Sleep Dentistry & Snoring

Many of Dr. Menchel’s patients suffer from sleep disturbances. The most common are insomnia, nocturnal bruxism (tooth grinding), snoring, and Obstructive Sleep Apnea (OSA). In the past, treatment of sleep disorders was handled by physicians but with the advent of oral sleep appliances the dentist now takes an active role in the management of these patients.

What is OSA? OSA is very common in the population and though it can occur at any age and in any gender it most typically occurs in men in middle age and beyond. Simply stated there is a narrowing or blockage of the airway during sleep, which causes a decrease in the amount of oxygen that is taken in.

Symptoms of OSA are:

1. excessive snoring and gasping for air during sleep
2. excessive daytime sleepiness
3. high blood pressure
4. erectile dysfunction (ED)
5. decreased work efficiency
6. depression

The following can contribute to developing OSA:

1. obesity
2. smoking
3. GERD (acid reflux)
4. thick necks

Treatments for OSA include:

1. Weight loss programs
2. CPAP (continuous positive airway pressure). This is a mask worn at night which forces air into the lungs. CPAP is the most effective treatment and the gold standard for treating OSA, however many OSA patients cannot tolerate the discomfort, noise, and bulk of the mask. It is also difficult to travel with this appliance.
3. Dental mandibular advancement appliance. These are plastic dental appliances which are worn over the upper and lower teeth and position the lower jaw forward so that the airway can open and the patient is properly oxygenated. Although they are not as effective for severe OSA patients they can be very effective for patients with mild to moderate sleep apnea.
4. Surgical procedures which remove excess tissue in the throat that may be blocking the airway. Often these are done with laser. Many doctors feel that these procedures only last short term and need to be repeated periodically.
5. Pillar Technique. Plastic rods are surgically introduced into the soft palate making it more rigid so it cannot drop down and block the airway. Not enough research is available on this technique and it is recommended that the patient have a follow up sleep study one month after to evaluate this. Most insurance companies will not cover this technique at this time.

Dr. Menchel is available for consultation for oral appliances to treat snoring and OSA. He works in conjunction with many sleep physicians and is available for consultation.