440 - Management Strategies for Pediatric Obstructive Sleep Apnea

Abstract:

Purpose: Early detection and management of pediatric obstructive sleep apnea (OSA) is critical given its impact on growth and development. Pediatric dentists can identify signs of OSA; however, little is known about management practices.

Methods: A survey on training, referral patterns, and management strategies was distributed to U.S. pediatric dentists. Confidence level in management (0-10 scale, with 10=highest confidence) and screening frequency were analyzed with ANOVA with Bonferroni post-hoc comparisons.

Results: Among 459 respondents (70% private practice, 4% academia, and 26% both settings), pediatric dentists reported overall low confidence in managing pediatric OSA (3.7±2.7). Confidence varied with screening frequency: those screening >75% of patients reported higher confidence (4.9±3.0) than those screening 25-75% (3.7±2.2, P < .001) or < 25% (2.4±2.0, P < .001). Approximately 95% refer at-risk patients, commonly to otolaryngologists (66%), primary care physicians (36%), orthodontists (29%), and sleep specialists or pediatricians (24%). Direct management was uncommon (14%), and more likely among pediatric dentists with longer experience (P < .001). Management practices varied by age: 2-5 years were primarily treated with frenectomy (22%) and myofunctional therapy (17%); 6-11 with rapid maxillary expander (RPE, 32%), frenectomy (18%), and myofunctional therapy (17%); 12-15 with frenectomy (13%), RPE (12%), myofunctional therapy (14%). Major barriers reported across private and academic settings included limited training (56%), lack of referral systems (53%), and poor patient or family collaboration (41% and 34%).

Conclusion: Pediatric dentists report low confidence in managing pediatric OSA. Education and referral pathways may enhance early intervention and collaboration in care.

Identify Supporting Agency and Grant Number: None