Dental Sleep Medicine

As health care providers, our priority is keeping you and your family healthy.

During each new patient and oral hygiene exam, Dr. Viernes will conduct an airway/sleep screening. First, parents/patients will have a short sleep questionnaire to fill out in addition to the medical history forms which will be used as part of the dental exam. During the oral dental exam, the dentist performs an airway exam and checks the tonsils and tongue size as it relates to the pharyngeal size. A Brodsky and Mallampati score are recorded which can indicate the need for further assessment due to the severity.

The answers on the sleep questionnaire and clinical findings may prompt a referral to the ENT- ear, nose & throat or PCP-primary care physician. If a referral is needed to the ENT doctor, we will fill out a referral form and fax it to the doctor to get an appointment set up for the patient.

Detail Dental Kids works closely with Dr. Scott Phillips, a pediatric ENT doctor who specializes in Ear infections, Tonsils & Adenoid problems, sinus infections, tongue ties, reflux in children, hoarseness and nose bleeds. Together we ensure the patients we refer to him with signs of sleep related symptoms receive proper care and treatment. Use the link at right to learn more about Dr. Scott Phillips.
The link at right will open a new tab taking you to the CENTA website for Scott Phillips, MD, FACS, FAAD.

What is Pediatric Sleep Apnea?

Pediatric obstructive sleep apnea is a sleep disorder where a child’s breathing is partially or completely blocked repeatedly during sleep due to narrowing or blockage of the upper airway. Due to the significant correlation between healthy sleep and healthy oral growth our dentist may recommend the use of oral appliance therapy.

What are the Pediatric Sleep Apnea signs?

The underlying cause for pediatric obstructive sleep apneamost children is enlargement of the adenoids and tonsils. Early diagnosis and treatment are important to prevent complications that can affect children’s growth, cognitive development and behavior.

Children with sleep apnea are more likely to have behavioral problems, perform badly in school, have difficulty paying attention, be hyperactive and even have poor weigh gain. During sleep, the signs your child may have pediatric sleep apnea include:


  • Snoring—or noisy breathing during sleep.
  • Periods of not breathing— although the chest wall is moving, no air or oxygen is moving through the nose or mouth into the lungs. The duration of these periods is variable and measured in seconds.
  • Mouth breathing—in some cases the nasal passage may be completely blocked by enlarged tonsils and adenoids this can lead to the child only being able to breathe through the mouth.
  • Restlessness during sleep— stop and go breathing can lead to frequent arousals or “tossing and turning” throughout the night.
  • Sleeping in odd positions— some children hyperextend or arch their neck backward in order to open the airway.
  • Behavior problems or sleepiness— this can include irritability, crankiness, frustration, hyperactivity, and difficulty paying attention.
  • School problems— children may do poorly in school, even being labeled as “slow” or “lazy.”
  • Bed wetting— also known as nocturnal enuresis, although there are many causes for bed wetting besides sleep apnea.
  • Frequent infections— may include a history of chronic problems with tonsils, adenoids, and/or ear infections.