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Academy of Periodontology
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of Anesthesiology
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Enhanced Dentistry
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Articles
John C. Chao, D.D.S., F.A.G.D
Anxiety Management,
Behavior Science,
Faculty, USC School of Dentistry
Snoring Treatable By Dental Device
A physician, Dr. Smith (not his real name), mentioned at his dental visit that he snores heavily and that recently his condition has been diagnosed as obstructive sleep apnea. Dr. Smith said that he had read that a certain kind of dental device can treat this condition and wanted to know whether he is a suitable candidate.
Sleep apnea occurs where there are episodes of cessation of breathing lasting 10 seconds or longer during sleep. The failure to breath triggers the brain to awaken briefly in order to reinitiate the breathing process. These arousals are so brief that they generally go unremembered. But the results of these frequent interruptions are daytime sleepiness, which may lead to disruption of work and social life. Difficulties with concentration, memory are some of the other symptoms. Severe sleep apnea may lead to high blood pressure, heart failure, heart attack and stroke.
Sleep apnea is estimated to affect about of 10% men between the ages of 30 to 50, but also has been found in both sexes of all ages. The most frequent form of sleep apnea is obstructive sleep apnea, in which the cessation of breathing is most often caused by excessive relaxation of the muscles at the back of the throat.
Dr. Smith was aware that medical remedies include the use of continuous positive airway pressure (C- PAP) which involves the use of wearing a mask over the nose and mouth. Air from a compressor forces air through the mask to keep the airway open. Surgical procedures involve the excising of excess tissue at the back of the throat, such as enlarged tonsils and adenoids. However Dr. Smith cannot sleep with the C- PAP mask and does not want surgery. He was interested in the mandibular advancement appliance that has been used to treat obstructive sleep apnea.
This dental device consists of two retainer-like plastic covers. One fits over the upper teeth and the other over the lower teeth. These two retainers are joined together by "connectors" which maintain the lower jaw slightly more forward than normal. By advancing the lower jaw (mandible) forward, the diameter of the throat is increased. More importantly, even if the muscles at the back of throat relax, the throat is prevented from collapsing. This forward placement of the mandible can prevent the blocking of breathing found in obstructive sleep apnea.
A mandibular advancement device was made for Dr. Smith. A subsequent polysomnograph (sleep study) confirmed that while Dr. Smith was wearing the oral device, he had no apnea episodes. His "oxygen saturation rate" was back to normal and he felt great. The snoring has greatly diminished to where it is almost not noticeable to his wife. He has continued to wear this kind of appliances for the past four years.
If you or your spouse suffers from the snoring of the other, there is hope. Visit your dentist. If you also notice that he/she has apnea episodes where breathing stops for 10 seconds or more, please see your physician to rule out sleep apnea. If you have sleep apnea, be sure you follow your doctors' instructions as to how to deal with this condition. Ask your physician if a mandibular advancement device could be a consideration.
