"Do you snore, John?" I asked a patient during a new patient exam. "Do I ever, just ask my wife," he said with a smile. He was a smart guy and wanted to know why I asked. I went on to tell him that his front teeth were worn, and that's a tell-tell sign of snoring. John also had a large neck and a large tongue that fell back into his throat when he opened his mouth. His shiny teeth were also a clue. Stomach problem can create excess acid in the mouth, which will cause teeth to have a shine. All of these conditions usually coincide with sleep apnea.
Dentists play a very important role in their patients overall health. It is part of that role to discover any potential problems, whether with teeth or not, and discuss them with our patients. With training, it is easy for a dentist to discover if a patient suffers from sleep apnea simply because the job requires us to look down their throats.
Sleep apnea is not new, but its importance is increasing. More and more it's becoming associated with overall health. If you suffer from sleep apnea treatment is necessary for living a long, enjoyable life. For example, Pennsylvania House of State Representative State Rep. Robert Donatucci died in his sleep on Nov. 9th, because of untreated sleep apnea. According to the report, Mr. Donatucci had gone through a sleep study about a week earlier, but found the Continuous Positive Airway Pressure mask that he was asked to wear to be uncomfortable and did not complete the test. It's reported that other well-known people like National Football League player Reggie White died because of apnea complications.
Even though I can screen patients for apnea, I cannot diagnose it, only a medical doctor can at this time. In order for a MD to diagnose, they must be specially trained and must perform a sleep study in a certified sleep clinic. This particular patient was aware of the process and wanted nothing to do with it. He didn't want to stay in a strange place with wires attached everywhere, and he didn't want to even think about wearing a CPAP. He is certainly not alone in his thoughts and feelings.
The dental profession is getting more and more involved in sleep apnea because we can easily see if a patient suffers. Dentistry also offers an effective treatment that helps with mild to moderate apnea. The device is like a mouth guard that keeps one from grinding teeth at night, except this device actually brings the jaw forward opening the back of the throat, allowing more air into the lungs. It is call the Mandibular Advancement Device and patient compliance is much higher than that of the CPAP.
Even though dental appliances work, there are several problems, in my opinion, to overcome in order to help our patients:
- Education and awareness within the medical community. MD's are not completely aware of the benefits of the dental devise so when they have non-compliant CPAP patients, they don't discuss alternatives.Teamwork and communication between treating MDs and dentists. There still needs to be a certified sleep study according to sleep specialists.Resistance from insurance companies to cover the dental appliance.
Sleep apnea is very serious and needs to be treated to help save lives. Unfortunately, a vast percentage of the public is ignoring the problem because they don't want to have a sleep study, nor do they want to wear a CPAP. I know that a properly made device can help. If you or your loved ones have a snoring problem, don't hesitate to discuss treatment options with your dentist and MD.