Prevention and Intervention Flashcards
How does nasal obstruction affect development of the maxilla?
Obstructed nasal airway will increase facial height, palatal arch, and decrease length and width of the maxilla (Harvold study).
How does mouth breathing – result of reduced nasal breathing (due to adenotonsillar hypertrophy, frequent respiratory infections, allergies, deviate septum, constricted maxillary arch) affect facial growth in children?
Extended posture of the head, retrognathic mandible, increased facial height, steeper mandibular plane, lower position of the hyoid bone, anteroinferior posture of the tongue.
How early should the airway be addressed to allow for proper development of the facial structures?
Before the sutures fuse (certainly prior to age 12 or 13).
How does adenoidectomy affect growth of the facial skeletal structures?
Growth is normalized after adenoidectomy if done early enough in life.
What facial characteristics are associated with OSA?
Retruded maxilla and mandible
Increased mandibular plane angle and facial height
Inferiorly positioned hyoid bone (>15mm from mandible)
Reduced length of mandible
Narrowed posterior airway space and lengthened soft palate
Increased tongue size
Increased craniocervical angulation
What does breastfeeding have to do with airway development?
Breast feeding stimulates proper development of nasal breathing and physiologic swallowing
The lips squeeze the areola where the lactiferous sinuses are located and the tongue presses the nipple against the palate as the mandible moves back and forth to milk the breast
Mandible movement stimulates mandibular sagittal growth
Why does palatal expansion increase the volume of the nasal airway?
Because as the palate expands, the palatal vault drops.
How does myofunctional therapy help treat OSA?
Oropharyngeal exercises have been shown to improve mild and moderate OSA
How does sleep bruxism change with age?
Bruxism decreases with age.
Is bruxism influenced by gender?
No.
Which medications/drugs worsen bruxism?
Those which increase stage 2 sleep, as bruxism occurs in stage 2 sleep (SSRIs, alcohol, caffeine, etc.).
What factors that are commonly claimed to affect bruxism do NOT actually affect bruxism?
Angle class II, premature contacts, malocclusion
In which stages of sleep does bruxism occur?
Stage 1 and 2.
85% of bruxism occurs within naturally occurring arousals.
How does nasal obstruction in children affect the odds that they will develop bruxism?
Children with nasal obstruction have a 65% chance of developing bruxism.
Which commonly prescribed treatments for bruxism are ineffective?
Occlusal adjustment, medications (muscle relaxants can help with symptoms but won’t prevent the bruxing), behavioral management (including, lifestyle changes, Botox will help symptoms but not stop bruxism, biofeedback, psychological therapy)
