October 29, 2017
Welcome to issue fourteen of YOUR DENTAL CARE News.
In this issue we will discuss issues related to snoring and sleep apnoea. There will be 2 parts to this subject. The first part will define and explain how snoring is related to sleep apnoea. The second will deal with the diagnosis and management of the condition.
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So what does snoring have to do with teeth? A lot if you need help to overcome it. Snoring can be a health hazard for some. And I don’t mean from the possibility of suffocation by your bed partner trying to get some sleep!
Snoring is a sign of airway obstruction whilst sleeping. In some individuals this may only be an annoyance for those around them but for others it may be a more sinister sign of a sleep disorder. Obstructive sleep apnoea is a condition which affects about 1 in 3 individuals.
Apnoea is a term relating to the person stopping breathing. This is a serious condition which if allowed to happen over many times during the night, will result in poor sleep. Insufficient hours of quality sleep will lead to day time sleepiness which can affect the individual’s alertness and ability to focus. People affected, in severe cases, are at higher risk of accidents whilst driving and operating heavy machinery.
The diminished levels of oxygen available to the body over the long term, resulting from the periods of apnoea, can lead to cardiovascular diseases like stroke and increased risk of heart attacks. Control of high blood pressure can be difficult as the cardiovascular system struggles to cope caused by the apnoea events overnight. Over a long period of time sleep apnoea will exact a heavy toll on the body.
Obstructive sleep apnoea is one condition of many sleep type disorders. The condition is often not detected until illness sets in or an accident happens. Signs and symptoms are often present long before it’s’ effects cause problems. The only way to diagnose sleep disorders is by undergoing a sleep study. A sleep physician needs to be involved in managing individuals diagnosed with a sleep problem.
Snoring is a byproduct of a constricted airway. This happens because of the tongue collapsing over the airway whilst a person is on their back. Individuals with narrow facial structures and retruded lower jaws have narrow airways. They are prone to having obstructed airways. Constricted anatomical structures and other factors like obesity, excessive alcohol consumption and smoking will create a perfect storm increasing the risk of obstructive sleep apnoea.
Not everyone who snores will suffer from sleep apnoea. Some will only snore but when put under a sleep study, display no visible signs of apnoea. These individuals may only need to make small changes in their lives like sleeping on their side, losing some weight, reducing alcohol consumption and ceasing to smoke, in order to alleviate snoring.
In addition, Dentist can also help alleviate snoring with the fabrication of custom fitted appliances. This appliance fits over the teeth to hold the lower jaw in a forward position. By doing this the tongue is prevented from dropping back over the airway. These appliances are called mandibular advancement appliances or splints. Such snoring appliances must be custom fitted and have the ability to adjust the degree of protrusion of the lower jaw. This will avoid damage to the teeth and jaw joints.
So what does snoring have to do with dentistry? Everything! The simple solution available to reduce or eliminate snoring relies on healthy teeth and gums to support a custom fitted oral appliance. Not every case will be suited for the use of the dental appliance nor will the appliance be successful in all cases. Hence, the need for other management tools may be necessary to supplement the appliance.
In our next issue we will discuss in greater depth the diagnostic process and the use of oral appliances and CPAP in assisting with snoring and obstructive sleep apnoea.
Thank you for reading.