You wouldn’t expect a dental practitioner to be concerned about sleep quality, but many issues related to interrupted sleep have to do with the mouth, tongue, jaw, palate, and the soft tissues in the throat. It makes sense that a dental sleep medicine doctor would integrate well with a patient’s general medical health practitioner in identifying and treating sleep-related breathing issues to improve their patients’ sleep quality and general health.
What is Dental Sleep Medicine?
According to the American Academy of Dental Sleep Medicine,
Dental Sleep Medicine is the discipline concerned with the study of the oral and maxillofacial causes and consequences of sleep-related problems: [o]rofacial pain; oral moistening disorders (oral dryness, hypersalivation); gastroesophageal reflux disorder; sleep-related breathing disorders (snoring, obstructive sleep apnea); and mandibular movement disorders (dyskinesia, dystonia, sleep bruxism).1
Dental sleep medicine doctors focus on managing sleep-related breathing disorders that include snoring and obstructive sleep apnea. By working with a patient’s physician, dental sleep medicine doctors can help their patients improve their quality of sleep using customized oral appliance therapy.
What are Sleep-Related Breathing Disorders?
Sleep-related breathing disorders are interruptions of the body’s natural breathing during sleep. There are varying degrees of airway obstruction, and different approaches to treatment depending on the level of severity. The most common sleep-related breathing disorders are snoring and obstructive sleep apnea.
It’s estimated that 50% of the population snore regularly while they sleep, which could be an indicator of obstructed breathing. Up to 12% of people suffer from obstructive sleep apnea (OSA): repeated interruptions of their nighttime breathing caused by a full collapse of the upper airway that prevents the body from getting the air it needs. OSA causes oxygen desaturation, repeated night waking, gasping for air, and making it difficult to get adequate rest. People with sleep-related breathing disorders can suffer from cognitive issues, cardiovascular disease, high blood pressure, and other health issues caused by lack of quality sleep.2
Can My Regular Dentist Help With Dental Sleep Medicine?
A traditional dentist has an important role in screening for sleep-related breathing disorders or bringing signs of potential apnea to your attention during a routine appointment, but a dental sleep medicine doctor has additional specialized training needed for oral appliance therapy.
The American Academy of Dental Sleep Medicine states that:
Dentists should screen for SDB/OSA; however, only dentists with good knowledge of dental sleep medicine or dentists who regularly update their knowledge and training in dental sleep medicine should be part of the multidisciplinary team to treat patients with SDB/OSA. It is important to know that there are more causes that affect sleep other than SDB that the dentist should be aware of.3
What does a Dental Sleep Medicine Doctor Do?
Dental sleep medicine doctors are represented by the American Academy of Dental Sleep Medicine (AADSM), a non-profit national professional society founded in 1991 to “lead and promote dentistry’s role in collaboration with our physician colleagues in reducing the burden of snoring and sleep apnea.”4
After the sleep study, if a diagnosis of obstructive sleep apnea is made, the patient’s physician will prescribe oral appliance therapy and refer to a dental sleep medicine doctor for analysis and construction of an appropriate oral appliance.
To create an oral appliance, a dental sleep medicine doctor makes a cast of the patient’s mouth. Then they create a custom appliance that is worn at night to reposition the lower jaw during sleep. When the jaw is moved slightly forward, it keeps the upper airway from collapsing, allowing for uninterrupted breathing.
Oral appliance therapy is an excellent treatment option for patients who cannot tolerate or have trouble consistently using a CPAP machine to treat their obstructive sleep apnea.
The American Academy of Dental Sleep Medicine states that,
A properly fitted oral appliance worn nightly will decrease the frequency and/or duration of apneas, hypopneas, respiratory effort-related arousals (RERAs), and/or snoring events. Oral appliances have been demonstrated to improve nocturnal oxygenation as well as the adverse health and social consequences of OSA and snoring. Oral appliances are indicated for patients with mild to moderate OSA and primary snoring. Oral appliances are accepted therapy for patients with severe OSA who do not respond to or are unable or unwilling to tolerate positive airway pressure (PAP) therapies. Although oral appliances are typically used as a stand-alone therapy, with some patients they may be prescribed as an adjunct to PAP therapy and/or other treatment modalities for the management of OSA.5
Patients who are using oral appliance therapy should have follow-up exams every six months for the first year, and at least once per year after that. Dental sleep medicine doctors will check for changes and improvements of any apnea symptoms, to see if there are any changes to the structure of the jaw or the position of teeth, and to make sure that the oral appliance is still in good condition.
They will also work with their patients to be sure that their oral appliances still fit well, and that it’s being used regularly. It may need occasional calibration or, in some cases, a new one made to accommodate any changes needed to be sure that the oral appliance allows the patient to have adequate air intake while sleeping and get the quality, restorative sleep that their body needs.6
Dental Sleep Medicine at Amber Dental in Wheaton
Dr. Michael Koehne, Diplomate of the American Academy of Dental Sleep Medicine, incorporates dental sleep medicine into his practice at Amber Dental as part of his whole-health approach to patient care. In addition to maintaining bright smiles and healthy mouths, he works in tandem with his patients’ physicians to provide dental sleep medicine to support their sleep quality and overall health. Contact the team at Amber Dental for an appointment to see if you can benefit from an oral appliance for sleep apnea.