It would seem perfectly normal to get our Dentist’s opinion on snoring but usually we make it a matter for our Doctor, Health Centre or specialist NHS Sleep clinic. In addition, I’m always reminding you all to make sure to keep your GP informed of the situation.
So, for a change, we’re going to talk about Dentists and the role they play. And once again other countries sadly seem to be leading the way in terms of giving good advice.
Recently a seminar was arranged in the United States by a typical Family Dentist and attended by over 60 people from the State in which she worked. The content was designed to be educational and was part of a very thorough outreach programme that was initiated to introduce the general public to the role that dentists play in the recognition and treatment of obstructive sleep apnoea or OSN.
The primary medical treatment for OSA is a device known as CPAP (Continuous Positive Air pressure) that supports the airway during sleep with pressurized air supplied through a tube from the CPAP machine to a nasal or facial mask.
This treatment with CPAP is 100% effective but is often very poorly tolerated by the patient. For those patients who cannot tolerate CPAP and for mild and moderate cases of OSA, specially educated dentists recommend a custom oral device that supports the lower jaw in a forward position. This appliance splints the airway during sleep preventing collapse during sleep. The treatment process is known as oral appliance therapy (OAT). The appliance, readily available here, is called a Mandibular Adjustment Device (MAD) – or in simple terms a Splint, or Mouthpiece.
Judging from the extensive discussion period that followed the seminar, many of the people present in the audience had been struggling with adhering to the CPAP regime prescribed by their General Practitioner.
Many of them complained that the CPAP provider never followed it up nad just left them to it – sink or swim – or should it be snore.. Most audience members had not had a sleep test with the CPAP unit in place to verify that their problem was being adequately controlled and consequently many of them have completely given up on their treatment.
When asked several times why their GP had never recommended the use of a mouthpiece for oral appliance therapy as an option it was explained that many physicians are not familiar with oral appliance therapy despite the fact that it is now a well-documented treatment for OSA. They are constantly trying to keep updated on so many things that affect illnesses that Snoring is relegated to the bottom of the Interest League.
This is despite the fact that Snoring and Sleep Apnoea are constantly linked with a rising incidence of serious and even life-threatening illnesses.
Around 20% of the population are estimated to get less than five hours of sleep a night, and those with OSA report snoring, morning headaches, daytime fatigue and irritability, high blood pressure and many other things as being common.
Fortunately, through these programmes mentioned earlier, Dentists are improving their focus on how to treat patients for both Sleep Apnoea and Snoring – and they’re doing it the sensible way – Oral appliance Theory.
Quick, inexpensive, effective…and possibly a life saver.
MAD – no simply sensible.
By John Redfern