Sleep Related Breathing Disorders
Obstructive sleep apnea (OSA) is caused by an airway blockage (obstruction) during sleep. During the day, muscles in the airway region keep the throat and airway passage wide open but when a patient has obstructive sleep apnea, the throat collapses during sleep, blocking the airway and preventing air from getting to the lungs. The site of obstruction in most patients is the soft palate, extending to the region at the base of the tongue. There are no rigid structures, such as cartilage or bone, in this area to hold the airway open. So as a person with OSA falls asleep, these muscles relax to a point where the airway collapses and becomes obstructed. Although obstructive sleep apnea (OSA) is typically considered an ‘adult’ condition, there is no age boundary and OSA can affect otherwise healthy children. OSA may in fact be the root cause of childhood behavior and attention problems. Enlarged tonsils and small structural features of the maxilla / nose, mouth and throat may contribute to OSA. Proper evaluation and testing is needed for accurate diagnosis.
OSA is a medical condition that is diagnosed by a medical doctor, but can be treated by a dentist with special understanding and training on this life threatening breathing disorder. At present, the primary method for diagnosing OSA is to have the patient undergo a sleep study, known as polysomnography (PSG) or home sleep test (HST). We are happy to assist our patients in coordination of necessary sleep testing.
TMJ & Sleep Therapy Centre provides dental sleep medicine. Dental sleep medicine is the management of medically diagnosed sleep-related breathing disorders (sleep apnea, snoring) using oral appliance therapy for adults and orthopedic orthodontics for airway development or correction for children. The doctors of the TMJ & Sleep Therapy Centre are specifically trained and experienced in dental sleep medicine.
Once a patient has been diagnosed with a sleep apnea condition, recommendations for treatment can include behavior and lifestyle changes, oral appliance therapy (OAT) CPAP wear (Continuous Positive Airway Pressure device), and surgery. Oral appliance therapy (OAT) is often the option for treatment. These appliances can be very effective for patients who suffer from snoring and mild to moderate sleep apnea. Oral appliances may also be recommended for the severe sleep apnea patients who are unable to tolerate CPAP.
There are over 100 different appliances approved by FDA for treating sleep apnea. Although these appliances have an appearance similar to mouth guards, they are unique and require specific design, fabrication and customized fittings to achieve successful treatment results through proper positioning of the lower jaw and tongue. The doctors of TMJ & Sleep Therapy Centre are specifically trained and experienced in oral appliance therapy. They utilize advanced technology and specialized equipment to measure the airway, predict improvement, and determine custom appliance designs. The doctors monitor patient care for success and efficacy in treatment results. To maintain success, the appliances require regular follow-up and monitor.
The patient considering OAT (oral appliance therapy) for sleep apnea should seek care from dentists specifically trained and experienced in dental sleep medicine and custom appliance design.
Orthodontics/Orthopedics for Treatment of OSA
Adult therapies for the management of OSA are not suitable for children. Therapies such as CPAP (Continuous Positive Airway Pressure) and (OAT) Oral Appliance Therapy have been known to arrest skeletal development of the growing child. The good news is, with proper diagnosis and communication between medical and dental providers, treatment of OSA shows better results when treated early in life!
Orthodontics for Airway Development
At TMJ & Sleep Therapy Centre, an increase in airway volume is always our goal in the treatment of Pediatric OSA. The airway is evaluated and any obstructions are addressed. Obstructions can occur anywhere in the airway and are not limited to the mouth and nose. Common procedures in airway development involve upper and lower jaw expansion and relationship changes, myofunctional tongue and lip exercises and lifestyle changes. Orthopedic airway development has a very high success rate in pediatric patients.
Pediatric obstructive sleep apnea (OSA) is a prevalent but under-diagnosed disease. The importance of screening for OSA in every child has been recently been re-emphasized by the American Academy of Pediatrics Guidelines. http://pediatrics.aappublications.org/content/early/2012/08/22/peds.2012-1671