Sleep Apnea: How Can a Dentist Help?

Obstructive sleep apnea is a condition that prevents proper airflow while one is sleeping. The tissue at the back of the throat will collapse during sleep, which causes a partial blockage of the trachea and hence reducing the amount of oxygen available for distribution to vital organs.

Patients present loud snoring, and may stop breathing for short periods of time - the body wakes itself up when oxygen levels fall critically low. This can happen many times a night without the patient's full knowledge, meaning that the patient doesn't enjoy restful sleep. This results in Daytime fatigue and sleepiness.

Other effects include irritability, headaches in the morning, memory loss, decreased libido, impaired concentration and depression. In addition, patients are at a higher risk for suffering heart problems and strokes and are more susceptible to accidents in the workplace or on the road due to impaired concentration.

Diagnosing Sleep Apnea

When a patient sets up an appointment with a sleep apnea dentist, the first step will be to keep a diary of one's sleeping patterns for two weeks or so. On the day of consultation, an initial interview will be conducted in order to help understand what type of sleep disordered breathing you may be suffering with. A polysomnogram test may need to be performed to examine the heartbeat, brainwaves, limb movements and breathing while the patient is asleep.

The dentist/sleep specialist will also be interested to know any underlying conditions that may interfere with one's sleeping patterns e.g. drugs and medication, sleep disorders, medical conditions, etc.

Treatment options

There are two main categories that sleep apnea treatments fall under:

1. Oral appliance therapy

2. Upper airway surgery

Oral appliance therapy (OAT)

The dentist will prescribe OAT where patients only present mild to moderate forms of sleep apnea. The first line of treatment is continuous positive airway pressure (CPAP) or fitting an oral appliance to prevent collapsing of the tongue. Behavioral changes are also suggested e.g. losing some weight and changing sleeping posture.

There are various designs for oral appliances, and the dentist will prescribe the most suitable one for your specific needs. In many cases, custom designed appliances will be used as they are more effective than standard OTC appliances. This will only be applied after a certified sleep physician has provided a diagnosis. Fitting of the appliance will be followed by weeks of on-going evaluation to determine efficacy.

Upper airway surgery

This is the last option considered where other less invasive treatments have been unhelpful or are intolerable to patients. There are many surgeries that can be performed, and they are specific to the site of maximum interference. The dentist along with an ENT will help you decide the surgery to be performed depending on the nature and location of obstruction.

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