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Dental Sleep Medicine 

Dental Sleep Medicine focuses on the management of sleep-related breathing disorders (SBD), which includes the continuum of snoring to obstructive sleep apnea (OSA), with oral appliance therapy (OAT) and upper airway surgery.

FAQ

What is sleep apnea?

  • There are two type of sleep apnea: Obstructive sleep apnea and central sleep apnea
    • Obstructive Sleep Apnea (OSA): OSA is a potentially life-threatening medical disorder that is more prevalent in males, and progressively worsens with advancing age and weight gain. It is caused by repetitive collapse and blockage of the upper airway while asleep that results in reduced oxygen delivery to body organs, most critically the heart and brain. OSA can be treated with oral appliance therapy (OAT) and upper airway surgery.
    • Central Sleep Apnea (CSA):  According to the Mayo Clinic, central sleep apnea is a breathing disorder that occurs when the brain fails to transmit signals to breathing muscles. Breathing repeatedly stops and starts during sleep. The condition is different from obstructive sleep apnea, in which breathing is interrupted because of an obstruction to the upper airway. Central sleep apnea is less common then OSA and cannot be directly treated by oral appliances. Patients with central sleep apnea need to see a physician for treatment. 

What are some symptoms of OSA?

  • Snoring and excessive daytime sleepiness (EDS) are the two most common symptoms of OSA. It may also cause memory loss, morning headaches, irritability, depression, decreased sex drive, and impaired concentration.

What are some consequences of untreated OSA?

  • Left untreated, OSA can result in hypertension, strokes, heart attacks, and sudden death while asleep, as well as motor vehicle accidents due to drowsiness while driving.

 What are the treatment options?

  • There are various ways to treat sleep apnea and include
    • Continuous positive airway pressure or CPAP:  This method, which is essentially a reverse vacuum that forces air into the lungs is very effective but many patients find it to be very uncomfortable.
    • Oral appliance therapy: The America Academy of Sleep Medicine recommends oral appliances as a first-line treatment for snoring and mild- moderate obstructive sleep apnea (OSA).
    • Behavioral modification therapy (includes weight loss and positional therapy).
    • Upper airway surgery: is used when other therapies (eg. positional therapy, weight loss, and CPAP– by sleep physicians) are non-applicable, unsuccessful, or intolerable. Surgery may be an effective treatment for sleep related breathing disorders, but only if performed competently and on correctly identified specific anatomic sites that contribute to upper airway obstruction, which varies between different patients.

What exactly is oral appliance therapy or OAT?

  • Oral appliance therapy (OAT) involves the selection, fabrication, fitting, adjustments, and long term follow-up care (and management of potential complications such as malocclusion and temporomandibular joint dysfunction) of custom-designed oral devices, worn only during sleep, to reposition the mandible and tongue base anteriorly to enlarge and stabilize the oropharyngeal airway. Oral appliances avoid the risks associated with surgery and the discomfort that can accompany other treatment methods. “OSA is a serious, life-threatening condition – but for many patients, alleviating its effects can be as easy as utilizing an oral appliance at night. Oral appliances, which resemble sports mouth guards, may control mild to moderate OSA with minimal discomfort or disruption,” explains ADSM president, Kent Moore, M.D., D.D.S.
  • In our office, we use the RESPIRE series oral devices.

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