Oftentimes, I recommend a referral to a dentist to treat obstructive sleep apnea. Most patients will ask me, “How is a dentist going to help me?” My answer is that since obstructive sleep apnea is mainly a problem from small jaws and crooked teeth, they have a variety of different ways of helping you to breathe better and sleep better.
I just came back from presenting at an Airway Dentistry conference in Laguna Hills, CA. It was definitely one of the most exciting and rewarding conferences I have ever attended. All the speakers and the attendees are at the forefront of not only potentially better treatment, but also better prevention of obstructive sleep apnea.
The most common way dentists can treat obstructive sleep apnea is by making a retainer-like appliance that pulls your lower jaw forward. Since the muscle that attaches the base of your tongue connects to the lower jaw, moving the jaw forward will pull the tongue forward. This option works well for most people and is usually better tolerated than CPAP. However, because it’s a device that sits in your mouth, protruding your lower jaw, it can sometimes cause problems like profuse salivation, jaw pain and shifting teeth. It uses the upper teeth as a lever to pull the lower teeth forward, so the upper teeth can shift back to various degrees. Fortunately, this is unusual, and can be adjusted for by your dentist. In many cases, people don’t mind because sleep is so much improved.
Now there are a newer generations of dental appliances that work not by pulling forward your lower jaw, but by expanding your jaw wider and more forward, all without surgery. Granted, it can take much more time, similar to braces. However, it’s different from braces in that rather just straightening teeth, the entire jaw structure is significantly expanded, opening up the airway.
The downside to these newer options is that because they are so new, not too many dentists know about it, and it’s not generally covered by insurance. It’s also important to remember that there hasn’t been large-scale studies on obstructive sleep apnea treatment effectiveness. Hopefully, studies will be forthcoming. Currently, most dental appliances that are FDA approved for obstructive sleep apnea are the advancement devices.
Up to date dentists are also incorporating orofacial myologists who train your tongue and throat muscles properly. Since your tongue is your most important orthodontic appliance, how it’s used (along with the lips and throat muscle) can have a profound effect on the eventual size of your jaws and your upper airway.
I challenge everyone reading this post to find out how much they know your dentist knows about obstructive sleep apnea. Does he or she appreciate how important the teeth are in relation to your upper airway? Does your orthodontist still remove teeth before applying braces for your child? If not, at the risk of possibly offending your dentist, please direct them to the American Academy of Physiologic Medicine and Dentistry, and the American Academy of Dental Sleep Medicine.
What has your experience been with your dentist? How well are they versed in the importance of the airway?