Dentists are important in the treatment of obstructive sleep apnea

Dentists have an important role in identifying patients with obstructive sleep apnea (OSA). As part of routine dental examinations, dentists can recognize a small upper airway and other anatomic risk factors for sleep apnea. They may use the opportunity to identify potential patients through use of simple screening questions and/or questionnaires.

OSA is a chronic condition when it causes sleep disturbances for three or more nights a week. If left untreated, sleep apnea can lead to serious medical consequences, reduce lifespans and impair your quality of life.

In this issue, we discuss the role of the dentist in addressing obstructive sleep apnea.

As we age, we lose muscle tone in many areas of the body, including the mouth and throat. Just like you may become flabby in your belly, you also can become flabby in the muscles controlling your airway. The usual scenario is to fall asleep on your back and your tongue falls back toward your throat. Also, your soft palate and your pharynx collapse a bit. You begin to snore as the air that you inhale goes through the airway, which is now narrowed because of the muscle collapse. When those muscles and tissues completely collapse, you stop breathing. After a while, the body responds and you wake up just enough to tighten the muscles in your airway and start breathing again.

This process can occur several times within an hour. The more often you awake out of a deep sleep, the more tired you are likely to be the next day. But it does not stop there. Sleep apnea increases the risk of high blood pressure, heart attack, stroke, obesity and diabetes.

The first line of treatment for obstructive sleep apnea is CPAP (continuous positive airway pressure). CPAP is a nasal/oral mask device connected by a hose to a machine that blows air into your airway to keep it from collapsing. Despite its effectiveness, many persons with obstructive sleep apnea, particularly a mild or moderate form, find the CPAP to be a nuisance and don’t use it or don’t use it effectively. Often times, they find it to be confining or claustrophobic while wearing the mask. Also, some CPAP users face bacterial infection from poor maintenance and sanitization practices of the tubing system.

The next best alternative to CPAP, according to the American Academy of Sleep Medicine, is an oral appliance provided by a dentist. Dentists have been involved in the collaborative evaluation and treatment of patients with obstructive sleep apnea using oral appliances for over 40 years. In my office, we assist some dentists with the diagnosis of obstructive sleep apnea by examining and evaluating the airway size with the use of a specialized x-ray – a Cone Beam CT Scan.

The oral appliance is a device, worn on the top of your teeth, that opens your jaw and moves it forward, thus opening your airway. The oral appliance opens the airway, stopping snoring and alleviating obstructive sleep apnea for many persons. It is the most predictable solution for those who don’t respond to CPAP.

Two common oral appliances are the mandibular advancement appliance and the tongue retaining appliance. These devices open your airway by bringing your lower jaw or your tongue forward during sleep. Also, it is very important to get fitted by a dentist with a keen understanding in sleep apnea. The patient should see the dentist on a regular basis to monitor any problems and periodically adjust the mouthpiece.

The use of a proper fitting oral appliance may not only make you a less noisy bed partner, it may also save you from daytime fatigue and low productivity, as well as reduce your risk of some serious diseases.

It is important that a collaborative relationship be established between a qualified dentist and a sleep physician, so that patients receive the most effective care for their obstructive sleep apnea. Both professionals have an important role to play in the treatment process.

 
• Dr. Kendal V.O. Major is the founder and CEO of the Center for Specialized Dentistry, which is a comprehensive family dental practice operating in New Providence and Grand Bahama. He is the first Bahamian specialist in gum diseases and dental implants since 1989. He is also a certified fast braces provider. His practice is located at 89 Collins Avenue, New Providence. He can be contacted at (242) 325-5165 or kmajorcsd@gmail.com.

The post Dentists are important in the treatment of obstructive sleep apnea appeared first on The Nassau Guardian.

source https://thenassauguardian.com/dentists-are-important-in-the-treatment-of-obstructive-sleep-apnea/