Sleep Disordered Breathing and Orthodontics

Many people do not realize how sleep disorders affect their overall health. Sleep disorders, systemic and oral health are closely connected, and dental professionals play an important role in recognizing the signs and symptoms of many common conditions.

Sleep Disordered Breathing (SDB)

According to Resmed.com, Sleep disordered breathing (SDB)  is described as a group of disorders characterized by abnormal respiratory patterns (e.g. the presence of apneas or hypopneas); or insufficient ventilation during sleep.It is a disorder which ranges from partial upper airway obstruction (snoring) to complete upper airway obstruction (Obsrtuctive Sleep Apnea).

The first sign of a sleep disorder is snoring, even though many patients won’t identify that as a sign of something more serious. There are other common symptoms too.

Obstructive Sleep Apnea (OSA)

According to DentistryIQ, this often undiagnosed disorder is characterized by pauses in breathing or shallow breathing during sleep. Patients with this condition tend to be overweight and have a larger neck circumference. Potential oral signs include a small or recessed chin, a scalloped tongue, a vaulted palate with decreased inter-molar distance, enlarged tonsils, eroded enamel and enamel wear from bruxism.

Sleepiness during the day can be a classic sign of OSA. If a patient exhibits the oral signs of sleep apnea, ask them to evaluate their daytime habits with the Epworth Sleepiness Scale. Keeping a close watch for these signs could help a patient toward vital treatment. DentistryIQ notes that OSA is associated with conditions such as heart disease, diabetes and depression.

In 2% of children, obstructive sleep apnea (OSA) appears commonly between the ages of 2 and 7 years due to adenotonsillar hypertrophy.The frequency of OSA in adults is 0.3 to 4% between the ages of 30-60 years.

What are the signs & symptoms?

Snoring, Choking
Frequent Upper Airway infections and chronic runny nose
Morning headaches
Excessive sleepiness
Impaired Concentration
Restless and bizarre sleeping positions
Hyperactivity and stunted growth
Constricted upper and lower jaw
Nasal Septal Deviation
Enlarged tongue

How to treat them?

The choice of treatment is a multi-disciplinary approach varying from non-surgical to surgical approach depending on the severity of the case and underlying cause.

Oral appliances like Rapid Maxillary Expansion (RME) and Functional Appliance Therapy with Face
masks have an established treatment option for snoring and mild to moderate OSA cases. Oral devices like Mandibular Repositioning Appliance (MRA) and Tongue Retaining Appliances (TRA) are mechanical devices designed to prevent choking during sleep. They are effective in reducing snoring and daytime sleepiness by advancing the lower jaw and thereby increasing the upper airway volume.

To know more about sleep disordered breathing and to have a snoring free sleep please visit us at Pearl Dental Clinic

Dr Esther Gina Hyginus
BDS, MDS
Orthodontics & Dentofacial Orthopedics