How dentistry helps
Sleep disorders and sleep deprivation can affect your health and quality of life. It can cause poor work performance, put you at risk for accidents, and affect your mood.
When you are sleeping, your body recovers from daily stress. However, oxygen deprivation and brain arousals, during sleep, prevent your body from recovering. The only way to find out if you have sleep apnea or a sleep disorder is to undergo a sleep test. If your physician or dentist suspects you have a sleep disorder, he or she will refer you to a sleep clinic and have you tested under the supervision of a sleep specialist.
Common Sleep Breathing Disorders
A mild form of airway obstruction that likely has no impact on overall health other than possibly disturbing one’s partner’s sleep.
Upper Airway Resistance Syndrome (UARS)
Increased breathing effort needed to get past the resistance in the upper airway. Due to the need for increased respiratory effort, the brain has to arouse itself from deeper stages of sleep. This interrupts the proper sleep cycle and interferes with the brain’s efforts to repair and restore itself. UARS can lead to Obstructive Sleep Apnea if remains unmanaged.
Involves apneas (pause in breathing) and hypopneas (reduction in breathing), where breathing repeatedly stops for 10 seconds or more and O2 saturation drops by 3% or more.
- Central: is where the brain doesn’t send proper signals to the muscles that control your breathing during sleep
- Obstructive: involves an obstruction in the upper airway that prevents one to take a breath during sleep
- Mixed: both central and obstructive apneas are involved
What Causes Sleep Breathing Disorders?
- Gender (more common in men)
- Family history
- Excess weight
- Large neck circumference
- Alcohol and sedative use
- Narrowed airways
- Limited tongue space
- Poor tongue function
- Retruded jaw position
- Enlarged tonsils and adenoids
- Nasal congestion/obstruction
- Deviated septum
- Enlarged nasal turbinates
What are the risks?
We can affect life-style and developmental factors because they cause lack of space in your airway. For example, losing weight or correcting a deviated septum can improve the physical space in your airway.
There are two types of sleep apnea, Obstructive Sleep Apnea (OSA) and Upper Airway Resistance Syndrome (UARS). Both are dangerous conditions that can shorten your life and predispose you to chronic conditions affecting quality of life. Some of the potential risks include:
- High blood pressure (hypertension)
- Risk of heart attack
- Risk of stroke
How can sleep dentistry help?
Often, one of the first signs of sleep disordered breathing is toothgrinding and dentists can detect this by assessing the wear of your teeth. Grinding can speed up wear and tear of your teeth, jaw muscles and joints. While tooth grinding may be the first sign, it isn’t the only sign of OSA you may have related to your oral health. Part of our semi-annual exam, we assess for certain dental signs of sleep disordered breathing, such as:
- Under-developed upper and lower jaws
- Tooth crowding
- Poor tongue tone and posture
- Restricted airways in the throat
- Enlarged tonsils
- Scalloped edges around your tongue
We also use questionnaires that help us determine level of daytime fatigue, snoring and your overall quality of sleep.
What are the treatment options?
There are two approaches to the treatment of sleep apnea. The first involves reducing the obstruction itself. The second is to by-pass the existing obstruction. Common therapies include:
Reducing the obstruction
- Life-style changes
- weight loss (exercise/diet)
- smoking cessation
- limiting alcohol use
- Myofunctional Therapy
- Dental Orthopedics and Orthodontics
- Laser therapy
By-passing the obstruction
- CPAP (considered the Gold Standard to OSA management today)
- Oral Appliances maintaining forward jaw position
- Positional therapy – sleeping propped up on the pillow; or sleeping on the side