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Raphael Center for Integrative Orthodontics Dr. Barry Raphael. Spreecast: Better Faces Less Braces.

Raphael Center for Integrative Orthodontics Dr. Barry Raphael. Spreecast: Better Faces Less Braces.

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  • 1. Better Faces - Less Braces A Spreecast Webinar by Dr. Barry Raphael Of the Raphael Center for Integrative Orthodontics November 13, 2013
  • 2. The link between crooked teeth, sleep and ADHD
  • 3. Spectrum of SDB Normal Prevalence: Snoring 8-10% UARS ? OSAS 1-3% 3
  • 4. Anatomic Determinants of SleepDisordered Breathing Across the Spectrum of Clinical and Nonclinical Male Subjects* Jerome A. Dempsey, PhD; James B. Skatrud, MD; Anthony J. Jacques, BS; Stanley J. Ewanowski, PhD; B. Tucker Woodson, MD; Pamela R. Hanson, DDS, MS; and Brian Goodman, PhD CHEST September 2002 vol. 122no. 3 840-851 •Apnea occurs due to craniofacial morphology and obesity, each with their contributions •The single most important cephalometric variable in predicting AHI severity was the horizontal dimension of the maxilla (ie, porion vertical to supradentale [PV-A] distance). •SDB increased five- to seven-fold in non-obese subjects and threefold in obese subjects
  • 5. Airway Size Matters
  • 6. Which is easier to breath through?
  • 7. Which would you rather have?
  • 8. Pharyngeal Airspace Mouth breather Nasal breather Mouthbreathers have significantly smaller airway space. (measurements PAS-OccL, PAS-UP, airway volume, area and minimum axial area)
  • 9. Nighttime symptoms of SDB in kids •Abnormal sleeping position •Bruxism •Chronic, heavy snoring •Delayed sleep onset •Difficulty breathing •Difficulty waking up in AM •Drooling •Enuresis •Frequent awakenings •Insomnia •Mouth breathing •Nocturnal migraine •Nocturnal sweating •Periodic Limb movement •Restless sleep •Sleep talking •Sleep terror •Sleep walking •Witnessed apnea
  • 10. Daytime symptoms of SDB in kids •Morning headache •Mouthbreathing •Morning thirst •Excessive fatigue •Abnormal shyness, withdrawn, and depressive presentation •Behavioral problems •ADHD pattern •Aggressiveness •Irritability •Poor concentration •Learning difficulties •Memory impairment •Poor academic performance
  • 11. Sleep Monitor SQI = 7.3 SQI = .41
  • 12. Airway Problems • Open Mouth habit • Mouth breathing • Snoring • Apnea/Hypopnea • Flexed Head • Gasping for Air • Stridor • Bruxism • Restless Sleep • Bed wetting • Tired and cranky
  • 13. In the News, March 2012