Comparison of Orofacial Characteristics in Children With and Without Long Term Histories of Snoring- A Pilot Study

Background: Sleep Disordered Breathing (SDB) is a continuum of breathing problems during sleep that may affect both children and adults. It includes a range of nocturnal breathing abnormalities ranging from primary snoring, upper airway resistance syndrome, to Obstructive Sleep Apnoea (OSA) which in its severe form can cause severe cardiac problems if untreated. Habitual snoring occurs in 10 % of preschool children and studies report 11.3% of children with habitual snoring in New Zealand (NZ). SDB may affect the orofacial and craniofacial features in children. There have been no previous studies carried out in New Zealand investigating orofacial or craniofacial features in children diagnosed with SDB. Although there are several studies assessing the craniofacial features and measurement using lateral cephalograms, there are not many studies that show orofacial/craniofacial assessment using panoramic radiographs. Objectives: To compare the orofacial characteristics of children with and without long term histories of snoring. Methods: Participants aged eight to ten years who were part of the long-term study: “Breathing and Educational Achievement and Readiness (BEAR) Study” were invited to take part in the current study. The snoring history was recorded based on parental report. Characteristics recorded included: intra-oral soft tissue health, dental health and occlusion development utilising clinical examination, panoramic radiography, study models and facial photographs. Results: There were 17 participants (12 males, 5 females) in the snoring group and 21 participants (9 males, 12 females) in the non-snoring group. Snoring participants showed significantly higher waking up frequency (p=0.039) compared with the non-snoring participants. The panoramic analysis revealed statistically significant differences for maxillary width (p=0.045), with snoring participants having a higher mean maxillary width compared with non-snoring participants. More snoring participants presented with hypomineralisation of some permanent teeth (p=0.064). Subjective analysis of dark circles beneath the eyes as seen on photographs, showed a higher percentage of dark circles in snoring participants (64.7%) compared with non-snoring participants (52.4%). Conclusion: No significant relationships were found between snoring children and the skeletal and soft tissue parameters evaluated in the participants in this study. Some trends observed in the snoring group included increased frequency of night waking, increased maxillary width on panoramic radiographs, increased occurrence of hypomineralisation of permanent teeth, and increased numbers with observable dark circles under the eyes. These are parameters that can be included in future investigations to assess further; the role prolonged sleep disordered breathing might play in orofacial development. This improved knowledge will help dental professionals to identify problems when there is a history of sleep disordered breathing