Medication and Heart Disease

For those who have never consulted a dentist about treatments for sleep apnea and snoring, it may be time to make an appointment. Dental sleep medicine is a growing segment of dentistry that focuses on managing snoring and sleep apnea with oral appliance therapy (OAT) – an effective alternative to the standard continuous positive airway pressure (CPAP) machine and mask. According to the American Academy of Dental Sleep Medicine (AADSM), up to 50 percent of sleep apnea patients do not comply with or tolerate CPAP.

Oral appliance therapy (OAT) uses a “mouth guard-like” device worn only during sleep to maintain an open, unobstructed airway. OAT devices prevent the airway from collapsing by either holding the tongue or supporting the jaw in a forward position. For many, oral appliance devices are more comfortable to wear than a CPAP mask. The devices are also quiet, portable and easy to care for. Research suggests that oral appliance therapy often can equal CPAP in effectiveness and offers a higher patient compliance rate than CPAP. There are more than 80 different styles of oral appliance devices that have received FDA clearance.

 

The many faces of OSA are revealed by examining frequently associated conditions such as: high blood pressure (hypertension), heart failure, heart rhythm disturbances, Atherosclerotic heart disease, pulmonary hypertension, insulin resistance, and even death are some of the known complications of untreated obstructive sleep apnea. Cognitive impairment (memory problems), depression, anxiety, and gastro esophageal reflux disease (GERD) are also among possible complications of untreated sleep apnea. Dentists can treat the vast majority of patients with OSA and have the ability to screen for it, at a minimum, within our patient population. The most commonly quoted statistics on OSA are summarized below.

1/3 of population suffers from some sleep disorders (20M OSA 10M PLMD, 20M Insomnia)

Snoring prevalence 67% general population. NSF 2005 (habitual snorers 35% Parati)

94% of OSA population snores, 6% are silent apneics
Wisconsin Study 1938: 17-20% of general population have some OSA (AHI>5)

Sleep Heart Health Study: 22% have OSA (Smoking gun intermittent Hypoxia)

Young in 1993, Wisconsin Study : AHI>5 w/o EDS (excessive daytime sleepiness), 9% females, 24% males
Metabolic Syndrome effects 24% of general population

Weight loss of 10% can decrease AHI (apnea-hyponea index) 30-50%

We are now providing oral appliance therapy for sleep-related breathing disorders.  It’s our goal to treat this disorder working with your physician and health care provider and improve your health and well being. 

The American Academy of Sleep Medicine now recommends oral appliances as a primary or first line of treatment for mild to moderate obstructive sleep apnea. The guidelines state that patients should always be offered the choice of an oral appliance if they have mild to moderate OSA.

 For Mild to Moderate Obstructive Sleep Apnea:
Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer OAs to Continuous Positive Airway Pressure (CPAP), or who do not respond to CPAP, are not appropriate candidates for CPAP, or who fail treatment attempts with CPAP or treatment with behavioral measures such as weight loss or sleep position change.

For Moderate to Severe Obstructive Sleep Apnea:
The American Academy of Sleep Medicine recommends Continuous Positive Airway Pressure (CPAP) for the treatment of moderate to severe sleep apnea. If patients have tried and failed CPAP, they should be offered treatment with an oral appliance. 

Patients with severe OSA should have an initial trial of nasal CPAP [prior to trying oral appliances]. Reference:  1.American Academy of Sleep Medicine website http://www.aasmnet.org

 Below is a SECURE CONFIDENTIAL LINK to complete our online sleep disorder/apnea evaluation forms.  

  Obstructive Sleep Apnea

Sleep Consult

 

 

Sleep Screening Consultation SleeSleep Screening Consultation Sleep Screening Consultation Sleep Screening Consultation  Sleep Screening Consultation Sleep Screening Consultatio Please have the following available before you begin.  This registration will take about 15-20 minutes to complete so please save enough time.  Once we have your information, we can visit further about your symptoms.

  1. your insurance card
  2. a list of your physicians
  3. a complete medication list and dosage 

 

Online Dental Education Librarycontact us contact us

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.

Online Dental Education Library

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us at 785-738-3758,   

                      

Know your Teeth

BCBS Delta Dental Care Credit

Certain kinds of medications can have an adverse effect on your teeth.

Long ago, children exposed to tetracycline developed tooth problems, including discoloration, later in life. The medication fell out of use, however, and is not an issue today.

The best precaution is to ask your family physician if any medications he or she has prescribed can have a detrimental effect on your teeth or other oral structures.

A condition called dry mouth is commonly associated with certain medications, including antihistamines, diuretics, decongestants and pain killers. People with medical conditions, such as an eating disorder or diabetes, are often plagued by dry mouth. Other causes are related to aging (including rheumatoid arthritis), and compromised immune systems. Garlic and tobacco use are other known culprits.

Dry mouth occurs when saliva production drops. Saliva is one of your body's natural defenses against plaque because it acts to rinse your mouth of cavity-causing bacteria and other harmful materials.

Some of the less alarming results of dry mouth include bad breath. But dry mouth can lead to more serious problems, including burning tongue syndrome, a painful condition caused by lack of moisture on the tongue.

If dry mouth isn't readily apparent, you may experience other conditions that dry mouth can cause, including an overly sensitive tongue, chronic thirst or even difficulty in speaking.

Heart Disease

Poor dental hygiene can cause a host of problems outside your mouth—including your heart.

Medical research has uncovered a definitive link between heart disease and certain kinds of oral infections such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors such as tobacco use.

A condition called chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.

In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That’s why it’s critical to practice good oral hygiene to keep infections at bay—this includes a daily regimen of brushing, flossing and rinsing.

Antibiotic Prophylaxis

In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.

It is possible for bacteria from your mouth to enter your bloodstream during a dental procedure in which tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection.

However, certain cardiovascular conditions in patients with weakened hearts could be at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.

Patients with heart conditions (including weakened heart valves) are strongly advised to inform our office before undergoing any dental procedure. The proper antibiotic will prevent any unnecessary complications.