Dental Sleep Medicine at Midwest Holistic Dentistry - treatment for Obstructive Sleep Apnea and snoring by improving jaw and tongue position, another area of Holistic Dentistry we provide.
Dental Sleep Medicine is an area of practice that focuses on the management of sleep related breathing disorders including snoring and obstructive sleep apnea through the use of oral appliance therapy and upper airway surgery.
Obstructive Sleep Apnea
Sleep apnea is a potentially life-threatening medical disorder that causes your body to stop breathing during sleep. The muscles in your throat relax and the tongue may fall back and block the airway as you sleep, reducing the amount of oxygen delivered to all of your organs including your heart and brain. People with sleep apnea may snore loudly and stop breathing for short periods of time. The breathing pauses from sleep cause your body to briefly wake while you remain unaware. This can happen hundreds of times per night, and you may wake up feeling not feeling refreshed.
In addition to snoring and excessive daytime sleepiness, sleep apnea can cause memory loss, morning headaches, irritability, depression, decreased sex drive and impaired concentration. When left untreated, sleep apnea can lead to hypertension, stroke, heart attack and sudden death while asleep. Any age or body type can have sleep apnea. The sleep disorder progressively worsens with age and weight gain. Anatomy and posture play a role in sleep apnea also. Many factors must be considered prior to treatment.
The vast major of sleep related breathing cases go undiagnosed and untreated. An Institute of Medicine report found that an estimated 50-70 million Americans suffer from chronic sleep disorders, including sleep apnea. Excessive daytime sleepiness alone costs the economy $150 billion in lost productivity and workplace accidents another $48 billion in medical expenses related to auto accidents involving drowsy driving. Nearly 1 in 5 car accidents causing serious injury are associated with excessive daytime sleepiness.
Dentists together with sleep physicians are challenged to respond to the health risks and economic impact of untreated sleep apnea and excessive daytime sleepiness. Obstructive sleep apnea is very common and potentially life-threatening medical disorder that prevents airflow during sleep. More than 18 million Americans have sleep apnea, and many are not receiving treatment.
Signs of Sleep Apnea
- Unintentionally falling asleep during the day
- General daytime sleepiness
- Unrefreshing sleep
- Waking from sleep with a choking sound or gasping for breath
- Loud snoring
If you have have these symptoms, you might have sleep apnea. The Epworth Sleepiness Scale and an interview with a trained Sleep Physician can help you further determine if you likely have sleep apnea.
Oral appliances are a front-line treatment for snoring and mild to moderate obstructive sleep apnea. This small plastic device fits in the mouth during sleep like a sports mouth guard or orthodontic retainer. Oral appliances help prevent the collapse of the tongue and soft tissues in the back of the throat, keeping the airway open during sleep and promoting adequate air intake. Oral appliances may be used alone or in combination with other treatments for sleep-related breathing disorders, such as weight management, surgery or CPAP. Combination Therapy of a CPAP and an Oral Appliance can be helpful for some CPAP patients who find the CPAP difficult to wear.
Oral Appliance Therapy
Oral appliance therapy involves the selection, fitting and use of a specially designed oral appliance that maintains an open, unobstructed airway in the throat when worn during sleep. Custom-made oral appliances are proven to be more effective than over-the-counter devices, which are not recommended as a screening tool nor as a therapeutic option.
Dentists with training in oral appliance therapy are familiar with the various designs of appliances and can help determine which is best suited for your specific needs. A dental sleep specialist will work as a team with your physician to provide diagnosis, treatment and ongoing care. A joint consultation will be required to determine the most effective treatment approach.
The initial evaluation phase of oral appliance therapy can take several weeks or months to complete. This includes examination, evaluation to determine the most appropriate oral appliance, fitting, maximizing adaptation of the appliance, and the function. On-going care, including short- and long-term follow-up is an essential step in the treatment of snoring and Obstructive Sleep Apnea with Oral Appliance Therapy. Followup care serves to assess the treatment of your sleep disorder, the condition of your appliance, your physical response to your appliance, and to ensure that it is comfortable and effective.
Advantages of Oral Appliance Therapy:
- Oral appliances are comfortable and easy to wear.
- Most people find that it only takes a couple of weeks to become acclimated to wearing the appliance.
- Oral appliances are small and convenient making them easy to carry when traveling.
- Treatment with oral appliances is reversible and non-invasive
How do Oral Appliances Work?
They work by repositioning the lower jaw, and tongue. Stabilizing the lower jaw and tongue, and increasing the muscle tone of the tongue
Types of Oral Appliances
The most effective Oral Orthotic I have used for myself and my patients is the Oral System Balance Family of Orthotics designed by Farran Robson DDS.
Fellow certified Oral Systemic Balance Practitioners (or Oral System Biology® Certified Practitioners working with Oral Systemic Balance® Orthotics):
- Dr. David Lawler DDS - has an extensive web site dedicated to Oral Systemic Balance Therapy.
- Wayne L. Whitley, DDS
Other Treatment Options
There are three primary ways to treat snoring and sleep apnea, in addition to lifestyle changes such as good sleep hygiene, exercise and weight loss. The most common
treatment is Continuous Positive Air Pressure. CPAP keeps your airway open by providing a steady stream of air through a tube connected to a mask that you wear as
you sleep. Another option is surgery performed by an AADSM member trained as an oral and maxillofacial surgeon. A surgeon can prevent airway collapses by eliminating
tissue in the soft palate, uvula and tongue.
Upper Airway Surgery
See The American Academy of Dental
More complex surgical procedures can reposition the anatomic structure of your mouth and facial bones. Dr. Johnson only refers to Oral and maxillofacial Surgeons who
understand the full scope of this complex surgery.
G. William Arnett, DDS, FACD and Michael J. Gunson, DDS, MD or surgeons who have been trained by them and who have adopted the their philosophy, is where I would get an evaluation if I was considering a surgical option for sleep apnea.