Tag Archives: Oral Appliance Therapy
Sleep apnea affects more than 18 million American adults, and at least 200,000 more are being diagnosed with it every year, according to the American Sleep Apnea Association.
Concerning as those numbers are, they’re probably on the conservative side because it’s suspected that the vast majority of sleep apnea cases go undiagnosed and, therefore, untreated.
Without treatment, sleep apnea can lead to persistent headaches, memory problems, weight gain, diabetes, impotence, high blood pressure, and heart disease.
Got your attention now?
This post isn’t meant to scare you. Instead, I want to show you how sleep apnea is diagnosed and treated so that if you’re waking every morning feeling exhausted and maybe with a raw throat, you’ll be more inclined to ask a doctor—or, yes, a periodontist—about it.
What is sleep apnea, exactly?
There are three kinds of sleep apnea: obstructive, central, and mixed. Obstructive is most the most common. It’s caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses and closes during sleep.
Regardless of the cause, with all three, you stop breathing repeatedly during sleep, sometimes as often as hundreds of times during the course of the night and usually for a minute or longer.
Sounds like kind of thing you’d notice if it was happening to you, right? Actually, in most cases, the sleeper isn’t aware because those long pauses and the disruptions that follow, surprisingly, aren’t enough to stir them completely awake. The brain rouses them, but only partially, to start breathing again. So, the sleep is usually very fragmented and unsatisfying.
These are a few indications you may have sleep apnea:
- You’re overweight
- You’re tired all the time
- You wake out of breath and in a panic during the night
- You wake in the morning with a dry mouth and a headache
- You snore—really loudly
It’s rare that someone would have all of these symptoms, but the snoring’s a big one. If you’ve been doing it for so long you’ve kind of gotten used to it, bring it up to your partner. They’ll tell you just how bad it is and if it’s getting worse.
So, how can a periodontist help?
You may be starting to wonder, Isn’t this the kind of thing my family doctor or some sort of specialist would handle? Yes, but periodontists are often the first to diagnose sleep disorders.
The first sign of sleep apnea is usually teeth grinding, or bruxism. It can cause excessive tooth wear and even breakage, along with inflamed and receding gums. You may also begin developing cavities because the damage to your teeth makes them more susceptible to cavity-causing bacteria.
Before your brain sends a signal to start breathing again, it’s typically tipped off by a tensing jaw and grinding teeth.
Beyond looking for worn tooth surfaces, a periodontist will also keep an eye out for a tongue with scalloped edges, a small jaw, and redness in the throat (caused by snoring a lot), all of which are potential signs of sleep apnea. If you’re already being treated for periodontal disease, or suspect that you may have it, it’s worth asking a periodontist if it may be a sign of a bigger problem. Excessive tooth decay could stem from grinding and undiagnosed sleep apnea.
If your periodontist thinks you could have sleep apnea, they may recommend a sleep study, which is usually conducted in a sleep lab, though home studies are becoming increasingly popular. An accredited periodontist is well-versed in the symptoms of and treatments for sleep apnea, but only a medical doctor can make an official diagnosis.
Once you are diagnosed, a periodontist can offer simple, effective treatment options. Oral appliance therapy is considered the first line of treatment for mild to moderate obstructive sleep apnea. It’s also recommended for those with more severe cases who aren’t able to tolerate or wear the CRAP devices.
There are over 100 different oral appliances that are FDA-approved for the treatment of obstructive sleep apnea. (Anything that can be purchased over-the-counter or online is not FDA-approved.) They’re worn in the mouth, like a sports mouth guard or an orthodontic appliance, while you sleep. Basically, they hold the lower jaw forward just enough to keep the airway open and prevent the tongue and muscles in the upper airway from getting in the way.
Despite how it sounds, the appliances are actually fairly comfortable because they’re custom-designed. It may take a few nights to get used to it, but once you do, you should doze off without a second thought.
Oral appliance therapy is covered by your medical insurance, not your dental insurance. Medicare reimburses for oral appliances under the durable medical equipment benefit.
This way to a better night’s sleep
If you think you may be suffering from sleep apnea, or even if you’re unsure, contact my office and schedule an appointment. I’ll conduct a Comprehensive Periodontal Evaluation. A better night’s sleep awaits.