For years, you’ve been going to your dentist, and it’s always the same routine: cleaning, X-rays and an exam. Your dentist has told you about the harmful effects of periodontal disease, its correlation to heart disease, and the importance of brushing and flossing daily. But what your dentist can see in your mouth may just save your life.
Recently, Rep. Gus Bilirakis, R-Fla., introduced House Resolution 384, titled “Recognizing the importance of increased awareness of sleep apnea.” This resolution is aimed at raising awareness of the consequences and treatments of sleep apnea.
Obstructive sleep apnea (OSA) is the most severe form of sleep-disordered breathing. It is characterized by “apneic events” — complete cessations of breathing that last at least 10 seconds — and can be diagnosed as mild, moderate or severe.
According to the Harvard-trained physician who coined the term “obstructive sleep apnea,” sleep apnea will soon be the most-common chronic disease in industrialized countries, and it by 2010, roughly 20 percent of adults may suffer from it.
If untreated, OSA can result in a number of serious health consequences:
- High blood pressure
- Stroke
- Heart attack
- Atherosclerosis
- Sexual dysfunction
- Acid reflux
- Cognitive impairment
- Congestive heart failure
OSA is also prevalent in children; therefore, early screening is extremely important. Obstructive sleep apnea in children can lead to hyperactivity, ADHD, sleepwalking, bedwetting, and as much as a 10-point drop in IQ. If it is not treated early, permanent brain changes can occur.
What role does your dentist play in diagnosing and treating sleep apnea? Believe it or not, quite a few signs of OSA are evident in the mouth.
For example, OSA patients are six times more likely to grind or clench than a normal group. Patients who have acid reflux will exhibit erosion of the tooth enamel. Of the number of people who suffer from temporomandibular joint disorder (TMD), 70 percent will screen positive for OSA. And if you stick out your tongue and see scalloping, or indentations of the teeth, on the edges of the tongue, that is 70 percent predictive of OSA.
While your physician should be looking for outward signs of OSA, such as large neck size and obesity, these are not the only hallmarks of sleep apnea. In fact, it is alarming how many patients do not fit that profile, yet are still diagnosed with OSA. And when you consider that untreated OSA results in a 20 percent reduction in life expectancy (and 95 percent of OSA patients are undiagnosed), it becomes of paramount importance that everyone is screened for apnea, regardless of their weight or neck size.
Obstructive sleep apnea can only be diagnosed by a specially trained physician after a sleep study is administered, and a referral can be made by either your dentist or your primary care physician. If the study returns positive, a sleep physician will most likely recommend continuous positive air pressure therapy, which is very effective if worn properly and consistently.
A custom oral appliance made by a specially trained dentist can also be effective for those with mild or moderate OSA, by holding the lower jaw forward and preventing a collapsed airway.
At a glance
For more information on obstructive sleep apnea, visit http://blog.functional
smiles.com/
Ariana Ebrahimian, DDS, is a Scotts Valley dentist practicing at Ebrahimian Aesthetic Dentistry with her father, Max Ebrahimian, also a dentist. She can be contacted at www.functionalsmiles.com.
