In September 1995, the American Sleep Disorder Association (ASDA) endorsed dental appliance therapy as the third currently acceptable treatment modality for snoring and sleep apnea. Dental appliances can be very effective in the elimination of snoring and sleep apnea.
Snoring is a social problem particularly for the spouse, but obstructive sleep apnea poses a significant health risk for the patient in that it can lead to irregular heartbeat, high blood pressure, heart attacks and strokes.
There are literally millions of patients who suffer from these sleep disorders, and the dental profession can possibly help them. Dentists who are trained with a functional orthopedic background are most qualified to treat these patients because of their experience in dealing with dental appliances, particularly maxillary (upper jaw) and mandibular (lower jaw) advancement appliances, airway problems, mouth breathing, TMJ dysfunction, anterior (front teeth) and posterior (back teeth), and open bites(teeth do not touch).
Sleep apnea is a type of breathing disorder which is a serious and potentially life threatening condition characterized by brief interruptions of breathing during sleep. There are three types of apnea
Central Apnea The upper airway is open, but no oxygen is getting into the system. This occurs because the patient is not getting a chemical response from the brain to stimulate the lungs and the diaphragm to assist with breathing.
Obstructive Sleep Apnea The lungs and the diaphragm are functioning normally, but no oxygen is entering the system because there is an obstruction in the upper airway.
Mixed Apnea This is a combination of central and obstructive sleep apnea, (OSA).
The signs and symptoms of OSA include snoring, excessive daytime sleepiness, gasping and choking during the night, non-refreshed sleep, fragmented sleep, clouded memory, irritability, personality changes and morning headaches.
Children can also snore and suffer from growth and development problems including narrow maxillas (upper jaw), high palatal (roof of the mouth) vaults and retruded (pushed back) mandibles (lower jaws). Often, they are highly allergic and their airway is blocked due to enlarged tonsils, adenoids or swollen nasal mucosa (lining of the nasal passages). Clinical signs would include
turned up nose
allergic shiners under the eyes
mucous draining out of the nose
nasal sound to the voice
The retrognathic (deficient length) maxilla and mandible leads to a forward head posture, which can cause posture as well as cervical problems. Other signs are
difficulty concentrating in school
Clearly, these children should be treated early in order to dramatically improve their quality of life. If the airway problem and skeletal problems are addressed early, then the more serious problem of obstructive sleep apnea may be eliminated. The treatment of airway problems can be done with upper and lower arch development appliances along with treatment by an ear, nose and throat (ENT) specialist who can remove the enlarged tonsils and adenoids. The skeletal jaw problems can be treated with the advanced lightwire functional (ALF) appliances. The ALF appliances can be used on adults as well.
In conclusion, snoring and sleep apnea are usually caused by a narrow airway. Below is a side view skull x-ray showing a very narrow airway passage due to a retruded (pushed inward) upper jaw.