One of the areas of medicine that works closely in conjunction with dentistry is the field of Sleep Medicine.
In recent years, this area of Medicine has grown due to the expanding population of people over 40 years of age. It is well documented that over 90 million people in the United States snore. Of this 90 million somewhere around 32 million have Obstructive Sleep Apnea.
Basically, OSA( Obstructive Sleep Apnea) is a disease that results from the narrowing of your airway. As we age and/or gain weight, the ability of the tongue-base musculature to expand the upper airway during normal respiration often declines.
This causes you to basically stop breathing while sleeping. This is what is known as an apneic episode. The apneic episode causes you to briefly awake long enough to gasp a few breaths of air and then resume your sleep and snoring.
Over the past 15 years, oral appliances have developed into a viable and scientifically sound method for eliminating upper airway obstruction in a larger percentage of patients.
The American Academy of Sleep Medicine has recently published a report that lends substantial importance and credibility to the use of oral appliances in the treatment of OSA.
Overall, those patients with mild to moderate OSA have a 52% chance of controlling their OSA with an oral appliance. Severe OSA patients, however, are best treated with CPAP (Continuous Positive Airway Pressure)Â devices or surgery.
The Different Types of Oral Appliances
The best success has come from appliances known as MRAs. MRA stands for mandibular (lower jaw) repositioning appliance.
There are non-custom (off the shelf, or boil and bite) appliances and custom-made (adjustable) appliances. Currently, the custom-made, adjustable MRA have been proven to work the best.
It is best to always seek a dentist who has experience with these type of appliances.
How The Oral Appliances Can Help:
Basically, these oral appliances work to expand the airway and improve breathing while sleeping. Young, thinner patients with lower body mass have some of the best response rates to these types of appliances.
Patients with or with out TMJ dysfunction may or may not be a contraindication to the use of oral appliances.
It has been shown that women are overall more successfully treated with oral appliances than men.
Are There Any Side Effects of Wearing These Appliances?
Fortunately, the side effects are minor compared to the side effects of OSA. There may be some limited tooth pain, dry mouth, and overall facial muscle soreness. Again it is important to receive care from a dentist or dental specialist who has expertise in the area of Dental Sleep Medicine and Obstructive Sleep Apnea.
There is one specific appliance that has been used for decades and is well documented in the medical literature to improve airway, decrease sinus and allergy problems and improve sleep. This appliance is called a Rapid Palatal Expander and is commonly used by Orthodontists for expansion purposes in young children.
Since dental sleep medicine and obstructive sleep apnea, are not included in the curriculum of most dental schools and post-graduate residencies, additional training is required before initiating treatment.
The American Academy of Dental Sleep Medicine (www.aadsm.org) is a good resource for locating physicians , dentists and other dental specialists who have expertise in these types of appliances.
If you think you might have sleep apnea and have questions, please call our office at 916-435-8000
