How sleep apnea is treated through holistic dentistry

How Sleep Apnea is Treated Through Holistic Dentistry

It is estimated that as many as 22 million Americans suffer from sleep apnea. If you are among them, you’ve probably heard of CPAP (continuous positive airway pressure) machines. Those who’ve experienced CPAP machines know how effective they are, but can also testify to the discomfort involved in using them. This discomfort leads to low adherence, which means that many people who need them don’t use them as often as they should. The other key trouble with CPAP machines is that while they alleviate the symptoms, they don’t treat the causes of sleep apnea.

So, how can a holistic dentist help?

A holistic (or integrative) dentist will look for causes of sleep apnea, not just the symptoms. Major causes of sleep apnea actually include poor alignment of the jaw, and of the tongue, which are all things your dentist can help treat. These conditions can include:

  • Retrognathia: Poor alignment of the jaw can often be seen when the lower jaw is pulled back. This can push the tongue and the pharyngeal tissue backwards, restricting the airway and causing sleep apnea.
  • High tongue: Dr. Mandanas also looks for a higher than average tongue level. During sleep, the tongue relaxes and falls back. If it is larger than usual or set higher, it could block the airway when it relaxes, causing you to struggle to breathe when you’re asleep.
  • Mouth breathing: This can be caused by either a bad habit, sometimes brought on by a persistent cold, or by a developmental issue such as a collapsed arch. Mouth breathing is sometimes a symptom of an underlying issue which is also causing sleep apnea. However, mouth breathing can also cause sleep apnea itself as well. The tonsillar tissue at the back of the throat is designed to catch and kill bacteria before they enter the lungs. Excessive use, caused by constant mouth breathing, can cause this tissue to swell and lead to sleep apnea. Nose breathing, on the other hand, has many benefits – for example, nose hairs filter bacteria before they enter the airway; nitric oxide gas in the nasal passage kills bad bacteria; nasal passages warm air before it enters the lungs.
  • Tongue positioning: The tongue is a strong muscle and over time it shapes the mouth. Improper positioning of the tongue can, therefore, lead to mouth breathing and sleep apnea as we age.

What treatments can a holistic dentist provide?

The treatment naturally depends on the cause of sleep apnea. For tongue issues, retraining exercises can help by teaching the tongue where to sit while not in use. However, if your sleep apnea is caused by retrognathia, Dr. Mandanas may prescribe a mandibular advancement device (MAD). This device prevents the lower jaw from slipping back during sleep.

Like the CPAP machine, a MAD is worn during sleep. However, unlike a CPAP machine, a MAD is much less restrictive, allowing the patient to roll over and sleep in their preferred position. As treatment progresses and the jaw learns to stay in the new position, the MAD is adjusted to gradually push the lower jaw forward. It’s a really effective treatment.

Dr. Mandanas is also studying Advanced Light Force (ALF) therapy for patients who need a more advanced treatment than mandibular advancement. The ALF device works by applying light pressure to the interior of the teeth and facial bones to adjust the cranial structure, enacting neurological as well as physical changes by using the natural forces of the body for advanced sleep apnea patients. It is able to be worn during the day and is almost invisible to others, making compliance so much easier and delivering great results!

What are my options?

When you visit Dr. Mandanas, she will assess the causes of your sleep apnea and recommend the best treatment plan for you. The integrative options discussed above are covered by most insurances, although that coverage does depend on the exact nature of your sleep apnea.

If you or a family member suffers from sleep apnea and you are interested in Dr. Mandanas’ approach as an integrative dentist, contact us during office hours to schedule an appointment! We look forward to seeing you.

What You Need to Know About Treatment of Sleep Apnea

What You Need to Know About Treatment of Sleep Apnea

Sleep apnea is a condition that can cause discomfort and tiredness for many people. There are multiple causes that can lead to the condition. Here we’ll cover some of those causes and address some of the treatments.

What are the most common causes of sleep apnea?

There are two main types of sleep apnea. The most common is called obstructive sleep apnea (OSA). The other form is called central sleep apnea and is a result of the brain not sending the correct signals to allow a person to breathe during sleep. OSA is caused by some kind of obstruction to the airways. Both the US National Heart, Lung, and Blood Institute, and the UK National Health Service list some of the most common causes of this obstruction. Among these are obesity, large tonsils, excess growth hormone leading to increased throat size, age, and changes in facial bone structure.

How is sleep apnea treated?

Sleep apnea is typically treated through the use of a CPAP machine. This stands for continuous positive airway pressure. The machine works by continuously and gently pumping air into a mask worn over the mouth and nose during sleep. This works by preventing your airways from narrowing while you sleep, thus improving your breathing. However, there are other options. An alternative is a device called a mandibular advancement device (MAD).

Although a post on the Harvard blog site suggests that this may not be effective for those with the more severe forms of the condition, a MAD may be useful for those with mild sleep apnea.

A MAD is a gum-shield-like device that works by pushing the lower jaw forward during sleep. This helps to open the airway, reducing breathing pauses. Its main advantage over the CPAP machine is increased comfort. Comfort is important in treating sleep apnea as compliance with the treatment is necessary for success. A MAD allows a patient to sleep on their side, rather than on their back, as with the CPAP.

Why should I see a dentist about sleep apnea?

Dr. Mandanas is a dentist, and you may be wondering what sleep apnea has to do with your teeth. However, Dr. Mandanas prides herself on her holistic and integrative approaches to dentistry. As a result of her experience with the mouth and its structure, she has a good idea of when patients may have an oral structure that could lead to sleep apnea. Although Dr. Mandanas is not able to provide diagnoses, she is able to identify symptoms and recommend a visit to your doctor to get a proper diagnosis.

If you are diagnosed with sleep apnea, contact Dr. Mandanas and she will be able to help with finding a treatment that works for you!

What Is a Mandibular Advancement Device? (How It Works)

What Is a Mandibular Advancement Device? (How It Works)

Do you or a loved one suffer from obstructive sleep apnea (OSA)? If so, your dentist may have recommended a mandibular advancement device (MAD), an up and coming alternative to the CPAP machine. Now you might be wondering, “What exactly is a device like this and how does it work?” We’re happy to answer these questions for you today. Dr. Mandanas has been successfully treating OSA patients with oral devices for years and her passion is helping people find a solution that works for them. Enjoy learning from her expertise!

Are you ready to get MAD about sleep apnea? Schedule an appointment with Dr. Mandanas!

What Is a Mandibular Advancement Device and How Does It Work?

The mandibular advancement device (MAD) is an alternative treatment to the CPAP machine for obstructive sleep apnea (OSA). It is a sturdy, plastic, oral device that fits over the upper and lower teeth much like a mouthguard with a hinge in the middle. It works by gently advancing the lower jaw (mandible) forward during sleep. Because the lower jaw is attached to tongue behind the chin, the MAD advances this tissue as well, preventing it from collapsing over the airway (causing obstruction), thereby preventing OSA.

For many years, the mandibular advancement device has been proposed as an effective alternative to the CPAP machine for treating mild to moderate cases of obstructive sleep apnea, especially when the patient is considered a “CPAP reject.” A CPAP reject is someone who cannot tolerate the CPAP machine, which is very common. The continuous positive airway pressure (CPAP) machine works by forcing air through the patient’s airway to keep it open throughout the night. The air is administered from the machine to the patient by means of tubing and a mask. Both the mask and the forced air can be very uncomfortable, causing patients to remove the mask.

The mandibular advancement device is often preferred by the patient and is historically better for treatment adherence than the CPAP machine. That said, whether or not the MAD can treat severe cases of OSA is still under study. One of the latest scientific articles regarding these studies was published in January of 2018. The article confirmed the growing body of evidence that the MAD is an effective alternative to CPAP (in large part due to patient adherence) and typically preferred by patients when given a choice. From the article:

“There is now a strong body of evidence supporting their (oral appliances) use in OSAHS and clinical guidelines now recommend their use in mild OSAHS and in more severe cases when CPAP fails.”

Journal of Thoracic Disease

“It seems that the higher efficacy of CPAP is offset by greater MAD compliance.

Journal of Thoracic Disease

The factors that determine whether or not a dentist will recommend the mandibular advancement device include:

  • The severity of your obstructive sleep apnea
  • The structure of your upper airway
  • Any other medical issues you may have
  • Your personal preference

If you think the mandibular advancement device might be right for you or your loved one who suffers from obstructive sleep apnea, we would love to get you in for an appointment with Dr. Mandanas. The MAD has helped many patients who are “CPAP rejects” sleep deeply through the night and wake up feeling fully refreshed with energy throughout the day! Dr. Mandanas has a strong understanding of what makes someone a good candidate for the MAD. Please schedule an appointment with our office today.