by Robert M. Grill, DDS Did I really want to treat “TMJ” patients? No! Who in their right mind would? It was 25 years ago, and I had been in practice for several years. Bob Isaacs, a brilliant local orthodontist, talked to me about a shared patient who had what was thought to be occlusal-muscular pain. Bob wanted me to equilibrate this patient’s bite. I recounted that I didn’ … [Read more...]
The Nose: Anatomy, Function, and Connection to OSA
by Allen J. Moses, DDS, Elizabeth T. Kalliath, DMD, and Gloria Pacini, RDH Introduction The diagnosis of obstructive sleep apnea (OSA) solely based a Poly-SomnoGraphic study (PSG) is a “rule-in” diagnosis. OSA is just one of many Sleep Breathing Disorders (SBD) that must be considered. There is more to treating OSA than Continuous Positive Air Pressure (CPAP) and intraoral app … [Read more...]
Changing the World, One Airway at a Time
by Diana Batoon DMD Maybe you have the next Steve Jobs, Lebron James, or Malala Yousafzai in your practice and they are 8 years old. Yet they have asthma, crooked teeth, and a bed-wetting problem. What’s a dentist to do? 20 years ago, we were focused on prep depth, line angles and shade-matching porcelain. Dentistry has changed; our duty is no longer limited to c … [Read more...]
Combination Therapy by Ronald S. Prehn, ThM, DDS
What therapeutic options does a sleep dentist have when Oral Appliance (OA) monotherapy fails? Since most dental sleep patients choose OAT (oral appliance therapy) because they have already rejected CPAP (continuous airway pressure) or are CPAP intolerant, what can be done? They can’t go back to CPAP! OAT is not resolving their sleep breathing issues. What is next? What can the … [Read more...]
Temporomandibular Joint Anatomy as Related to OAT
by Samuel J. Higdon, DDS This is the fourth article in a series that has addressed the issues of Temporomandibular Disorders (TMDs) as they relate to providing Oral Appliance Treatment (OAT) for Sleep Disordered Breathing (SDB) such as Obstructive Sleep Apnea (OSA). In previous articles I have discussed the risks of developing a TMD in response to OAT (Winter 2016), what … [Read more...]
Digital Scans and Digital Bite Record for Oral Sleep Appliance fabrication
We Are Not Our Symptoms by Barry Raphael, DMD
Despite the fact that orthodontic training programs have been teaching about growth and development ever since the beginning of the profession and the relationship between breathing behavior and facial growth has been written about for equally as long, once an orthodontist gets into practice much of that training gets set aside as an intellectual maxim but has very little … [Read more...]
Exploring TMJ Symptoms as a Result of MAD for Sleep Apnea
by Mayoor Patel, DDS, MS In recent years, dental devices have taken an increasingly important role in the treatment of snoring and obstructive sleep apnea (OSA). Increasing evidence suggests that mandibular advancement devices (MAD) improve sleep-disordered breathing.1 MAD is the most common class of oral appliance used to treat snoring and OSA. While there are several MAD … [Read more...]
Screening Patients for TMDs in a Sleep-Oriented Dental Practice by Samuel J. Higdon, DDS
As the subspecialty of dental sleep medicine has evolved and matured, reasonable concerns have been voiced regarding potential undesirable results from doing mandibular advancement during sleep as a long-term treatment for sleep disordered breathing (SDB). Several studies have been done on long-term changes that may occur, including not just TMD-related effects, but also … [Read more...]
Chronic Rhinitis and the Sleep Dentist by Warren Schlott
Every sleep dentist has patients who include chronic nasal congestion and/or post nasal drip on their list of complaints. More often than not, the patient suffers from chronic rhinitis. This condition can play a prominent role as a cause of snoring and sleep apnea. It is known that congestion can lead to an increase in intra pharyngeal pressure that leads to open mouth posture … [Read more...]
