Tuesday, August 24, 2010

Dentists Overcome Challenging Sleep Apnea Case

A new study in the Journal of Oral Rehabilitation evaluated the use of an oral appliance (OA) for the treatment of obstructive sleep apnea (OSA) in a patient with severe dental problems and multiple missing teeth.

Dentists used a custom-made mandibular advancement device (MAD). This type of device moves the lower jaw and tongue base forward during sleep to keep the airway open.

The patient was 58 years of age and male. He had moderate OSA and experienced pauses in breath more than 20 times per hour of sleep. With only ten teeth, the patient exhibited severe dental and periodontal concerns.

Wearing the MAD produced a significant decrease in his OSA. Instead of 20 pauses in breath, the patient experienced only eight pauses per hour – more than halving the severity of his condition.

Dental and periodontal treatments were also performed to reestablish his oral health. The OA was modified after each treatment to adapt it to each new oral condition.

After 18 months, the oral health was reestablished and the patient received a final MAD.

Three years later, no side effects related to the OA treatment were detected.

These results show the feasibility of treating OSA patients with OA despite poor oral conditions and missing teeth.

Click here to read a recent study in Sleep and Breathing that discussed performing oral appliance therapy on a sleep apnea patient with no teeth.

Some patients who wear oral appliances to treat sleep apnea experience side effects. These effects include:

• Jaw, tooth, gum, tongue, or facial pain
• Dry mouth
• Salvation
• Gagging
• Changes in the biting surface of the teeth

The American Academy of Sleep Medicine (AASM) recommends the use of OAs for mild to moderate apnea patients if they prefer the appliance to CPAP, cannot tolerate CPAP, or cannot use positional therapy or weight loss to control their apnea. OAs are also recommended for severe patients if they are unable to tolerate CPAP.

The American Academy of Dental Sleep Medicine trains dentists to treat OSA patients with custom-made oral appliances. Find an AADSM-Member here.

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Disclaimer

The Official Blog of the American Academy of Dental Sleep Medicine (AADSM) is intended as an information source only. Content of this blog should not be used for self-diagnosis or treatment, and it is not a substitute for medical care, which should be provided by the appropriate health care professional. If you suspect you have a sleep-related breathing disorder, such as obstructive sleep apnea (OSA), you should consult your personal physician or visit an AASM-accredited sleep disorders center. The AADSM, and the American Academy of Sleep Medicine, as the managing agent of the AADSM, assume no liability for the information contained on the Official Blog of the AADSM or for its use.