A: Dentists and dental laboratories fabricate sleep apnea appliances or mandibular advancement devices. There are many versions available. The common characteristic of these appliances is that they keep the lower jaw forward thereby minimizing the possibility of the tongue falling back to block the airway. Dental offices routinely fit dentures, bite guards, retainers, and similar appliances. Making an appliance that fits over both upper and lower jaws with some form of hardware linking them together is relatively easy.
Over the last ten years or so there has been a heightened awareness in dentistry regarding obstructive sleep apnea. It has almost become a subspecialty. In fact, there are dentists and dental offices that have narrowed their focus exclusively on the treatment of sleep breathing disorders or sleep apnea.
A: Sleep apnea is a condition in which breathing is irregular during sleep. Breathing is repeatedly stopped and started. Vital tissues are temporarily deprived of the necessary oxygen to perform optimally. This increased stress over time on the body manifests in the following ways :
A: Yes. Obstructive Sleep Apnea is a silent epidemic in this country. An estimated 22 million Americans suffer from moderate to severe sleep apnea or 1 in 12 Americans. It is said that 75-80% remain unidentified. This means it is often overlooked as a risk factor for heart failure, stroke, and coronary heart disease.
A: Excess weight, thick necks, a narrowed airway, being male, being older, family history, use of alcohol or sedatives, smoking, and nasal congestion. It is noteworthy that obesity in the United States has had a proportional correlation with the rise of obstructive sleep apnea.
Sleep bruxism presents a dilemma for many dentists familiar with both regular bruxism, clenching, grinding of teeth, AND obstructive sleep apnea. Patients often believe they simply need a nightguard due to worn teeth, morning headaches, or TMD (Temporomandibular
Disorder often confused with TMJ). The underlying reason for nighttime grinding could be sleep apnea. If this is the case a dentist might provide a nightguard but fail to acknowledge the underlying deadly cause of the grinding.
The pattern of sleep bruxism is one in which the tongue blocks the airway. The patient’s mind perceives the lack of oxygen throughout the body. The lower jaw begins an attempt to reopen the airway. During this brief period, teeth interfere and are chipped or worn down. This pattern can repeat itself over 30 times an hour.
It is imperative to know if you have a sleep breathing disorder before your dentist prescribes a bite guard, nightguard, occlusal guard, or bite splint. By law, dentists are not licensed to make this diagnosis. At Thornton Park Dental Arts we rely on physicians to determine the proper diagnosis. We also guide our patients to contact either SNAP or Blackstone Medical Services.
Both SNAP and Blackstone have board-certified sleep specialists who interpret home sleep tests. They also coordinate with your medical insurances and your physicians.
A: The gold standard is a CPAP. It is the least invasive treatment and the most effective. There are surgeries designed to further open the airway. At Thornton Park Dental Arts we fabricate appliances that fit upper and lower jaws. We have made EMAs, TAP Appliances, Dorsal Fin Appliances, and Herbst Appliances. We suggest our patients try to adapt to a CPAP before trying a MAD (mandibular advancing device).
If sleep apnea has been ruled out but our patient wants something to minimize snoring we also provide an appliance known as Silent Nite.
If you have more questions and believe we can help you please contact our office to set up a consultation with Dr. Angulo.