What Does Sleep Apnea Have to Do with Dentistry?

Certain types of sleeping disorders can directly impact your oral health, and vice versa. Particularly obstructive sleep apnea or OSA.

Obstructive Sleep Apnea is a sleep disordered breathing condition that causes physical airway blockage. It’s typically due to oral tissues at the back of your mouth collapsing in on one another, sealing off your upper respiratory tract.


Oral Structures that Cause Sleep Apnea

OSA is specifically caused by your oral tissues sealing off your airway. Even partial blockage can lead to snoring, frequent waking, or low oxygen levels. You may never realize that your body is waking itself up to unblock your airway since you’re still in a lighter level of sleep.

So, what’s happening in the back of your throat anyway? Typically, when you’re sleeping your muscles relax. If you have larger oral tissues or a smaller airway, the back of your tongue can sleep backward up and against the back of your throat. At that point your tongue, tonsils, and upper airway are sealed completely together due to the moisture and mucous membranes involved. It’s impossible for air to flow through, whether by your mouth or your nasal passages. That’s one reason why CPAP machines use such heavy pressure; they physically push those tissues apart with air, in order to get oxygen to your lungs.

But instead of forcing air through collapsed oral tissues, why not move the tissues out of the way for natural oxygen flow? That’s exactly what an oral appliance does.


How Oral Appliances Help You Sleep More Safely

Depending on the type of sleep apnea you have, an oral appliance may be an appropriate method of treatment. Specific designs of oral sleep aids are FDA-approved for the management of obstructive sleep apnea (OSA) but not other types of sleeping disorders. It boils down to the way the device works and why you’re sleeping the way you are.

In the case of OSA, an oral appliance guides your mandible (lower jaw) into a slightly more forward position. Some also help to keep your tongue forward as well. Both naturally draw the soft tissues away from the back of your throat. As a result, there’s a natural widening of your upper airway and less tissue blockage.

Here’s where you perform a little experiment. While you’re reading this, push your lower jaw slightly forward and pay attention to what happens at the back of your mouth. Can you feel your tongue being brought forward as well? This motion prevents the back, bulkier portion of your tongue from slipping backward while you’re sleeping. In turn, it can’t seal against your throat.

Treating Sleep Apnea: Here’s the Catch 

Oral sleep appliances are FDA-approved medical devices. And that’s because they’re proven to be effective for treating obstructive sleep apnea. Only there’s a catch. You can’t get them from your pulmonologist or sleep physician. Why? Because technically they’re a dental appliance. So even though your medical provider can write you a prescription for a dental sleep aid, only a trained sleep dentistry team can fit you with one.

At Raleigh Dental Arts we can streamline the process where you’re screened for, diagnosed, and prescribed an oral appliance when appropriate. If you’re someone who suspects that you have a sleeping disorder, are already using a CPAP to no avail, or you want a second opinion, we’re more than happy to answer any questions you may have.

CPAP vs. Oral Sleep Apnea Appliances

CPAP machines use continuous air pressure to physically force air into your lungs. Unfortunately, this also requires bulky equipment that often makes it challenging to sleep in your preferred position or travel out of town with other people. As discreet as modern CPAP machines can be, there’s the extra factor of keeping them clean, stored properly, and the noise that’s created. Especially if you’re sharing your bed with someone else.

With an oral sleep appliance, there are no mechanical pieces, bedside machines, tubes, or nosepieces to deal with. All that’s involved is an oral appliance you wear over your teeth, similar to a mouthguard. But instead of this appliance forcing air into your lungs, it widens your airway for natural oxygen flow.

Compared to a CPAP machine, oral appliances are:

  •   More discreet
  •   Easier to travel with
  •   Allow for various sleep positions
  •   Simpler to clean and maintain

But can oral sleep appliances be calibrated or adjusted to the patient? Yes! Although many of our patients see significant improvement in just the first night or two, others may require fine-tuning of the appliance to ensure it fits just right.

Another added perk of oral appliances is that they can work independently of other equipment or in conjunction with your CPAP machine. Depending on the severity of your condition, some people who are CPAP intolerant can completely transition to a dental appliance and give up their CPAP for good. 


Sleep Apnea Screenings with Our Raleigh Dentist

A sleep apnea screening in the dental office starts with a thorough review of your medical history. We’ll discuss risk factors such as high blood pressure, fatigue, sleep problems, depression, weight gain, and other warning signs. Please be sure to let us know of any medications you’re currently taking, or sleep studies that you’ve had in the past.

During your oral exam, our Raleigh sleep dentist will evaluate anatomical risk factors that may play into your sleep health. For instance, a large neck circumference or small lower jaw can raise your likelihood of sleep disordered breathing. But we’ll also want to assess the size of your tonsils, tongue, and positioning of your soft palate.

More obvious oral signs of sleep apnea can include flattened teeth and a scalloped tongue. Worn enamel is a side effect of sleeping disorders because people naturally clench their teeth tightly together when they’re oxygen deprived. Over time it will lead to excessive tooth wear, fractured enamel, and broken dental work. The clenching and biting combined with your tongue pressing against your teeth can lead to scalloped marks along the sides of your tongue (where it meets your teeth.)

As a trained sleep dentistry provider, our Raleigh dentist understands your oral tissues almost better than anyone. So, if your particular sleeping disorder is attributed to OSA, trusting us as your partners in health will ensure you’re doing everything holistically possible to treat your condition in a noninvasive manner.


Home Sleep Apnea Studies

You don’t necessarily have to go into a sleep lab overnight to have a sleep study done. Today’s advancements make it possible to record your sleep data in the convenience of your own home. Although equipment varies, most home sleep study machines will include a small attachment that goes over your finger and around your wrist. There will also be a sensor that you place on your upper chest.

As you’re sleeping, the bedside sleep machine records your breathing rates, pulse oxygen levels, snoring, and sleep quality. All of the data goes into software that is then downloaded by a licensed sleep physician or medical provider to be interpreted.

If you’ve never seen a sleep physician, having a home study can allow for a proper diagnosis of your sleep health. And now you can have the peace of mind knowing your sleep is evaluated by a specialist without ever having to stay overnight in a strange medical office. 


Don’t Ignore the Warning Signs

Untreated sleep apnea can strain your body’s cardiovascular system and increase internal inflammation. Unfortunately, it’s not uncommon to hear of people with OSA having a stroke or fatal heart attack. But when you treat sleeping disorders your body is better rested, less stressed, and swelling goes down. In turn, your heart and stroke risks are reduced as well.

Is snoring a red flag? Not necessarily. Snoring does accompany some types of breathing disorders, but it’s not a concrete sign as to whether you have sleep apnea. Some people have it, others don’t. An oral device can definitely help with snoring as well, so don’t hesitate to let us know if that’s a concern.

Although it might seem a bit of a stretch to say that a sleep apnea screening could save your life, it really isn’t. You may never realize that you have a sleep problem until it’s too late. Giving your body the respite it needs to regulate other systems can improve your overall wellness, attitude, and energy levels. After a few nights of quality sleep, you’ll be a believer.

Raleigh Sleep Dentistry Treatment

At Raleigh Dental Arts we provide oral appliance therapy for people with obstructive sleep apnea. If you suspect a sleeping disorder, we can also guide you through the screening process for a formal diagnosis and care plan.

Are you already someone using a CPAP machine? Are you looking for an alternative therapy? Ask us how an oral sleep aid could help you get a better night’s rest. Call our Raleigh sleep dentistry team today to schedule a consultation.


Tarun Agarwal

Dr. Tarun Agarwal, DDS is considered one of the top dentists in the country. He is a recognized speaker, author, and dental leader. He has been featured on CBS, NBC, ABC, FOX, and News 14 Carolina. Dr. Agarwal has been awarded '40 under 40' Business Leaders by the Triangle Business Journal. He is regularly invited to teach other dentists around the world and recently built a training center within the practice dedicated to sharing his expertise. Most importantly he is a loving husband and dedicated father of three wonderful children. His biggest accolade was being voted 'Best Dad in the World' by 2 of his 3 kids.