Do you snore? Do you wake up tired in the morning? Have trouble concentrating? Suffer from headaches or gastroesophageal reflux? Are you overweight, middle aged, menopausal? Do you have Polycystic Ovarian Syndrome (PCOS)? Are you pregnant? Do you have Cardiovascular Disease or high blood pressure?
If you answered yes to any of the above questions, you could suffer from Sleep Disordered Breathing (SDB). SDB is caused by an obstruction in the oral and/or nasal airway that occurs during sleep. The airway loses its patency, or muscle tone, and the soft tissue collapses in on itself, making it exceedingly difficult to breathe in enough oxygen and exhale carbon dioxide effectively. Snoring is not just an annoyance—it’s the first sign of a sleep disordered breathing problem; the sound heard is the soft tissue vibrating against itself as it relaxes when the snorer falls asleep. Upper Airway Resistance Syndrome (UARS) is more severe than snoring, and is accompanied by conditions including asthma, depression, and gastroesophageal reflux. Obstructive Sleep Apnea is marked by the complete collapse of the airway, sometimes hundreds of times a night. It can be fatal.
Sleep Disordered Breathing is now identified and treated within a new field called Sleep Disorders Dentistry, airway assessment and Oral Appliance Therapy.
Because the airway is the primary location associated with sleep disordered breathing, it is the first place a dentist should look when trying to determine the existence of a problem. Examining the airway is crucial, and is accomplished through a routine dental examination that incorporates an assessment of the patient’s airway as well as the use of x-rays and imaging technology, which can vary from dentist to dentist.
Further, airway assessment is important for the dentist to perform when fitting a patient for an oral appliance. After the appliance is created in the lab, a dentist will titrate it, which means the appliance is slightly modified according to the patient’s specific bone and teeth structure. Guessing at oral appliance placement and positioning in the mouth can lead to over-titration, insufficient titration, and is even thought to possibly cause sleep disordered breathing.
Every patient has a different airway and requires specific titration. There is no “magic appliance” that works for everyone, and airway assessment is very, very important.