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Airway conference gives dentists tools that can make difference in children's lives

September 03, 2018

By David Burger

Photo of Drs. McDavid, Kraus and Hui at Airway Conference
Camaraderie: Three dentists from Texas converse during a break at the 2018 Children's Airway Health conference at ADA Headquarters Aug. 24-25. From left are Drs. Alan McDavid, Collin Kraus and Jason Hui.
For Dr. Niki Latiolais, a general dentist from Mount Pleasant, Texas, the issue of children's sleep-disordered breathing hits close to home.

Her daughter would wake up more than 10 times a night as a toddler. In addition, she suffered from night terrors, regularly wet her bed and was having difficulty in school.

But once Dr. Latiolais' daughter had her tonsils removed and was fitted with an oral appliance designed to keep the mouth closed and her airway open, the difference was like night and day. The girl now sleeps deeply without disturbances and even though she is only in the second grade, reads at a fifth-grade level.

Dr. Latiolais said she has a passion for helping her own patients struggling with sleep apnea and other obstructed airway issues, which explains why she was one of more than 260 people attending the sold-out 2018 Children's Airway Health — A Practical Conference at ADA Headquarters in Chicago Aug. 24-25.

"It is a long-overdue meeting," said Dr. Steve Carstensen, a diplomate of the American Board of Dental Sleep Medicine and emcee of the conference. "All of the speakers have told me that we should have done this a long time ago."

With dentists making up 80 percent of the audience, the conference brought together experts in sleep-disordered breathing from both the medical and dental communities, signaling how a team of doctors are needed to successfully diagnose and treat the disorder.

Photo of Drs. Ombrello and Latiolais at Airway Conference
Engaged: Drs. Jill Ombrello and Niki Latiolais smile when watching David Gozal, M.D., give his keynote speech on approaches to diagnosing pediatric obstructive sleep apnea.
"This is an evolving field," said attendee Dr. Alan McDavid, a general dentist who has an office in McKinney, Texas. He also has a second office called Texas Sleep Solutions, a clinic that specializes in treating patients with sleep-disordered breathing. He said he attended the conference with his colleague Dr. Jason Hui to "see if I can pick up a few more pearls." He said he appreciated the opportunity to hear the perspective from those in the medical field.

The symposium focused on compromised airway health in pediatric patients — and the role dentists can play in risk assessment, referral for diagnosis and treatment.

Ron Mitchell, M.D., professor of otolaryngology and pediatrics and chief of pediatric otolaryngology at the University of Texas Southwestern and Children's Medical Center in Dallas, spoke about achieving the best outcomes for pediatric patients with obstructive sleep apnea. He stressed that if diagnosed and treated early in life, patients could grow up to be adults without sleep disorders.

Dr. Mitchell recommends that every dentist who sees children should ask the parents about their children's sleep patterns. In addition, if a patient is at risk and/or corrected early, the sleep patterns should be evaluated over a person's life to ensure "a lifetime of awareness and healthy living."

Continual learning and asking questions at dental visits about sleep habits are crucial, echoed Dr. Carstensen.

Requiring parents to fill out medical history forms as a way to screen for disorders is a big part of how speaker Dr. Jill Ombrello treats her patients, she said in a talk called "Pediatric Sleep-Disordered Breathing: A Silent Epidemic."

Dr. Ombrello said the questionnaires are necessary to diagnose disorders as early as possible, because they almost always get worse, quoting Taylor Swift's song "Bad Blood": "Band-Aids don't fix bullet holes."

Treating sleep-disordered breathing in children, Dr. Ombrello said, "unlocks their potential and lets them be the best versions of themselves."

Conference organizers are planning to continue the conversation and dive deeper into this topic at ADA Headquarters March 3-4, 2019. Those interested should keep their eyes open for registration information.

Photo of the large crowd at Airway Conference
Packed: A standing-room-only crowd of more than 260 people attended the conference.
In 2017, the House of Delegates approved an ADA policy statement addressing dentistry's role in sleep-related breathing disorders, developed as a result of a 2015 resolution. The adopted policy emphasizes that "dentists are the only health care provider with the knowledge and expertise to provide oral appliance therapy."

The adopted policy statement outlines the role of dentists in treatment of the disorder.

Key components include assessing a patient's risk for the disorder as part of a comprehensive medical and dental history and referring affected patients to appropriate physicians. In children, the dentist's recognition of suboptimal early craniofacial growth and development or other risk factors may lead to medical referral or orthodontic/orthopedic intervention to treat and/or prevent the disorders. The policy also covers evaluating the appropriateness of oral appliance therapy as prescribed by a physician; recognizing and managing appliance side effects; continually updating dental sleep medicine knowledge and training; and communicating patients' treatment progress with the referring physician and other healthcare providers.

The entire policy can be found online at ADA.org.