Stroke, obesity, diabetes, heart disease, drug-resistant hypertension, coronary artery disease, cardiac arrhythmias, congestive heart failure, depression, and anxiety are all linked to sleep-related breathing disorders (SRBD) and obstructive sleep apnea (OSA). In addition, lack of sleep can cause irritability, poorer focus, an increased risk of automotive or industrial accidents, and decreased productivity.
SRBD is linked to a number of oral health concerns in addition to the health impacts described. In reality, studies have shown the influence of untreated SRBD on dentistry and the prognosis of several dental treatments during the last decade. Inter-disciplinary dentistry includes the treatment of sleep disorders.
Bruxism and Sleep
The link between SRBD and bruxism is one of the most researched subjects. Some people appear to clench when they are having difficulty breathing while sleeping. Dentists have in the past treated the symptom by placing bumpers (night guards) and lost the opportunity to treat the fundamental cause, which could be SRBD. Worse, bruxing guards may exacerbate the SRBD’s effects in some situations. A simple sleep screening and test will help you determine the best treatment option.
Because bruxism affects so many various treatment options, many dentists would be wise to examine the impact of untreated or undiagnosed SRBD during the data collection phase of treatment planning. This is critical since studies demonstrate that using correct mandibular repositioning devices to address OSA reduces sleep bruxism in patients with the condition.
Periodontal Therapy and Sleep
According to studies, effective periodontal care lowers health risks. According to this research, there is a link between untreated SRBD and periodontal disease. The specific process by which one influences the other is unknown; nevertheless, the high prevalence of periodontal disease in SRBD patients has been linked to:
- High prevalence of mouth breathing
- The immune system is compromised, which has a negative impact on periodontal disease recovery
- There is a lot of systemic inflammation, which affects their periodontal health
When studies reveal that treating sleep apnea reduces the levels of inflammatory markers in SRBD patients, the inflammatory character of periodontal illnesses becomes even more essential. As dentists, we must examine the impact of SRBD on our periodontal treatment plans, given the frequency of periodontal disease and how various treatment techniques and protocols have been tested or recommended.
Ortho and Sleep
Proper breathing and sleep are also essential for dentofacial and craniofacial development. Retrognathia is more likely to occur in children who have respiratory problems, airway difficulties, sleep problems, or poor craniofacial growth. Furthermore, these craniofacial anomalies may raise the chance of children developing OSA.
Of course, OSA can have a negative impact on a child’s learning, emotions, and behavior in addition to their craniofacial development. Another reason for the need of early detection and treatment of SRBD is the high prevalence of ADHD in pediatric OSA patients. When dentists evaluate the role of airway anatomy in OSA and the potential impact of orthodontic and orthopedic therapies, it’s evident that OSA screening should be included in every orthodontic data collection and treatment planning phase.
Surgery and Implantology, Sleep and TMD
Patients with OSA are more likely to develop TMD (pain and compromised movement of the jaw joint and the surrounding muscles), according to recent research, potentially due to greater levels of blood inflammatory markers (such as IL-6, IL-8, C-reactive protein, etc.). Due to a lack of REM sleep, OSA patients typically heal slowly and have a higher pain perception (hyperalgesia). These factors could have a big impact on TMD prognosis and pain management. These characteristics, in combination with sleep bruxism, may explain why OSA patients have a greater rate of implant restorative failure.
Interdisciplinary dentistry requires sleep and airway examination as part of overall treatment planning. If left untreated, SRBD can have a negative impact on the outcome of numerous dental procedures, and if left untreated, it can jeopardize the duration of dental care. The question is not whether or whether sleep and airway management should be included in our comprehensive evaluation, but rather how and where it should be included.
Dentists agree that screening is an important element of dentistry, but we need to know how it affects the dentist’s entire treatment planning and sequence. Among the inquiries:
- When should SRBD be addressed?
- What if the patient refuses to undergo any treatment?
- How can we reduce or manage the effects of OSA on our dental health?
- Is OAT appropriate for every patient who reacts to mandibular protrusion? Even if they have a sufficient number of teeth?
- What role do complementary therapies and some newer, promising treatment modalities play?
- Is sleep dentistry a specialized field or a component of general dentistry?
- How should an OSA-positive patient be treated by a general practitioner?
- Is it possible to postpone OSA therapy till a different dental treatment phase is completed?
If we want to be more effective as dentists, we need to know the answers to these questions. To obtain predictable outcomes, prevent surprises, and improve clinical prognosis, we must prioritize our efforts and pursuit of complete treatment planning for airway and sleep. Because the airway and breathing affect everything, treatment planning should prioritize analysis over function, biology, and aesthetics.
SRBD Can Be Treated By Dentist
Dentists could always take impressions and produce appliances in the past, but treating a medical condition was always out of the question. In the past, a patient had to return to the doctor to perform a test with the appliance to see if it was beneficial. Unfortunately, it only succeeded in around 60% of cases, and with a treatment charge of $3,000-4,000, patients and dentists were unwilling to take the risk. We also discovered that altering the appliance in an anterior-posterior plane resulted in varied outcomes.
Dentists can now complete a treatment plan after completing a two-night MATRx plus test ahead of time to determine if the sleep appliance will treat the illness, and how to customize the appliance for effective therapy. In fact, if a patient has to be diagnosed, the MATRx plus can perform a home sleep test. Contact us at My Smile Artist to learn more.