A traumatic brain injury makes most of us think of a pro football player or boxer having his “bell rung.” We can all picture the physical trauma of soft brain tissue impacting hard bone and understand what trauma means. But in reality, brains can sustain injuries just as damaging in the long run without any physical impact at all.
Ron Harper, PhD neurobiologist, has done extensive research at UCLA using MRIs on young children with OSA. His articles describe the various areas of the brain affected as well as the outcomes that can occur with only one night of reduced oxygen saturation. When he talks about the long-term irreversible damage, he gets my attention — and should get yours. Don’t take my word for it. You can Google him and read his work for yourself and decide if your child or patient might have a problem.
David Gozal, MD is past president of the American Thoracic Society and well known in the world of sleep medicine. Years ago he lectured about a 10-point IQ drop for kids with OSA. I’ve heard elsewhere it might be 15. Gozal says that drop can be the difference between a college education and no college education. The point is that one does not have to be physically struck in the head to sustain a traumatic injury.
The interesting thing is that this information is not new. Charles Dickens in the mid-1800s described how sleep and breathing issues caused delinquency and criminal behavior in people. If he had had MRI available at the time, he might have been able to document the actual neurological changes like Dr. Harper has.
More recently, Dr. Phil Cooper, a dentist and friend of mine from Savannah, GA, wrote a book entitled Why African-American Children Cannot Read. He outlines how some kids from this disadvantaged group often have OSA-produced brain damage that keeps them from being able to learn to read. The same thing can happen to kids of any racial group.
Would you like to be part of a group that is trying to prevent these traumatic brain injuries? That is exactly what airway-centered orthodontics is about. The connection between craniofacial development, airway size, and sleep-disordered breathing is well established in the literature — and it points directly to the orthodontic chair as one of the most important places where intervention can happen early.
The question is not whether sleep apnea causes harm. The research is clear. The question is whether the dental profession is ready to act on what it already knows.
