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.
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.
- your insurance card
- a list of your physicians
- a complete medication list and dosage
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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,
Infants should be seen by our office after the first six months of age, and at least by the child's first birthday. By this time, the baby's first teeth, or primary teeth, are beginning to erupt and it is a critical time to spot any problems before they become big concerns.
Conditions like gum irritation and thumb-sucking could create problems later on. Babies who suck their thumbs may be setting the stage for malformed teeth and bite relationships.
Another problem that can be spotted early is a condition called "baby bottle tooth decay," which is caused by sugary substances in breast milk and some juices, which combine with saliva to form pools inside the baby's mouth.
If left untreated, this can lead to premature decay of your baby's future primary teeth, which can later hamper the proper formation of permanent teeth.
One of the best ways to avoid baby bottle tooth decay is to not allow your baby to nurse on a bottle while going to sleep. Avoid dipping pacifiers in sweet substances such as honey, because this only encourages early decay in the baby's mouth. Encouraging your young child to drink from a cup as early as possible will also help stave off the problems associated with baby bottle tooth decay.
Teething, Pacifiers and Thumb-Sucking
Teething is a sign that your child's gums are sore. This is perfectly normal. You can help relieve this by allowing the baby to suck on a teething ring, or gently rubbing your baby's gums with the back of a small spoon, a piece of wet gauze, or even your finger.
For babies under the age of 4, teething rings and pacifiers can be safely used to facilitate the child's oral needs for relieving gum pain and for suckling. After the age of 4, pacifiers are generally discouraged because they may interfere with the development of your child's teeth.
Moreover, thumb-sucking should be strongly discouraged because it can lead to malformed teeth that become crooked and crowded.
Primary and Permanent Teeth
Every child grows 20 primary teeth, usually by the age of 3. These teeth are gradually replaced by the age of 12 or so with a full set of 28 permanent teeth, and later on, four molars called "wisdom teeth."
It is essential that a child's primary teeth are healthy, because their development sets the stage for permanent teeth. If primary teeth become diseased or do not grow in properly, chances are greater that their permanent replacements will suffer the same fate. For example, poorly formed primary teeth that don't erupt properly could crowd out spaces reserved for other teeth. Space maintainers can sometimes be used to correct this condition, if it is spotted early enough.
Babies' gums and teeth can be gently cleaned with special infant toothbrushes that fit over your finger. Water is suitable in lieu of toothpaste (because the baby may swallow the toothpaste). Parents are advised to avoid fluoride toothpastes on children under the age of 2.
Primary teeth can be cleansed with child-sized, soft-bristled toothbrushes. Remember to use small portions of toothpaste (a pea-sized portion is suitable), and teach your child to spit out, not swallow, the toothpaste when finished.
Fluoride is generally present in most public drinking water systems. If you are unsure about your community's water and its fluoride content, or learn that it has an unacceptable level of fluoride in it, there are fluoride supplements your dentist can prescribe. Your child may not be getting enough fluoride just by using fluoride toothpaste.
Toothaches can be common in young children. Sometimes, toothaches are caused by erupting teeth, but they also could indicate a serious problem.
You can safely relieve a small child's toothache without the aid of medication by rinsing the mouth with a solution of warm water and table salt. If the pain doesn't subside, acetaminophen may be used. If such medications don't help, contact your dentist immediately.
You can help your child prevent oral injuries by closely supervising him during play and not allowing the child to put foreign objects in the mouth.
For younger children involved in physical activities and sports, mouth guards are strongly encouraged, and can prevent a whole host of injuries to the teeth, gums, lips and other oral structures.
Mouth guards are generally small plastic appliances that safely fit around your child's teeth. Many mouth guards are soft and pliable when opened, and mold to the child's teeth when first inserted.
If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see our office. Remember to hold the dislocated tooth by the crown—not the root. If you cannot relocate the tooth, place it in a container of cold milk, saline or the victim's own saliva. Place the tooth in the solution.
First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the cheek near the injury. This will keep down swelling.
For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling.
If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.
If a child's primary tooth has been loosened by an injury or an emerging permanent tooth, try getting the child to gently bite down on an apple or piece of caramel; in some cases, the tooth will easily separate from the gum.
Irritation caused by retainers or braces can sometimes be relieved by placing a tiny piece of cotton or gauze on the tip of the wire or other protruding object. If an injury occurs from a piece of the retainer or braces lodging into a soft tissue, contact our office immediately and avoid dislodging it yourself.
Sealants fill in the little ridges on the chewing part of your teeth to protect and seal the tooth from food and plaque. The application is easy to apply and typically last for several years.