Kellye N. Rice, DMD of Middle Tennessee Dental Sleep Specialists, PLLC
Sleep apnea is a serious but often undiagnosed condition that affects millions of Americans more and more every year. Patients often find that they power through the symptoms because they are just used to being tired during the day. When asked, many of our patients say they don’t sleep well, but they can’t believe that they could possibly have sleep apnea.
If you know that you are not sleeping well or if you snore or feel groggy or fall asleep during the day, Dr. Rice at Cool Springs Laser Dentistry may be able to help. She has recently reached the Qualified status with the American Academy of Dental Sleep Medicine, the only non-profit association dedicated to the education and treatment of sleep disordered breathing by dentists. She can help screen you for sleep apnea and help you find the right treatment for your needs. And, if you already know that you cannot tolerate your CPAP machine, she can help you with an oral appliance or NightLase Laser therapy to open your airway.
The 2007 Wisconsin Cohort Study showed us that those with untreated sleep breathing issues have a significantly reduced life expectancy–do it for your loved ones. Get screened, tested by a physician, and find the best treatment for you! Call now (615) 649-0556 for a complementary sleep consultation.
Sleep Apnea Screening and Treatment Q & A
Cool Springs Laser Dentistry, PLLC and Middle Tennessee Dental Sleep Specialists, PLLC
What is sleep apnea?
Sleep apnea is a medical condition that results from the patient’s inability to keep their airway open when asleep which stops the airflow for 10 seconds or more. It’s commonly caused by an obstruction in your airway, which is why it’s often referred to as obstructive sleep apnea. If you snore, you do not always, but most likely have some degree of obstructive sleep apnea. It affects your major organs, like your heart and kidneys, and can be life threatening.
The latest study out of Harvard University associated moderate to loud snoring with hardening of the carotid artery due to the vibration transmitted to the surrounding areas of the head and neck. Sleep Apnea is a condition that makes it very hard to get the right percentage of O2 to your vital organs while sleeping. The tongue and throat can relax to the point it closes up and you stop breathing. This will affect your cardiopulmonary system and can have detrimental effects on your overall health, along with the possibility of death.
Sleep apnea may also result from insufficient brain signaling, called central sleep apnea. Breathing is typically a process that happens naturally, but with central sleep apnea, your brain is not sending your respiratory system the proper signals.
Either form of sleep apnea requires immediate medical treatment. If left undiagnosed and untreated, you are likely to suffer from sleep loss, fatigue, exhaustion, and mental fog due to an inability to reach deep sleep. Recent studies have linked Alzheimer’s to sleep breathing issues, so we all need to make sure our airways are open!!!
How do I know if I have sleep apnea?
To know exactly whether you have sleep apnea and to what degree, you should have a sleep study. The results of the sleep study can help identify the best possible treatment for your needs. Some signs of sleep apnea are grogginess during the day, feeling sleepy even after a “good” night’s sleep, snoring, and breathing stops during sleep. Chronic, disruptive snoring indicates you may have sleep apnea, but it’s not the only symptom. Other signs include:
- Daytime sleepiness and feelings of sleep deprivation
- Difficulty concentrating
- Sexual dysfunction
- Learning and memory challenges
People who are overweight, have high blood pressure, and suffer from heart disease may be at greater risk of having sleep apnea.
How does a dental office treat sleep apnea?
Treating sleep apnea with a Continuous Positive Airway Pressure (CPAP) machine is the one best method for treating your sleep apnea. However, it’s not the only solution. and some people just can’t tolerate the breathing machine.
Cool Springs Laser Dentistry offers a variety of methods to treat sleep apnea. These include Mandibular Advancement Devices (MAD) and NightLase therapy. The goal of an Oral Appliance Therapy device (OAT) is to reposition the mandible in order to open your airways when sleeping. This basically pulls your lower jaw and tongue forward so there is more space in the airway and no interruption in the flow of air when you are fully relaxed during REM sleep. People who never achieve the necessary amount of REM sleep are often never fully rested. If you have sleep apnea due to a large tongue or a small jaw, you may be a good candidate for these types of appliances.
We also provide the NightLase LightWalker procedure by applying the non-cutting laser light and warmth to the soft palate and under the tongue to shrink those tissues and open the back of the throat by promoting collagen production. NightLase shrinks the soft palate upward and toward the front of the oral cavity to open the airway, firming them without creating scar tissue like most surgical procedures, and making those tissues less loose in the oral cavity. Three 30-minutes sessions 21 days apart are needed in most cases. Smokers or long time CPAP users may need 4 sessions. Individual consultations with Dr. Rice will determine the best course of action.
Are the dental appliances comfortable?
Most people tolerate their sleep appliance just fine. Some people have a longer adjustment period, but our goal is to walk with you on this journey, no matter how long the adjusting or “calibration” period takes. Then we send you back to your sleep doctor for confirmation that success is achieved. The appliances fit similarly to a mouth guard or orthodontic retainer. Basically, this treatment is non-invasive and simple, and for most people much more comfortable than the headgear of a CPAP machine. Some of the advantages include:
- No outer headgear
- Easy of use and care
- Portable, so it’s convenient for travel
I’ve had a CPAP machine but it was just too uncomfortable and I can’t use it. How does dental sleep medicine replace a CPAP?
The CPAP machine is the gold standard of care for sleep apnea, however, if you are unable to use it, it does not help. If the results of your sleep study indicate alternative treatments Dr. Rice is able to make a custom device that can help open the throat and improve breathing during sleep. There are several types of devices available, Dr. Rice can consult with you to determine the best possible option for you. Call now to set up a complimentary one on one sleep consultation.
What do the appliances look like? Why can't I just get one over-the-counter type?
Dr. Rice fabricates custom devices, not only fitted specifically to the shape of your teeth but also made with a specialized George gauge bite registration that allows calibration of the device to the proper jaw position for maximum airway opening and to minimize jaw pain while wearing the appliance. Over-the-counter brands don’t allow for this type of adjustments. Plus, all visits regarding calibration of the device are included in the cost. Dr. Rice even checks in on patients via VIP phone calls to make sure they are doing well with their appliances. In addition to fabricating the device for you, included in the fee is a “Morning Repositioner.” This small custom bite wafer is critical to ensuring your chewing stability. Over-the-counter devices don’t take this key theory into consideration. See photos of several appliances that are among the ones Dr. Rice fabricates.
Is NightLase Painful? What is the downtime?
NightLase is the non-ablative soft tissue warming protocol to gently heat the tissue and promote collagen formation to shrink the tissues of the soft palate and base of the tongue in order to open the airway. Its heat generation is similar to a sip of hot coffee. Most people tolerate the procedure very well. Some patients prefer the use of a topical numbing gel or nitrous oxide during the visit. The entire treatment takes about 30 minutes and is packaged as 3 sessions, 21 days apart for maximum collagen formation over time for best results. Touch up sessions are needed as the tissue becomes lax over time as a result of the aging process or if the patient’s sleep partner notices snoring returning. Results can last 12-18 months.