At Desert Smiles Cosmetic & Restorative Dentistry we are passionate about helping patients with snoring and sleep apnea. These conditions can negatively affect your life in many ways, as well as lead to serious health issues if left untreated. Dr. Wilcox and Dr. Tenney personally understand the seriousness of sleep apnea, as Dr. Wilcox was diagnosed with the condition and has worn an oral appliance since 2007, which has dramatically helped his overall health. Dr. Wilcox is also a member of the American Academy of Dental Sleep Medicine and the Dental Organization for Sleep Apnea.
If you live in the areas of Glendale, Phoenix, Scottsdale, or Peoria and believe you or a loved one may be suffering from chronic snoring or sleep apnea, contact us today at 602-978-1790 to schedule a free consultation.
What is Snoring?
Snoring is the sound made by vibrations of the soft palate and other tissue in the upper airway (mouth, nose, and throat). When these airways are narrowed during sleep, air is pushed through a smaller passage, and any partial blockages can then result in snoring.
In most cases, the body continues to get adequate amounts of oxygen with little or no harm. However, snoring can also be an early sign of sleep apnea. Most sleep apnea sufferers snore between bouts of apnea, or oxygen interruption.
What is Obstructive Sleep Apnea?
Obstructive Sleep Apnea (OSA) is a potentially life-threatening condition that is more common than generally recognized, as over 20 million Americans suffer from OSA. Sleep apnea occurs when breathing stops for 10 seconds or more while you sleep. In a given night, those who suffer from OSA events may stop breathing 30 to 50 times, and in some extreme cases, as many as 60 to 100 times per hour. These events can leave individuals exhausted each morning, as they’ve been fighting for oxygen all night.
Coughing or choking sensations, which force you to wake up, are common signs of OSA. These abrupt disturbances during sleep place significant strain on your heart and cardiovascular system. Snoring is often associated with OSA, although not everyone who snores has this condition. OSA prevents air from reaching the lungs even though your body continues its effort to breathe. This condition is associated with a higher risk for heart attacks and strokes.
Central sleep apnea is much less common. With obstructive sleep apnea, air cannot flow into or out of the person’s nose or mouth although efforts to breathe continue. With central sleep apnea, the brain fails to send the appropriate signals to the breathing muscles to initiate respirations.
Symptoms of Snoring and Sleep Apnea
While there are many potential causes of this debilitating condition, one of the most common is obesity and excess weight. Other causes include the collapse of the soft tissues of the throat, which may be due to a poor bite, as well as hypothyroidism, allergies, and a deviated septum. Regardless of the cause, many of the symptoms associated with sleep apnea can be confused for other ailments. You may be suffering from sleep apnea if you’re experiencing any of the following:
- Chronic loud snoring that may wake yourself or your partner
- Daytime exhaustion
- Periodic episodes in which the patient stops breathing (typically observed by a partner)
- Headaches and sinus problems
- Sexual problems, decreased sex drive, and even impotence
- Mental fatigue and bad judgment
- Frequent sadness and mood swings
- Depression and irritability
- Dry mouth or bad morning breath
- Night sweats and overheating
- Kicking, twitching, punching during sleep
- Heartburn and indigestion
- Reduced energy
- Hearing loss
- Weight gain
Risks and Medical Consequences of OSA
In addition to these symptoms, certain risk factors are associated with a higher incidence of sleep apnea. Any of the following places you at elevated risk of developing the condition:
- Smokers are three times as likely as nonsmokers to develop sleep apnea
- Men are twice as likely as women to suffer from the condition
- Overweight individuals suffer from sleep apnea more frequently than those of healthy body weight
- Those over the age of 60 are more likely to develop sleep apnea
- African Americans suffer from sleep apnea more commonly than those of other ethnicities
- Users of alcohol, sedatives, and tranquilizers are more likely to develop the condition
Any of the symptoms listed above, alone or in combination with snoring, should prompt a sleep apnea evaluation if they continue for longer than a few weeks. If left untreated, sleep apnea can lead to other serious health issues. These include:
- High blood pressure
- Heart attack
- Type 2 diabetes
- Weight gain
- Decreased sex drive, erectile dysfunction
- Acid reflux (heartburn)
- Memory loss, lack of concentration
- Excessive daytime sleepiness
- Dry mouth
Diagnosing Snoring and Sleep Apnea
If you believe you may be at risk or are suffering from sleep apnea, Desert Smiles Cosmetic & Restorative Dentistry has experience in diagnosing and treating the condition. On your first visit, Dr. Wilcox or Dr. Tenney will conduct a dental exam to confirm your oral health status and checks for underlying health conditions.
We may suggest that you undergo a sleep study. There are two major sleep study tests: Polysomnogram (PSG) is conducted in a sleep center or hospital or an ambulatory sleep test, which conducted in your own home. For those who wish to do their sleep study at home, we will create an at-home sleep study, in which a wearable, wireless physiological recorder, called the Medibyte Jr, is worn around the chest during sleep. This device measures your:
- Blood oxygen saturation
- Pulse rate
- Respiratory effort venous volume
- Snoring levels
- Body movement
- Body position
After you drop off the recorder, the data is transferred to a team of sleep specialists who then interpret the severity of your sleep apnea. For those who have been diagnosed with obstructive sleep apnea and need further assistance, treatment options will be discussed to determine the best course of action for your condition.
Another simple test that can be taken to grade your chronic sleepiness is called the Epworth Sleepiness Scale. Additionally, a Bed Partner Survey should be filled out by anyone who regularly observes the potential sleep apnea. Not all those who have OSA will score high, but if you do, it is a very good sign of OSA.
We utilize the Plameca ProMax 3D Mid, an advanced CBCT imaging system that provides detailed information about the airways. With this technology, Dr. Tenney can perform a 3D scan running from the nasal passage to the oral pharyngeal pathway, enabling him to measure the volume of air and determine where constrictions are occurring. This tool can prove exceptionally effective in properly planing treatments for snoring and sleep apnea.
How is it treated?
If it is determined that you suffer from obstructive sleep apnea, there are three major treatments for snoring and sleep apnea:
- CPAP machine
- Dental Appliances
The most common method of treating sleep apnea uses a device called the Continuous Positive Airway Pressure, or CPAP machine, which assists your breathing while you sleep to ensure your airways don’t close. This medical device delivers continuous air pressure through a facemask or nasal tube attached to a pump. Proper adjustment of the CPAP is vital to achieve maximum clinical benefits and minimal side-effects. Wearing a CPAP is a lifetime commitment and the mask (or tubes) must be in place whenever you sleep or nap.
However, only a minority of CPAP owners are still compliant after one year. If you are one of the non-compliant, we can fabricate an oral appliance that will help open your airway and reduce the severity of your sleep apnea.
Dental appliances reduce sleep apnea associated health risks without the need for surgery, medications, or other therapies. A custom oral appliance worn while sleeping holds the lower jaw forward and open, preventing the tongue and throat tissues from collapsing the airway. This also tightens the pharyngeal walls and the soft palate. There is a 96 percent success rate (snoring) for people treated with these appliances. Sleep apnea results can often be improved 50 percent or more.
Dental appliances we use:
- Thornton Adjustable Positioner (TAP)
- SomnoMed MAS™
- Herbst, Herbst Telescopic and SAUD Appliance
- Tongue Retaining Device (TRD)
- Moses Oral Appliance
- Oasys Sleep Appliance
The Thornton Adjustable Positioner (TAP) oral appliance is a mandibular advancement device composed of two separate arches (maxillary and mandibular) containing a mechanism which permits unlimited advancement of the lower jaw. The arches are custom fit to a patient’s models. It is the only appliance that allows adjustments made while the patient is sleeping by the spouse or while a sleep test is ongoing.
The SomnoMed MAS™ is a mandibular advancement splint (MAS) that treats snoring and mild to moderate OSA by moving the lower jaw forward slightly. This forward movement tightens the soft tissue and muscles of the upper airway, which prevents obstruction while you sleep. The SomnoMed MAS™ is a custom-made device, consisting of upper and lower dental plates with a unique patented fin-coupling component, which allows normal mouth opening and closing. The device is adjustable which improves the efficacy and comfort level of treatment, as the jaw is moved only as far as is required to alleviate the condition. Dr. Wilcox personally uses this device for his sleep apnea and it is the most recommended appliance from our office.
The Herbst Appliance has been proven to be effective on chronic snoring and mild to moderate obstructive sleep apnea sufferers. This appliance allows patient’s mouths to move laterally and vertically without disengaging the appliance. The Herbst Telescopic version allows the clinician to advance more precisely if needed. The SUAD appliance allows more lateral movement than most of the appliances, and is specially made for our patients who grind their teeth at night.
The Tongue Retaining Device (TRD) is lab constructed from a flexible polyvinyl material adapted to the general contours of the teeth and dental arches. It does not depend on teeth for retention. Rather, the tongue is held forward by the negative pressure created in the vacuum bulb on the front of the appliance.
A recent addition to our options, the Moses Appliance has shown to be effective to prevent or significantly reduce obstructive sleep apnea and snoring. It is comfortable to wear, encouraging patient compliance, and the open anterior facilitates tongue protrusion to the lips. The patient is able to talk or drink with appliance in place and can easily open and close their jaw with the appliance in their mouth. Patients generally are able to sleep with lips closed comfortably.
The Oasys Sleep Appliance has built-in nasal dilation and it works in a similar manner to Breathe Right Strips. The Oasys Oral/Nasal Airway System is the first dental device to be reviewed by both the dental and ENT divisions of the FDA and to be approved as a dental device for treatment of snoring and sleep apnea through mandibular repositioning, and also as a nasal dilator for reduction of nasal resistance and improved nasal breathing.
If your condition requires more treatment than what a dental appliance can provide, there are several surgical procedures available to address snoring and sleep apnea. The most popular surgery for OSA is radiofrequency surgery, which is a minimally invasive procedure that reduces and tightens excess tissue in your upper airway.
Other surgical options include uvulopalatopharyngoplasty (UPPP), which removes or reshapes tissue in the throat, such as the tonsils and adenoid, and laser-assisted uvulopalatoplasty (LAUP) which uses laser technology to shrink the size of an enlarged uvula. Further options include tongue reduction surgery, jaw reconstruction, and in some cases a tracheostomy.
While it may be an effective treatment of sleep apnea, with any surgical procedure, there is always the risk of post-surgical complications. After your diagnosis, Dr. Wilcox and Dr. Tenney will discuss with you the options available and work with you to decide on the right treatment for your condition.
Dr. Tenney is dedicated to providing the safest and most effective treatments for our patients. To assist those struggling with the discomforts of sleep apnea, he has completed a mini-residency in dental sleep medicine. Led by a multi-disciplinary faculty and complete with lectures from sleep physicians, neurologists, Registered Polysomnographic Technologists (RPSGT), and other industry leaders, this four session, eight day course is designed to assist dental professionals in providing the best apnea treatments currently available.
The mini-residency completed by Dr. Tenney emphasizes hands-on learning, enabling practical and effective sleep apnea treatments to be easily incorporated into our practice. Focusing on the entire process from the examination to appliance delivery and fitting, along with any follow-up/calibration appointments that may be needed, Dr. Tenney has been provided with all of the tools necessary to ensure that our patients get the most out of their sleep apnea treatment.
In addition to learning advanced methods for the treatment of airway obstruction, the mini-residency provided Dr. Tenney with a strong referral network of physicians who can administer diagnostic tests for sleep apnea. This helps ensure that the treatments we provide safely and effectively restore your capacity to breathe while sleeping.
Dr. Wilcox is an experienced sleep apnea dentist with extensive training on treating the condition and is also a sleep apnea sufferer himself, which gives him a unique understanding of the seriousness of this condition.
If you or a loved one are exhibiting any of the symptoms listed above and believe you’re suffering from obstructive sleep apnea, contact Desert Smiles Cosmetic & Restorative Dentistry at 602-978-1790 to schedule a free dental consultation. We proudly serve the areas of Phoenix, Scottsdale, Peoria, and Glendale, Arizona.