歯科からの睡眠医療への貢献 : これまでの研究とこれから

Obstructive sleep apnea (OSA) is a respiratory disorder caused by an obstruction of the upper airway during sleep. Pediatric OSA often leads to mouth breathing and malocclusion, such as a narrowing of the maxillary dentition and mandibular retrusion. Moreover, OSA is suspected upon confirming snoring habits by an interview. Therefore, a pedodontist conducting oral management in children can screen pediatric OSA. Conventionally, pediatric OSA treatment involved adenotonsillectomy. However, the efficacy of rapid maxillary expansion, inducing mandible growth forward and oral myofunctional therapy have been suggested in recent years. Furthermore, adult OSA is possibly caused by a narrowing of the pharyngeal airway because of mandibular retrusion and maxillary lateral inferior growth by nasal obstruction, except when caused by obesity. Thus, a pedodontist can prevent adult OSA by preventing maxillary narrowing and mandibular retrusion and promoting the appropriate development of the maxillo-mandibule.
　Based on the findings of our review, we proposed three new roles of a pedodontist, namely contribution to sleep medicine, screening and treatment of pediatric OSA, and prevention of adult OSA.