Efficacy of Preformed Sleep and Habit Appliances to Modify Symptoms of Sleep-Disordered Breathing and Oral Habits in Children With Focus on Resolution of Mouth Breathing.

UNLABELLED: Pediatric sleep-related breathing disorders (SRBDs) have been studied by various fields both diagnostically and therapeutically because of the detrimental symptoms associated with this condition in attempts to better understand the etiology, pathophysiology of associated comorbidities, and best means by which to screen, diagnose, and treat these patients. Common symptoms of SRBD or clinical conditions that can be exacerbated by sleep and airway issues include neurocognitive and behavioral problems, chronic inflammatory conditions, and skeletal and dental developmental issues.

METHOD: This study of 220 children aged 2 to 13 years used a parental questionnaire to determine the initial severity as well as treatment changes over a mean 6.4 months of night-time passive wear of a removable preformed appliance.

OBJECTIVE: The study aimed to evaluate whether a preformed oral appliance could deliver clinical outcomes comparable to current therapeutics accepted in clinical practice for the treatment of pediatric SRBD (tonsil and adenoid tissue, myofunctional therapy, medication, other dental appliances); or in some instances, to discuss and compare the issues associated with each therapeutic pathway. Additionally, the research aimed to emphasize the need for a cross-disciplinary understanding and approach to the treatment of this pediatric condition to optimize clinical outcomes.

RESULTS: With passive night-time wear of the preformed appliance, 75% of total symptoms measured (N = 2054) experienced improvement, with a mean improvement of 76%. The most successful symptom corrected was headaches in the morning, where 85% of cases (n = 220) experienced complete correction (100%), while 98% of those having an improvement obtained a mean correction of 94%. The most frequently observed symptom was night-time mouth breathing, occurring in 69% of cases. Complete correction (100%) of night-time mouth breathing occurred in 43% of cases, while 83% of those cases with success had a mean improvement of 78%, when evaluating all symptoms measured (N = 2054).

CONCLUSIONS: All 27 symptoms had statistically significant improvement, while 75% of total symptoms measured (N=2054), experienced a mean improvement of 76%. Treatment changes were not dependent on differences in the patient's gender, length of treatment time, the initial severity, and the age of the patient during treatment. 0.3% of all observed symptoms (N=2054) showed an increase in severity, and 24% had no change during the mean treatment period.