Dental Sleep Medicine: What? , How? , Why?

Dental sleep medicine is fast gaining popularity both as an alternative and an initial form of therapy for sleep disorders. Let’s look at why the work being done in this area of oral health is being commended, supported and carried forward to such a great degree.

What is Dental Sleep Medicine?

According to the American Academy of Dental Sleep Medicine (AADSM), it is defined as a dental health practice that aims to treat breathing disorders during sleep, with the use of specialized oral appliances. It can help with conditions like snoring, bruxism (teeth grinding), upper airway resistance syndrome and OSA (obstructive sleep apnea).

OSA is a common sleep disorder, and people suffering from it may experience shallow breaths or repeated pauses in breathing during sleep, anywhere from five to thirty times (or even more) an hour. Dental sleep medicine has often been used along with traditional forms of OSA treatment, like CPAP (continuous positive airway pressure) therapy.

In fact, the use of a mouth guard to curb snoring was pioneered by dental health specialists over 30 years ago. During the course of these therapies, dentists and physicians realized that these oral appliances also played a role in reducing the symptoms of OSA, since heavy snoring has been found to be a key risk factor for this disorder.

Over time, the design for these dental appliances has been tweaked and improved tremendously, especially in terms of controlling the upper airway, lower jaw and tongue.

How Can Dental Sleep Medicine Help Treat Sleep Disorders?

Dentists are uniquely qualified to recognize and treat OSA, bruxism and other sleep disorders that reflect in the mouth, jaw, and throat. During an oral health consultation, dentists could be alerted to the presence of breathing or sleep disorders in patients who display certain signs. These include:

  • If a patient falls asleep in the chair during a dental checkup (or complains of daytime fatigue), this can signal insomnia or fragmented sleep.
  • Visible signs of tooth grinding could point to the presence of nighttime restlessness and a lack of quality sleep.
  • Complaints of jaw pain or an inability to follow the dentist’s instruction to “open wide” may also act as a red flag.
  • An oversized tongue/uvula, narrow dental arches or a receding “soft chin” also suggest obstructed breathing.
  • Difficulty in breathing (while reclining on the examination chair) could be caused by obstructed airways and extra weight around the neck.

Dental sleep medicine mainly focuses on the use of snoring mouthpieces (snore guards) and mandibular advancement devices (dental appliances) to treat sleep-disordered breathing.

Snore Guards are simple devices that minimize vibrations and friction in the airway by advancing the lower jaw, but dental appliances are more complex. They are custom-built and fitted for each patient, and open the upper airway (to remove obstructions) by repositioning the lower jaw and tongue forward during sleep.

Why Consider Dental Sleep Medicine for Sleep Disorders?

Sleep Disorder

When left untreated, repeated pauses in breathing during sleep can cause several complications. The most serious detrimental effects include cardiovascular disorders such as hypertension, arrhythmias (irregular heartbeats), congestive heart failure, and cardiomyopathy (an enlarged heart).

Consequently, sleep apnea patients have a higher risk of suffering strokes or heart attacks. In addition, this condition may cause daytime drowsiness, chronic fatigue, slow reflexes and poor coordination due to sleep deprivation. This raises the risk of work-related accidents and car crashes, as well as irritability, mood swings, and sexual dysfunction.

While CPAP helps treat obstructed breathing, it can be uncomfortable to use. Adjusting to it can also be difficult for patients with allergies, a deviated septum or claustrophobia. Working as part of the team, dentists help build a cooperative model where oral appliance therapy (OAT) is used along with CPAP, behavioral therapy and other solutions.

For diagnosis and treatment of a sleep disorder, visit an experienced and qualified dentist specializing in dental sleep medicine, like Dr. Amruta Patel at All About Smiles. She and her team can help you get the restful night you deserve!


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