Sleep apnea is a sleep disorder that affects millions of people around the world. It is characterized by repetitive pauses in breathing during sleep, which can last from a few seconds to several minutes. These pauses in breathing can lead to disrupted sleep, reduced oxygen flow to the brain, and numerous health problems, including high blood pressure, heart disease, stroke, and depression. It affects approximately 25 million American adults, and about 80% of sufferers are undiagnosed. While the connection between oral care and sleep apnea is not yet well understood, your dentist can play a critical role in diagnosing and treating sleep apnea. A well-trained dentist can evaluate the airway and jaw position to determine if any physical factors contribute to the condition. Dentists can also help patients diagnosed with sleep apnea by providing custom-made oral appliances to help keep the airway open and prevent these frequent pauses in breathing.
Sleep apnea is a significant sleep disorder that results in the temporary cessation of breathing during sleep. The condition is diagnosed when breathing is interrupted for ten seconds or more. The resulting breathing pauses can occur dozens or even hundreds of times throughout the night, preventing individuals from entering a deep, restful sleep cycle. Although people with sleep apnea may be unaware of these events, they often experience exhaustion or drowsiness the following day.
Sleep apnea symptoms include:
- Daytime fatigue
- Experiencing a dry mouth or sore throat upon awakening
- Morning headache
- Difficulty concentrating and forgetfulness
- Changes in mood
- High blood pressure
- Decreased sex drive or libido
- Waking abruptly, gasping or choking
What causes sleep apnea?
The actual causes of sleep apnea will vary from patient to patient. Men are much more likely to be affected by sleep apnea than women, and it most often occurs in people over 40.
Sleep apnea risk factors include:
- Nasal obstructions or sinus problems
- Enlarged tonsils
- Large tongue or large neck
- Small jawbone
- Family history of sleep apnea
Sleep apnea comes in three forms: obstructive sleep apnea, central sleep apnea, or complex sleep apnea.
Obstructive Sleep Apnea (OSA) is the most common form of sleep apnea. OSA accounts for over 80% of cases in the United States. OSA occurs when the muscles that support the soft tissues in your throat, such as the tongue and soft palate, relax too much, narrowing your airway. The causes of OSA can range from sinus and allergy issues to obesity.
Central Sleep Apnea: Central sleep apnea is a neurologic issue in which the brain fails to activate respiratory muscles during sleep. Central sleep apnea is typically associated with a neurological disorder like a stroke or Parkinson’s disease.
Complex Sleep Apnea: A combination of central and obstructive sleep apnea. This type of sleep apnea means breathing problems persist even after airway obstruction is treated.
Sleep Apnea and Oral Health
A dentist is often the first medical provider to notice and diagnose sleep apnea. A variety of factors can cause sleep apnea’s most common symptoms. Below are a few signs your dentist can use to diagnose sleep apnea:
Bruxism (Teeth Grinding)
Teeth grinding during sleep can result in headaches, neck, and jaw pain. Recent studies indicate that about 13% of adults grind their teeth while sleeping, with over 80% of them being unaware of the habit. Dr. Marielaina Perrone can detect teeth grinding through the visible wear on the teeth.
Bruxism, or teeth grinding, may be a natural defensive response to obstructive sleep apnea. Studies suggest that when the airway becomes obstructed during sleep, the jaw reflexively closes to prevent blockage. Bruxism and OSA may be related to specific sleep positions. Mandibular advancement devices, customized mouthguards, can help alleviate both bruxism and OSA.
Temporomandibular Joint (TMJ) Disorders
Obstructive sleep apnea is often linked to temporomandibular joint (TMJ) disorders. The TMJ connects the upper and lower jaw with two joints. When the joint or surrounding muscles become misaligned or damaged, patients can experience neck stiffness, headaches, ear pain, and clicking or popping noises when the jaw moves.
Although the precise connection between TMJ disorders and sleep apnea is not yet fully understood, both conditions involve dysfunction in the muscles surrounding and within the mouth. Some studies have revealed that individuals with sleep apnea are twice as likely to develop TMJ disorders compared to those without sleep apnea.
Sleep apnea patients often breathe through their mouth at night due to narrow nasal airways that are more susceptible to obstruction. Breathing through the mouth for extended periods can cause dryness, which can contribute to the development of plaque, gingivitis, and advanced periodontal disease.
Saliva naturally washes away bacteria and debris from the surface of the teeth, which is why dry mouth can be harmful to oral health. Although gingivitis and tooth decay alone are not conclusive indicators of sleep apnea, when considered along with other factors, they can suggest a potential sleep apnea diagnosis.
How Can Your Dentist Help With A Sleep Apnea Dental Appliance?
An official sleep apnea diagnosis is needed and must come from a medical doctor with the possibility of a visit to a sleep center. A dentist can fabricate a sleep apnea dental appliance used to reposition the tongue and lower jaw forward during sleep to maintain the open airway. Usually, a sleep apnea dental appliance is recommended for mild to moderate obstructive sleep apnea patients.
A sleep apnea dental appliance can also be utilized in severe obstructive sleep apnea patients who cannot tolerate using a CPAP machine. The standard medical treatment right now is using a CPAP (called Continuous Positive Airway Pressure). Approximately 25%-50% of sleep apnea patients do not regularly use or tolerate CPAP machines.
Some recent clinical studies have shown that a sleep apnea dental appliance is the most effective in treating snoring and mild to moderate obstructive sleep apnea.
Types Of Sleep Apnea Dental Appliance
Mandibular advancement device (also called MAD).
This is the most popular sleep apnea dental appliance prescribed for obstructive sleep apnea patients. This sleep apnea dental device is very similar in appearance to an athletic mouthguard. A hinge between the upper and lower part of the sleep apnea dental appliance allows the lower jaw to be eased forward.
The Thornton Adjustable Positioner (TAP) is a sleep apnea dental appliance that allows further adjustments than most. This TAP sleep apnea dental appliance controls the degree of lower jaw advancement for even more comfort and control of obstructive sleep apnea.
Tongue Retaining Device (TRD).
More popular than the sleep apnea dental appliance above.
This device works by holding the tongue in place, keeping the airway open. Ask your dentist which sleeps apnea dental appliance is right for your particular case of obstructive sleep apnea.
Sleep Apnea Dental Appliance Conclusion
The optimal treatment plan for obstructive sleep apnea is determined by several factors, such as the severity of the condition, the physical structure of the upper airway, any other medical conditions, and patient preferences. Choosing the right dental appliance for sleep apnea is a highly individualized decision that should be made in consultation with Dr. Perrone.
Speak to Dr. Marielaina Perrone about which sleep apnea dental appliance is right for you. There are proven scientific links between a lack of a good night’s sleep and many problematic symptoms, including depression, memory loss, hypertension, and weight gain. With the help of your dentist and a sleep apnea dental appliance, you can improve your sleep and overall health!
Dr. Marielaina Perrone is a highly respected and experienced dentist in Henderson, Nevada, with over two decades of expertise in providing quality dental care to her patients. She graduated from Stony Brook University School Of Dental Medicine and has completed advanced training in cosmetic dentistry, implant dentistry, and orthodontics.
Dr. Perrone is committed to staying up-to-date with the latest advancements in dentistry and continuing education to provide the best possible care for her patients.
Dr. Perrone takes a patient-centered approach and believes in personalized treatment plans tailored to each individual’s unique needs and preferences. Her gentle and compassionate demeanor creates a comfortable and relaxed atmosphere for patients during their dental appointments.
Aside from dentistry, Dr. Perrone enjoys spending time with her family, traveling, and cooking. She also volunteers her time and expertise to various charitable organizations in her community.