Sleep Well, Grow Healthy

Depending on your child’s age, sleep problems can range from nightmares and sleepwalking to bedwetting and sleep apnoea. Here, Dr Arif Khan, Paediatric Neurologist and Founder of Neuropedia, a company that specialises in a wide range of childhood neurological conditions, talks about the various sleep difficulties that children experience and how best to solve them.

Dr Arif Khan, Paediatric Neurologist, Founder of

Nuropedia, a company that specializes in childhood neurological conditions such as epilepsy and seizure disorders, headaches and migraines, sleep disorders, neuromuscular conditions, movement disorders, neonatal neurology, cerebrovascular stroke, cerebral palsy, neurometabolic conditions, neurogenetic conditions, neurobehavioural conditions, autism and ADHD. Sleep problems in children are common and the most frequent one is insomnia. Insomnia can either present with the child refusing to go to bed or his/her inability to fall asleep. In most cases, these are behavioural insomnia driven by long-term poor sleep hygiene and sleep schedule.

Most often these problems are under-recognised. To get a shortcut solution, parents seek help from physicians and invariably their kids get put on medications. However, while medications treat the symptoms, they do not treat the underlying cause. Medications can lead to developing a problematic cycle of dependence and complications.

Sleep is a learned behaviour and many factors contribute to poor sleep behaviour in a child. These factors have to be isolated and tackled. The first step in most of these cases is behavioral modifications, which will require patience and perseverance from both parents and physicians. I use medications only when conservative measures have failed or just to get a quick start to a new sleep pattern. Usually working towards moving bedtime forward 15 minutes every week helps in most cases and at times adjuncts such as melatonin may be required. There are other sleep pathologies like parasomnias, sleepwalking, sleep talking, and night terrors. These usually do not require any interventions but some caution has to be taken in making sure that the child is safe.

Try and keep screens away from your child at least two hours before bedtime

There are sleep-related breathing problems such as sleep apnoea too, which need to be identified early and treated, otherwise it will affect the child’s daytime performance, behaviour, and general health as their sleep quality will be affected. The most important aspect of sleep hygiene is to make sure that your child’s sleep schedule is consistent and adequate.

Try and keep screens away from your child at least two hours before bedtime. Do not encourage ‘reward systems’ whereby the child is allowed to walk to their parents’ bed and co-sleep, or taken out in a car for a ride to fall asleep.

This will help develop an association to sleep which will be difficult to undo.

However, sometimes a pediatrician or a pediatric neurologist will have to be consulted, especially if your child keeps waking up at night, has abnormal physical movements in sleep, or wakes up in the morning looking tired and drowsy. You should also seek help if your child has excessive daytime sleepiness or snores at night. Sleep is the key to our wellbeing. Nonetheless, we tend to ignore its importance and consider it to be a waste of time. Don’t!

While medications treat the symptom, they do not treat the underlying cause

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TAKING THE WORRY OUT OF WEARING BRACES

For a youngster, getting braces on their teeth can seem like the end of the world. Many children worry about how braces are going to affect their appearance and what their friends may say. They’re also often concerned about the pain associated with having their braces when they are tightened or fitted. To allay some of these fears, Education UAE spoke to Dr Rodrigue Abi Nakhle, a paediatric dentist at Vilafortuny in Dubai.

Dr Rodrigue Abi Nakhle,

Paediatric Dentist at Vilafortuny, pursued his DDS And MSc in Paediatric Dentistry at Saint Joseph University in Lebanon. He is a member of the Lebanese Society of Paediatric Dentistry and IAPD, International Association of Paediatric Dentistry.

EdUAE: Can you provide some tips for parents that can help their children prepare for and become used to wearing braces on their teeth?

Dr Rodrigue: When it comes to wearing braces, lots of kids might get a little bit nervous because it’s a new thing. Communication is key when it comes to making sure that children feel calm and prepared.

Some of my top tips include:

 Listen to the child’s concerns and explain the importance of wearing braces. Try to simplify the problem, discuss the process, and highlight the benefits in terms of better function for the teeth.  Make sure all the dental work (cavities, restorations, cleaning) is done before the braces go on as this will make the process much smoother.  Get orthodontic wax ahead of time as it will help soothe the discomfort from possible irritation.  Make sure a soft diet is followed after braces go on.  Always remind the child of the end goal with positive reinforcement.

EdUAE: What are the benefits of braces?

Dr Rodrigue: There are many benefits to braces, but the most common benefits are the enhancement of the smile as well as the facial appearance. Braces can also help correct the bite by repositioning the teeth, which helps ensure the ability to chew foods is not affected, and it can also help with speech clarity and pronunciation.

EdUAE: What types of braces are there?

Dr Rodrigue: There are several types of braces that parents can choose from for their kids.

Metal Braces: Also known as traditional braces, these are usually made from metal and wires attached to the front side of the teeth. As these are the most common type of braces in use, they are the least expensive and very effective. However, metal braces are very noticeable and irritating to surrounding soft tissues.

Ceramic Braces: Ceramic braces are like metallic braces in size, shape, and effectiveness, but the material it’s made from is different. These are less noticeable and more comfortable to wear. Self-ligating braces: Self-ligating braces are very similar to traditional metallic braces but are assembled with clips instead of elastic bands to hold the wire in place. These allow better control over the alignment movement.

Lingual Braces: These braces are also made from metal and wires, but they are attached from the inside of the teeth. The main advantage point is that they are not visible to people. However, they are less effective than the traditional ones and may require more time to achieve proper alignment.

Clear Aligners: These are a series of orthodontic clear plastic models/appliances that are worn over the teeth for a period of time. As they are invisible, they are more aesthetic and less irritating than conventional braces, but they are more expensive.

EdUAE: Are there lifestyle changes to be made for children before getting braces?

Dr Rodrigue: No major changes would be done to the diet, but they’d be required to follow a soft diet. Hard or crunchy food (popcorn, caramel candies,

Listen to the child’s concerns and explain the importance of wearing braces Aftercare at home is very important for maintaining braces and getting the desired result

etc…) can damage the braces, which may lead to a longer time to achieve the proper alignment.

EdUAE: How long will braces treatment take?

Dr Rodrigue: Treatment depends on each individual case. On average, classical cases take around two years to achieve proper alignment.

EdUAE: What will be the aftercare at home?

Dr Rodrigue: Aftercare at home is very important for maintaining braces and getting the desired results. We always recommend avoiding biting your front teeth and hard foods, chewing crunchy, and protecting the teeth while playing sports with a sports guard. A couple of other tips to remember are to brush your teeth regularly with orthodontic brushes and to never skip your appointments with your orthodontist.

EdUAE: How often will we need to come back to the dentist for check-check-ups?

Dr Rodrigue: After set-up is complete, the child should come back for a check-up once a month regularly, and more if there’s an emergency.

EdUAE: What will a child’s braces cost?

Dr Rodrigue: The cost can vary depending on the type of braces chosen and the duration of the treatment, which depends on the severity of the case. Usually, metallic braces are the least expensive and clear aligners are the most expensive.

EdUAE: Are braces covered on insurance plans and are there payment options?

Dr Rodrigue: Although most insurances do not cover braces, most clinics offer installment plans to help make payment easier. It’s crucial that you should agree on all aspects of the treatment with your dentist, such as cost, installment, follow-up visits, reparation fees, etc, before starting treatment.

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