SPEECH AND ORTHODONTIC ANALYSIS IN CHILDREN WITH SYMPTOMS OF OBSTRUCTIVE SLEEP APNEA - PILOT STUDY

Tsvetomira Boycheva; Ekaterina Todorova; Venelin Marinov; Greta Yordanova; Gergana Gurgurova

doi:10.35120/medisij040433b

Authors

Tsvetomira Boycheva New Bulgarian University, Department of Health Care and Social Work, Bulgaria Author
Ekaterina Todorova New Bulgarian University, Department of Health and Social Work, Center for Support for Students with Special Educational Needs, Bulgaria Author
Venelin Marinov University Hospital Sofiamed, Medical University of Sofia, Bulgaria Author
Greta Yordanova Medical University of Sofia, Faculty of Dental Medicine, Department of Orthodontics, Bulgaria Author
Gergana Gurgurova Medical University of Sofia, Faculty of Dental Medicine, Department of Orthodontics, Bulgaria Author

DOI:

https://doi.org/10.35120/medisij040433b

Keywords:

adenoid vegetation, orthodontic analysis, ENT, speech and language disorders, upper jaw compression, distal bite, open bite

Abstract

The topic of children's sleep health and the consequences that arise from its disorders is becoming an increasingly relevant and discussed topic. The interdisciplinary team is united around the idea that the manifestation of symptoms of obstructive sleep apnea is also associated with manifestations of orthodontic deformities, as well as communication disorders. The purpose of this study is to investigate the relationship between obstructive sleep apnea, speech disorders, and orthodontic deformities. Methodology: For this study, nine children were examined, their histories were taken, and diagnoses were provided by an ENT specialist, an orthodontist, and a speech-language therapist. Each parent completed the sleep questionnaire after an otorhinolaryngological examination. For the study of language and speech, the "Methodology for assessing the educational needs of children and students" was applied, as well as the Diagnosis and prevention of language 3–4. Orthodontic diagnostics was performed through a primary examination by an orthodontist. The patients were given a photo protocol with extra- and intraoral photographs; digital impressions were taken; X-ray examinations were prescribed (orthopantomography and teleradiography); and they underwent a detailed orthodontic analysis. Results: The PSQ results divided the children into a clinical group (five) and a borderline group (four). The ENT diagnosed adenoid vegetation in all children, grades III-IV, and four with hearing loss after audiometry and tympanometry. In three children from the clinical sample, disorders of receptive language were observed, and in one, an expressive language disorder was also present. Among the children with a borderline value according to the PSQ, one child with an expressive form of language disorder stood out. All children were diagnosed with an articulation disorder of the polymorphic type. The orthodontic examination in the clinical group identified two children with an Angle Class II occlusion, accompanied by a deep bite and cross-bite in the posterior segment, due to compression of the upper jaw, a direct consequence of mouth breathing. In the borderline group, two children are with Angel class II sagittal occlusion, with an open bite in the frontal segment and cross bite in the posterior segment. One of the children has an Angel class I and an open bite in the frontal segment. Conclusion: The study's data reveal connections between obstructive sleep apnea symptoms, speech and language disorders, and orthodontic changes. As a consequence of prolonged sleep disturbance caused by adenoid vegetation, which led to irregular breathing and tongue position at rest, occlusal irregularities in the three planes—sagittal, vertical, and transverse —and, last but not least, speech and language disorders.

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