Diagnosis and Treatment of Sleep Apnoea
As a dentist I can not diagnose you with sleep apnoea for this you have to have a sleep study, however, I can spot and pick up a lot of the warning signs by examining your teeth, jaws, mouth and throat and by taking thorough health and sleep history.
Dentists are actually considered to be the best placed to detect the telltale signs of snoring and apnoea and to also treat them because we are able to provide prosthetic devices that position your jaw to create and maintain the most open airway while you sleep.
Treatments for Sleep Apnoea and Snoring
Treatment depends on the severity of your condition and we are usually looking to manage your condition rather than fully cure it, as we can’t fix the narrow airway or tissue collapses that cause the obstructions.
A common treatment that I use involves dental appliances that work on the premise that if you can control the position of your jaw or the posture of the tongue then you can control or improve the volume of air that enters your airway.
There are a vast array of oral devices on the market now and I would never recommend you buy an over the counter one size fits all device. The goal is to help you breathe at night and the device needs to be custom made and optimally positioned to give you the most benefit and results. Sticking a device in your mouth that is ill-fitting or has your jaw incorrectly positioned can and will cause more harm and can worsen you apnoeas by over 50%. Why because that appliance is taking up room in your mouth and cramping your tongue up worse than it was before so it now has even less room and this makes it even harder for you to breathe.
A custom made well-positioned device is like a tailor-made suit it is highly individualized to the specific needs of your body and what will give you the best results. Not all dental sleep appliances are the same as no two people are the same. These appliances are made to measure based on anatomical considerations and what is required to maximise the airway without stressing the TMJ and what will be best suited for comfort and wearability.
Other Treatment Options
Occasionally people need to have obstacles in their airways removed, like large boney growths in the mouth, polyps in the nose, enlarged tonsils or correction of narrow jaws via orthodontic expansion or treatment of a deviated septum to increase nasal airflow.
The main treatment for OSA is CPAP and or a dental appliance but as we are talking holistically one of the best ways to help yourself is modifying your lifestyle and this includes a fat management program. The goal is to reduce body fat percentage and lose weight. This will often see improvements that reduce or reverse sleep apnoea in a lot of people but there are the additional benefits of bringing blood sugars and triglycerides (fats) back to normal levels, and reducing inflammation.
Jaw Development, Teeth Crowding and Airways
So I would also like to talk about the airway and its importance in proper facial and jaw development in kids.
People with airway issues in childhood are at high risk of becoming adults with sleep apnoea. Without proper care, these children will grow up with not only airway disturbance but with systemic problems as well.
To compensate for a compromised airway as children we make postural and breathing adaptations in an attempt to draw in more air and these adaptations get made worse with age.
Many of these children have recurrent tonsil problems, ear infections, allergies, hay fever, asthma plus a retruded or small lower jaw. To compensate and get enough air these children will develop a head forward posture to open the airway and will often also mouth breathe. The head forward posture places enormous pressure on the cervical spine in the neck and leads to problems with lower back pain and hip and knee issues, even flat feet.
The mouth open and head forward posture mean the tongue sits too low and the shape of the jaws become altered, as they do not grow properly or fully. If addressed early these issues can be corrected as the child grows to avoid orthopedic and airway issues later in life, this is done by providing airway orthodontics to improve the head and neck posture, airway and hence breathing and facial development. The most common problem is undeveloped jaws, both upper and lower, this will be seen as crowding in the baby teeth and new adult teeth as they erupt.
Why Removing Teeth To Fix Crowding Is NOT The Answer
Traditionally the answer to crowded teeth was for the dentist to remove teeth which is the worst thing possible as it makes the jaws even smaller, the answer is to grow the jaw in width length and height to accommodate the teeth. Orthopedic appliances can help develop the size and jaw to a much more ideal shape. This may take time but gives a much better end result and is easier to do while the bones are still soft and growing rather than waiting until the teeth all come in or trying to attend to it later in life. Essentially the jaw needs to be enlarged so the teeth fit and bite correctly and the tongue and airway are not compromised.
Having an efficient and open airway goes a long way to supporting your oral health and overall health and wellbeing so if you are experiencing tiredness, short term memory issues, get regular headaches especially on waking, a sore throat or dry mouth on a morning, wake frequently at night, urinate frequently at night, you do not feel rested or refreshed when you get up or you snore or have been told you struggle for breath when you sleep I strongly urge you to get your airway and sleep breathing assessed.
If you suspect you or your loved ones could be suffering from sleep apnoea or sleep disordered breathing call us to find out how we can help 07 3720 1811.