The Role of the Dentist in the Treatment of Sleep Apnea

Lack of air, constant tiredness, neuro-psychiatric problems, migraines, cerebro-vascular alterations, frequent headaches, drowsiness, fatigue, high blood pressure, exhaustion, interruption of night rest, heaviness … And all this added to the rumors give rise to the appearance of Sleep Apnea or sleeping sickness. The role of the dentist is becoming increasingly important in the process of detection and treatment of this sleep disorder.

Obstructive Sleep Apnea Syndrome

How does Obstructive Sleep Apnea work?

Obstructive Sleep Apnea Syndrome (OSAS) affects breathing during sleep which is interrupted negatively impacting the quality of rest and producing continuous micro-awakenings. The duration of these pauses can vary from a few seconds to several minutes and may involve total pauses or sometimes simply breathing that becomes slower and shallower. The periods of air interruption can be longer than ten seconds and can last up to two minutes. The suffocation that it produces awakens the individual, in a process that can be repeated between 300 and 400 times in the same night.

It is estimated to be more than two million people that there are in Spain suffering from sleep apnea are snoring. However, the biggest problem is that most patients who suffer from this problem are usually not diagnosed. Another problem is the high demand and the low supply (in addition to the lack of information) of Sleep Units in the hospital dependencies for the performance of sleep tests.

Although there are several treatments that are prescribed for the treatment of sleep apnea, depending on their severity, not all are adapted to the needs of patients and some do not tolerate certain solutions.

What solution does OrthoApnea propose?

Patients with mild or moderate apnea have the option to carry out a treatment with Mandibular Advancement Devices (MAD) to treat their respiratory distress during rest. These devices arise from an interdisciplinary work between professionals specialized in Oral Sleep Medicine and professionals of Dentistry. DAMs , like  OrthoApnea , consist of splints made of a plastic material and made to fit the patient’s arch. Its function is simply to maintain an opening during the rest of the upper airway avoiding snoring and apnea.

American Sleep Disorders Association

The American Sleep Disorders Association (ASDA) defines DAMs as devices that are inserted into the mouth and modify the position of the jaw, tongue and other supporting structures of the VAS (upper airway) for the treatment of snoring and / or SAHS. This prestigious association considers them as a valid alternative of first choice for   simple snorers, and as a second choice in patients who do not respond or reject positive pressure devices (CPAP), patients with high surgical risk and poor response to surgical treatment.

This chronic disease must be treated and can occur in adults but also in children. Failure to carry out proper treatment, this disease can influence the quality of life of those who suffer from it and can be potentially dangerous. Untreated sleep apnea increases the risk of heart problems, heart attacks, arrhythmias, stroke, and even obesity … and without talking about parallel consequences such as driving accidents, working with industrial machinery or competing in sports activities, example.

And what is the role of the dentist in the treatment of sleep apnea with AMD?

According to institutions such as Athenea Dental Institute – School of Dentistry of Barcelona, around 40% of patients who enter the dentist’s office suffer from sleep apnea, but a high percentage of them have not been correctly diagnosed. Being sleep apnea one of the most frequent sleep disorders that exist along with insomnia, hypersomnia, narcolepsy or sleepwalking, and understanding that the patient who goes to a dental clinic may suffer from it, the dentist must be prepared and trained to face the doubts of his patients with apnea and snoring.

Treatment of Sleep Apnea with AMD

Although it is ultimately the sleep specialist who must determine the presence or absence of sleep apnea and prescribe the correct treatment, the dentist acts in the task of diagnosis, recognition and application of intraoral devices. His knowledge in dental planning of the treatment of orthodontic cases, the interrelation between the different orthodontic treatments and the OSAS, are essential for a correct development of the treatment with MAD.

These devices are designed and manufactured to fit the arcade of each patient and it is the dentists and sleep specialists who, through multidisciplinary work, will perform periodic supervision.

In the case of children, some schools of dentists  recommend that parents take their children, from an early age, to periodic check-ups with their usual professional, since orthopedic-orthodontic treatments are key in the prevention of children with abnormalities of the Maxillary and / or mandibular growth. In this sense, the dentist not only aims to provide good placement of the minor’s teeth but, in addition to providing the small patient with a facial skeletal pattern, which is less prone to closure of the upper airway (VAS).