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...]
ADA Updates Guidelines to Protect Patients Under Sedation
When new patients come into my office, I always ask if they have been diagnosed with sleep apnea. It’s an important piece of their medical history that I need to know before I begin sedation. If a patient has been diagnosed with sleep apnea, I will treat him or her differently and monitor them more closely. A few years ago, a patient said no when I asked her this question. I … [Read more...]
XyliMelts oral adhering discs in the management of oral dryness associated with treating sleep apnea
Dentists are in a unique management position with respect to the treatment of OSAS because they can provide primary care via the prescription of intra-oral appliances in cases of mild to moderate OSAS and, in addition, they can aide in managing the dry mouth that frequently occurs during treatment with continuous positive airway pressure (CPAP), the most common medical … [Read more...]
Whole Body Alignment: Physical Therapy for TMD
What percentage of patients that you have fit with an anterior mandibular positioning device return complaining of jaw and/or face pain? One study reports the incidence as high as 40% in long-term users, and up to 50% of all patients quit using the device because of dissatisfaction with side-effects.1 What if you could increase compliance by addressing undesired pain without … [Read more...]
