Dentistry plays an extremely important role in sleep medicine, not only in treatment, but also in the recognition of the clinical signs, and screening for, sleep disordered breathing. Along with obesity, the incidence of sleep apnea is on the rise, yet it is both under diagnosed and undertreated. Much of the healthcare budget and resources are spent managing the comorbidities associated with sleep apnea, yet the underlying problem remains undiagnosed. Thankfully, awareness is increasing among the medical and dental professions and the public alike, and one day the future may not equal the past. (Read more…)
Sleep apnoea results in repetitive collapses of the airway and the only way the breathing is kick started again is through arousals from sleep. These repetitive arousals fragment the sleep and turn up the stress response of the body. Instead of a time of healing, recovery, memory consolidation and renewal, the mind and body are fighting the effects of an upregulated stress system. This puts sufferers at great risk of heart attack stroke and diabetes. In fact sleep apnoea suffers are at 4x the risk of dying from all causes including motor vehicle accidents, and 5x the risk of dying from a heart attack or stroke than a non sufferer.
This physiologic upregulation of the stress response of the body needs to be understood and respected if dentists are to become involved in treating sleep apnoea. What we do to patients needs to support their physiology. We need to optimize their head, neck and jaw position to support the airway when they are most vulnerable, lying down and asleep!
If you went to the Doctor with a broken arm, he does not reset it in its broken position. He corrects it first then stabilises it. People who have sleep apnoea are also broken. There are many compromises and adaptations going on in their system, or they would not have sleep apnoea. The physiologic approach to the dental treatment of sleep apnoea recognises that it is important to optimise the system first, before determining where the jaw should be held every night to manage the sleep apnoea. It is the dentist's responsibility to not only provide an airway but to optimise the physiology which has been on overdrive. This way the patient will be in the best position to benefit physiologically from the treatment with the upside of increased comfort rather than side-effects.
The 3 day program on “Physiologic Approach to Understanding and Treating Snoring and Sleep Apnoea” is designed to ensure dentists have a full appreciation of the physiology and pathology associated with sleep apnoea, how to optimize the physiology before taking the bite and how to incorporate this treatment into your practice and manage the patient effectively for best treatment outcomes
The undertaking of my Masters Degree in Sleep Medicine has reinforced the importance of this physiologic approach. Medicine has long measured physiology. It is time dentistry caught up. There are many tools and treatment protocols available to optimize the physiology; the technology is available, the education is available, and the patient is worth it.