title: Craniofacial changes and symptoms of sleep-disordered breathing in healthy children.
abstract: BACKGROUND
  The main cause of mouth breathing and sleep-disordered breathing (SDB) in childhood is associated with upper airway narrowing to varying degrees.
  
  
  OBJECTIVE
  The aim of this study was to assess the prevalence of morphological and functional craniofacial changes and the main clinical symptoms of SDB in healthy children.
  
  
  METHODS
  A cross-sectional observational study was conducted. A sample comprising 687 healthy schoolchildren, aged 7-12 years old and attending public schools, was assessed by medical history, clinical medical and dental examination, and respiratory tests. The self-perceived quality of life of mouth breathing children was obtained by a validated questionnaire.
  
  
  RESULTS
  Out of the total sample, 520 children were nose breathers (NB) while 167 (24.3%) were mouth breathers (MB); 32.5% had severe hypertrophy of the palatine tonsils, 18% had a Mallampati score of III or IV, 26.1% had excessive overjet and 17.7% had anterior open bite malocclusion. Among the MB, 53.9% had atresic palate, 35.9% had lip incompetence, 33.5% reported sleepiness during the day, 32.2% often sneezed, 32.2% had a stuffy nose, 19.6% snored, and 9.4% reported having the feeling to stop breathing while asleep. However, the self-perception of their quality of life was considered good.
  
  
  CONCLUSIONS
  High prevalence of facial changes as well as signs and symptoms of mouth breathing were found among health children, requiring early diagnosis and treatment to reduce the risk of SDB.
authors.affiliation: Dental Clinic department, Universidade Federal do Espírito Santo, Vitória, Brazil.
authors.forename: Maria Christina Thomé
authors.initials: MC
authors.lastname: Pacheco
authors.affiliation: Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
authors.forename: Bruna Santos
authors.initials: BS
authors.lastname: Fiorott
authors.affiliation: Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
authors.forename: Nathalia Silveira
authors.initials: NS
authors.lastname: Finck
authors.affiliation: Physiological Sciences department, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
authors.forename: Maria Teresa Martins de
authors.initials: MT
authors.lastname: Araújo
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D006801:Humans; D006984:Hypertrophy; D008046:Lip / Q000473:pathology; D008310:Malocclusion / Q000453:epidemiology; D008487:Medical History Taking; D009058:Mouth Breathing / Q000453:epidemiology* / Q000523:psychology; D009668:Nose Diseases / Q000453:epidemiology; D024343:Open Bite / Q000453:epidemiology; D057887:Overbite / Q000453:epidemiology; D010159:Palate / Q000002:abnormalities; D014066:Palatine Tonsil / Q000473:pathology; D010808:Physical Examination; D015995:Prevalence; D011788:Quality of Life; D012129:Respiratory Function Tests; D012891:Sleep Apnea Syndromes / Q000453:epidemiology*; D012894:Sleep Stages / Q000502:physiology; D012912:Sneezing / Q000502:physiology; D012913:Snoring / Q000453:epidemiology