32,2%, espirros frequentes; 32,2%, nariz entupido; 19,6% roncavam e 9,4% relataram ter a sensação de parar de respirar durante o sono. Entretanto, a autopercepção da qualidade de vida desses escolares foi considerada boa.

CONCLUSÃO:: foi encontrada alta prevalência de alterações faciais, de sinais e de sintomas clínicos de respiração bucal nos escolares saudáveis examinados, necessitando diagnóstico e tratamento para reduzir o risco de DRS.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil / epidemiology
  • Child
  • Cross-Sectional Studies
  • Humans
  • Hypertrophy
  • Lip / pathology
  • Malocclusion / epidemiology
  • Medical History Taking
  • Mouth Breathing / epidemiology*
  • Mouth Breathing / psychology
  • Nose Diseases / epidemiology
  • Open Bite / epidemiology
  • Overbite / epidemiology
  • Palate / abnormalities
  • Palatine Tonsil / pathology
  • Physical Examination
  • Prevalence
  • Quality of Life
  • Respiratory Function Tests
  • Sleep Apnea Syndromes / epidemiology*
  • Sleep Stages / physiology
  • Sneezing / physiology
  • Snoring / epidemiology