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Sleep Apnea

Sleep apnea is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep.  The term sleep apnea is derived from the Greek etymology meaning “without breath”.  Breathing pauses can last anywhere from several seconds to minutes, and happen as often as 30 times or more per hour.  Ongoing disrupted breathing causes an imbalance between the carbon dioxide and oxygen levels in the bloodstream, as not enough carbon dioxide is exiting and not enough oxygen is entering the body.

Sensing this imbalance, the brain sends a message to the body, telling it to wake up to restart the breathing process.  People with sleep apnea will partially awake as they struggle to breathe, and this is often accompanied by loud snoring or choking sensations.  Because people with sleep apnea don’t always completely awake during the episodes, they are often unaware they have a sleeping disorder and it can remain undiagnosed.

There are two main types of this disorder; central sleep apnea which occurs when the brain fails to send important signals to the breathing muscles, and obstructive sleep apnea which occurs when air cannot flow through the nose or mouth even though the body is still trying to breathe.  Obstructive sleep apnea is far more prevalent and easily treatable by the dentist.

Common signs of obstructive sleep apnea can include severe early morning headaches, sleepiness in the daytime, and insomnia. Fortunately, the dentist is equipped with the necessary technology and expertise to treat sleep apnea in several different ways.

Reason for treating sleep apnea

It is very important to seek medical attention if sleep apnea is suspected. A sufferer can completely stop breathing numerous times per hour, and this can quickly turn into a deadly situation. Obstructive sleep apnea occurs when the soft tissue lying at the back of the patient’s throat collapses into the airway. The tongue then falls towards the back of the throat which tightens the blockage and prevents oxygen from entering the lungs.

The problem worsens when the chest region, diaphragm, and abdomen fight for air. The efforts they make to obtain vital oxygen only cause a further tightening of the blockage. The patient must arouse from deep sleep to tense the tongue and remove the soft tissue from the airway.

Because sleep apnea causes carbon dioxide levels to skyrocket in the blood and oxygen levels to decrease, the heart has to pump harder and faster to compensate for the lack of oxygen. Sleep apnea patients can technically “die” many times each night. Sleep apnea has been linked to a series of serious heart-related conditions, and should be investigated by the dentist at the earliest opportunity.

What does sleep apnea treatment involve?

Initially, the dentist will want to conduct tests in order to investigate, diagnose, and pinpoint a suitable treatment. The dentist can offer many different treatment options which depend largely on the exact diagnosis and the health of the patient. The dentist may advise the patient to halt some habits that aggravate sleep apnea such as smoking, alcohol consumption, and tranquilizer use.

Sleeping masks were traditionally used to keep the patient’s airways open while they slept, but nowadays there are some less intrusive options. Dental devices that gently tease the lower jaw forward are very effective in preventing the tongue from blocking the main air passage. These dental devices are gentle, easy to wear, and often help patients avoid unwanted surgeries.

A more permanent solution is to have surgery that sections the lower jaw and helps pull the bone holding the tongue forward slightly. This surgery has an impressive success rate and is simple for the dentist or oral surgeon to perform. The dentist needs to formally make a diagnosis of each individual case before recommending the best course of action.

If you feel you may benefit from sleep apnea treatment, contact our practice today.

Sleep apnea appliances fall into two categories: fixed and adjustable.  Here are brief descriptions of some commonly used sleep apnea dental appliances:

TAP® 3 (Thornton Adjustable Positioner)

The TAP® 3 is the smallest, most comfortable member of the TAP family.  It is a two-part custom-created sleep apnea appliance that fits over the teeth in much the same way as a sports mouthguard.  The TAP® 3 projects the jaw forward to prevent the tongue and soft tissues from impeding the airway.  The lower jaw positioner is adjustable, which means that it can be altered to suit the comfort level of the wearer.  The TAP® 3 appliance can accommodate the three main types of malocclusion, and allows the lips to fully close.

Silent Nite® sl

Snoring can be a real problem, not only for the person who snores, but also for the partner and other family members who live with the snorer. However, there is a dentist-prescribed solution for a more restful night’s sleep: Silent Nite® sl. This affordable device is flexible, thin and comfortable for your patients, and it exhibits documented clinical success in mitigating or even preventing the disruptive, unhealthy effects of snoring and sleep apnea.

Silent Nite sl positions the lower jaw forward using special Side-Link connectors that are attached to upper and lower trays. These trays are comprised of a soft inner layer with a hard outer layer that is durable and BPA-free. The new, improved connectors are stronger than those found on the original Silent Nite and are easily interchangeable by the patient. This intraoral appliance is indicated for patients with a minimum of eight teeth per jaw and a body mass index (BMI) of 30 or less.

EMA®

The EMA® (Elastic Mandibular Advancement) oral appliance is a customized removable appliance created for the noninvasive treatment of snoring and obstructive sleep apnea (OSA). The appliance is designed to both advance the mandible and open the bite to allow for less restricted airflow during sleep.

EMA devices help promote a deeper, more restful sleep by preventing snoring and relieving the symptoms of OSA. The EMA does not interfere with breathing through the mouth, even in cases of congested nasal passages. It has many options for advancement with nine strap lengths (13 mm–21 mm) and four different elastic tension options, indicated by color. The shorter the strap, the farther the mandible is advanced. The 36 different straps allow for the most effective repositioning of the jaw with maximum comfort. Due to the varying elastic bands, non-restricted lateral/protrusive movement is possible while wearing the device.

The EMA is indicated for patients with either a full or partial set of natural teeth. The patient’s remaining teeth should have sufficient height of contour for the device to gain retention at the gingival third, and the edentulous ridge must be fully captured in the impression.

 


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