Tandhygienisters upplevelser av barn med sömnrelaterade andningsstörningar inom tandvården : En kvalitativ intervjustudie

Sammanfattning

Introduction: Obstructive sleep apnea (OSA) and other sleep related disorders (OSDB) in children can affect children´s overall health, development and quality of life. It can also be associated with orofacial deviations and altered occlusal development. Dental care providers regularly meet children through recurring examinations and may therefore constitute an important arena for early detection. In Sweden dental care collectively encounters children aged 1-19 years of age free of charge. At the same time there is limited research on how dental hygienists experience their work with children with suspected OSA and OSDB. Aim: The aim of this study was to investigate how dental hygienists experience the assessment and management of children aged two to eight years with sleep related disorders breathing conditions within dental care. Methods: The study was conducted using a qualitative method and semi-structured interviews with licensed dental hygienists working in pediatric and adolescent dental care. The interviews were conducted in a region of central Sweden. Strategic sampling method was applied. The data material was analyzed using qualitative content analysis according to Graneheim and Lundman. The COM-B model was used as the theoretical framework. Results: The results were presented through an overarching theme, categories and sub-categories. The findings show that dental hygienists perceive that dental care can contribute to early detection of children with suspected OSA/ OSDB. Partly through anamnesis, clinical observations and recurring contact with children and caregivers. At the same time barriers were identified in the form of insufficient knowledge and uncertainty regarding routines and referral pathways. Organizational limitations and inadequate collaboration between Health care Services were also highlighted. The findings reveal a perceived discrepancy between professional responsibility and organizational conditions required to act. Conclusion: Dental hygienists may play a significant role in the early identification and detection of children with OSA and OSDB. However, this requires strong knowledge, clear routines, organizational support and improved collaborations recording OSA and OSDB. Keywords: Public Health, Oral Health, Obstructive sleep apnea (OSA), Obstructive sleeping disorder breathing (OSDB) and Dental hygienist.