Dental Sleep Medicine

The quality of your sleep affects everything.

Sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety.

The way you feel while you’re awake depends in part on what happens while you’re sleeping. During sleep, your body is working to support healthy brain function and maintain your physical health. In children and teens, sleep also helps support growth and development.

The damage from sleep deficiency can occur in an instant (such as a car crash), or it can harm you over time. For example, ongoing sleep deficiency can raise your risk for some chronic health problems. It also can affect how well you think, react, work, learn, and get along with others.

A better night’s sleep may start with a trip to your dentist

Dentistry can have a huge effect on health and quality of life by screening for risk factors or conditions that may impact your sleep quality, like sleep apnea or TMJ.  We will then refer you to a sleep specialist to diagnose, and  if a positive diagnosis for sleep apnea is found, we work with physicians to offer therapy options to our patients, like oral appliances (mouth guards).

The American Academy of Sleep Medicine recommends oral appliances as a first line therapy for the treatment for mild to moderate obstructive sleep apnea and for patients with severe sleep apnea whose CPAP treatment has failed or is intolerable.

What types of treatments seem most effective for patients with sleep issues?

If a patient is high risk, but does not currently have sleep apnea, we counsel them on their risk factors and offer suggestions on how to reduce their risk, protect their teeth, and remain healthy.  It’s important for high risk patients to understand that they need to continually monitor their sleep quality and seek additional testing in the future if their symptoms worsen with age or weight gain.

There are multiple modalities for treating Downtown Dental patients with diagnosed sleep issues, but one of the most effective options is oral appliance therapy. Patients often prefer the more user-friendly option of an oral device because of the ease of use, portability, and the fact that it requires no surgical intervention. Mouth devices (like night guards) advance and support the lower jaw to allow proper oxygen flow, joint decompression, and muscle relaxation. We use a device called the MicrO2.

What is MicrO2?

MicrO2 is an easy-to-use and comfortable device that safely alleviates snoring and symptoms of Obstructive Sleep Apnea. If a patient has been diagnosed with Obstructive Sleep Apnea or snores, the MicrO2 lower jaw advancement device will assist him/her in waking with a better sense of rest and provide the energy needed to enjoy the day.

The MicrO2 is designed to be the smallest and most comfortable custom-made jaw advancement device available. It is intended to offer the most tongue space, as well as the ability to open and close during wear. The MicrO2 device holds the lower jaw in a slightly forward position, thus gently moving the throat tissues away from the back of the throat. This opens the way for airflow and helps reduce snoring and Obstructive Sleep Apnea.

Only a trained sleep dentist can provide MicrO2. Specially trained dentists like Dr. Clark play a key role in screening for Obstructive Sleep Apnea. Then, partnering with medical doctors, the MicrO2 is provided to treat those suffering from Obstructive Sleep Apnea as well as individuals needing an alternative therapy to CPAP.

Devices like the MicrO2 work by pushing the lower jaw and tongue slightly forward, which helps prevent throat muscles and issues (such as the pharynx) from collapsing back into the airways allowing for normal breathing during sleep. Dental sleep apnea devices are adjustable, allowing your dentist to fine-tune the position of the jaw for maximum effectiveness.

Oral appliances used to treat sleep apnea look very similar to night guards used to treat joint and muscle dysfunction, that’s because they are!  The difference between using the Micro2 device to treat TMJ and muscle discomfort and to treat apnea is in the positioning of the jaw and titration of the device.  Both devices fit into the mouth by snapping over the upper and lower dental arches and use wings to softly support your jaw in a position that maximizes airflow while decompressing the jaw joint and minimizing muscle activity and discomfort.

Pros of Dental devices

  • Many patients find dental devices to be more comfortable and tolerable to wear as opposed to CPAP masks.
  • Patients on CPAP often complain of dry, itchy noses from the air pressure drying out their sinuses. Oral devices do not have this problem.
  • Patients who use CPAP often clinch and grind their teeth and require the use of a night guard to protect tooth enamel from wearing away.  MAD does both of these things at once!
  • Patients who suffer from sleep apnea may also be suffering from joint dysfunction and/or muscle discomfort.  Only a MAD can treat both of these conditions simultaneously
  • There is less equipment to become entangled with during sleep, or knock off during slumber, for patients who are active movers during sleep.
  • There is a lot less equipment involved, and therefore easier to travel with.

Cons of Dental devices

  • For patients with severe craniofacial development problems or those treating severe apnea with a MAD due to CPAP intolerance, temporary joint discomfort may be experienced as the device is titrated forward
  • Temporary sore teeth and/or gums
  • Excessive salivation or dry mouth
  • Possible damage or permanent change to jaw position/bite if doctor recommendations are not followed specifically
  • Loosening of compromised dental restorations (crowns, bridges, etc)

Who may qualify for dental appliances?

  • Patients with mild to moderate sleep apnea
  • Patients with primary snoring (in absence of sleep apnea)
  • Patients who have tried and failed with CPAP therapy
  • Patients who were unsuccessful with or refused surgeries such as tonsillectomy, adenoidectomy, craniofacial operations, or tracheostomy
  • Patients who successfully use CPAP therapy but would like to reduce the air pressure settings to reduce negative side effects such as gastrointestinal discomfort or claustrophobia