Sleep Apnea & Snoring Dental Treatment
Why Have A Dental Sleep Medicine Trained Dentist Treat Sleep Apnea?
Let me start by saying that I am extremely passionate about treating sleep apnea. Apnea and sleep breathing disorders are an area where I spend a great deal of time and energy keeping my knowledge current. It began for me when I witnessed one of my undiagnosed sleep apnea patients experience apnea episodes while under IV sedation by an anesthesiologist. He asked to be sedated for routine dental procedures in my office because of anxiety. The physician had to manage his airway during the rest of the procedure because his apnea was so bad. It really got my attention and since that time I have sought out every source for education in dental sleep medicine that I could find. I attend a monthly study club out of town with dentists and MD’s who specialize in sleep medicine, as well as attending numerous courses in various places such as the Academy of Dental Sleep Medicine (AADSM) meeting. I work closely with local sleep physicians, ENT’s and sleep labs in order get my sleep apnea patients the treatment they need.
So Where Do You Start?
If you are reading this, you may suspect that something is not right with your sleep. So whether you have had a sleep test yet or not I would encourage you to make an appointment here in my Victoria dental office. If you need a sleep study, we will help you get one. We can also get you to a sleep physician if necessary.
What Should You Expect?
We will examine the mouth for oral signs and symptoms of a potential airway issue. There are other signs that we look for, as well as questions that will help us to screen. I see many patients who are reluctant to discuss airway issues because they believe that the CPAP mask is their only option. So, they will not even attempt to be screened or have treatment. I hope that we can educate those patients of the existence of alternative treatments such as oral appliance therapy for sleep apnea. What I can assure patients is that the treatment that they will receive from me is that which is best for them and that they are comfortable with. If they prefer a CPAP then I would never discourage them from that.
Sleep Apnea Information
Many patients are either undiagnosed with an airway issue such as sleep apnea or have tried CPAP treatment for it that was not working for them. For such cases, we can help get you to the right place and involve a trained sleep physician to get you diagnosed and if needed make a dental sleep apnea appliance.
Waking up very tired after being asleep all night is one typical example of a symptom of many sleep apnea and upper airway resistance syndrome (UARS) patients. Many patients believe that they just snore and don’t have a breathing problem. That may be the case but heavy snoring can be damaging to arteries by itself but can be corrected with an oral dental snoring appliance.
Signs of a Possible Sleep Breathing Disorder
- Getting up to use the restroom one or more times during the night
- Waking up tired or with “brain fog” after adequate sleep time
- Waking up with a “choking sensation”
- Difficulty getting to sleep or staying asleep
- Severe wear on teeth
- Grinding teeth or clenching teeth
- Waking up sweating
- Needing to take naps during the day
- Gastric reflux (GERD) of unknown origin
- A hoarse voice in the morning
- Waking up with headaches or migraines
- Restless legs or jerking movements of legs during sleep
The Dangers of Snoring
- Snoring is related to high blood pressure, heart disease, and acid reflux
- Snoring has been shown to contribute to carotid artery plaque formation that can lead to strokes
- Daytime sleepiness and fatigue
- Sleep disturbances that can affect memory, irritability and fatigue
Let’s Take A Quick Test
Use the short questionnaire (click the image for a larger view) that can help you determine your possible risk for sleep apnea: In the last 30 days, how likely are you to doze off or fall asleep in these situations?
What if you score 10 or greater? The next step is to schedule an appointment here with us for a more in-depth screening in the office. Should it be determined that you are at risk for sleep apnea or another upper airway problem we can help you get a sleep study and have it read by a sleep physician.
There are 2 types of sleep studies, overnight studies done in the lab and those done with take-home equipment in your own bed. The in lab studies are more comprehensive in what they test for, but for those who are unable to do that, the take-home studies are diagnostic as well.
Sleep Apnea Treatment
After a sleep study is completed and a diagnosis is made of sleep apnea or another treatable airway disorder, then the appropriate treatment may be recommended by the sleep physician. If sleep apnea is severe, then a CPAP machine will usually be recommended by the physician although if the patient cannot tolerate the CPAP then the dental appliance is recommended. If sleep apnea is diagnosed as mild or moderate then according to the AADSM the patient should be given the option of either a CPAP machine or a dental mandibular advancement device (MAD), which is an oral sleep apnea treatment appliance. Also, any patient who is unable to wear the CPAP all night every night should consider an alternative therapy such as the MAD.
Below are some examples of the 40 or so types of the many MAD devices
Dental Sleep Apnea Device For Denture Patients
When the teeth are missing, as with a denture patient it is still possible to make a dental appliance to treat sleep apnea. The sleep apnea appliance uses the same suction that the denture uses for retention. As long as there is a sufficiently large ridge where the teeth used to be still present, there should be sufficient suction. If there is not a large enough edentulous ridge present, then dental implants would be indicated for retention of the dental sleep apnea appliance. Those same dental implants could also serve a dual purpose to snap onto the sleep apnea patients denture during the day for a more secure denture fit.
If you are a denture wearer with sleep apnea who can’t wear a CPAP it would be advisable to call us for a consultation in order to see what your options are to treat the sleep apnea.