Dental Sleep Medicine– Oral Appliances or CPAP
The field of Dental Sleep Medicine is growing. Obstructive Sleep Apnea has always been a problem, but awareness of the severe effects and real causes is recent. The resources to easily test and diagnose OSA were not readily available in the past.
Now virtually every large city typically has many sleep labs and accredited sleep centers. Now, there are sleep labs even in small communities. This increase in our diagnostic abilities lead to a great increase of patients being diagnosed with OSA.
An even better alternative to the sleep labs is the invention of the home sleep test equipment that is becoming widely used.
The Home Sleep Test allows you to get the diagnostic test you need in the comfort of your own home in your own bed.
Is It Snoring Or Sleep Apnea?
Snoring is mostly caused by vibration of the tissues of the oropharynx and the soft palate. Snoring may not only disturb the sleep of the bed partner, but it may fragment the person’s sleep and may be a sign of OSA. This occurs when the tissues of the oropharynx collapse during sleep and block the airway.
A complete blockage for 10 seconds or more is called an apnea. A reduction of airflow of about 40% with an oxygen reduction of 4% is called a hypopnea. The total of apneas and hypopneas measures the severity of OSA and is referred to as the apnea-hypopnea index (AHI).
The Old Standard
In the past the standard treatment for OSA is continuous positive airway pressure (CPAP). While it may have been a breakthrough treatment, CPAP has some serious drawbacks
About ten percent of those diagnosed with OSA are not willing to try CPAP. Of those who try CPAP, 20-40% give up within one year. Many of those who continue to use CPAP won’t wear the mask long enough at night to achieve the benefits they need to resolve their sleep apnea.
The reasons they offer for discontinuing are many;
- The mask fits poorly and is uncomfortable
- The mask leaks or air leaks through the mouth
- A skin reaction occurs
- The straps that hold the mask on create problems
- Their bed partner complains of the noise of the system
- Dry nose or mouth and sinus problems
- Even dental problems
Sleep Dentistry… The Solution For Sleep Apnea
A Sleep Dentist can help those patients who are CPAP intolerant. According to American Academy of Sleep Medicine guidelines, oral appliance therapy (OAT) is indicated as a first line therapy in mild-to-moderate OSA (AHI=5-29)and is also indicated in severe OSA (AHI=30+) when a patient has failed CPAP. Surgery is generally not successful with OSA.
The principle behind Oral Appliance Therapy is simple. When a patient has obstructive sleep apnea the airway is blocked by the tongue obstructing the airway during sleep.
The oral appliance (OA) keeps the lower jaw forward during sleep. There are several appliances on the market that work well to achieve a reduction in AHI.
Knowing what appliance to use, how to adjust it, and treatment of side effects such as TMJ pain, myalgia, tooth movement, and bite changes is where proper training comes in.
But I Just Want To…
Often patients will say something like, “I just want to stop snoring” or “I just want to stop grinding my teeth.”
They don’t know those are symptoms and that there may be a much larger problem that is creating those symptoms. They aren’t usually aware of the fact that obstructive sleep apnea has severe consequences. It affects not just the quality of life but can take years off of your life.
If their dentist only treats the symptoms and ignores the underlying cause, they are doing their patients a disservice They are putting their patients health at risk by treating patients only for snoring without a proper medical evaluation.
There Is No Way To Tell By Just Looking
There is no quick way to know if they just snore or if they have OSA. Accurate diagnosis, and proper treatment is why it is important to be treated by an expert trained in Dental Sleep Medicine. Treating OSA is straight forward. The impact on patient’s lives is awesome.
Dentists are in a position to be one of the main doctors to refer patients for sleep studies. They spend much more time with patients than medical doctors do. They are looking right at the patient’s airway.
At The Northwest Institute Of Dental Sleep Medicine we see many patients that just think that snoring is their biggest issue. In many cases we will have them take home a portable sleep test unit that we have available in our office. It is important to know for sure what the real cause is of their symptoms.
Many patients who are clenching their teeth are doing so because they have an underlying sleep disorder. They are, in effect, protecting the closing of their airway by clenching their teeth. The brain is much more concerned about oxygen than it is about us hurting our teeth.
The Dentist’s Role
The dentist’s role in the diagnosis and treatment of obstructive sleep apnea continues to expand. The dentist is in a position to make an incredible contribution and literally add years to the lives and life to the years of many, many patients.
We at The Institute of Dental Sleep Medicine have been thoroughly trained in Sleep Dentistry by the top experts in the field. We are truly pleased to be in a position to help our patients literally change their lives by finally getting the restorative sleep that they have been missing.
If you snore, are tired during the day or grind your teeth at night you really need to find out if there is more to it than just those symptoms. You may have sleep apnea and your health is at risk.
Find a qualified Sleep Dentist to get a diagnosis and relief. If you are In North Idaho or Eastern washington You can get the relief you seek in Coeur d’ Alene by calling Lori @ (208) 667-4551 to schedule your free consultation .