If you answered yes to any of the above questions, you could suffer from Sleep Disordered Breathing (SDB). SDB is caused by an obstruction in the oral and/or nasal airway that occurs during sleep. The airway loses its patency, or muscle tone, and the soft tissue collapses in on itself, making it exceedingly difficult to breathe in enough oxygen and exhale carbon dioxide effectively. Snoring is not just an annoyance—it’s the first sign of a sleep disordered breathing problem; the sound heard is the soft tissue vibrating against itself as it relaxes when the snorer falls asleep. Upper Airway Resistance Syndrome (UARS) is more severe than snoring, and is accompanied by conditions including asthma, depression, and gastroesophageal reflux. Obstructive Sleep Apnea is marked by the complete collapse of the airway, sometimes hundreds of times a night. It can be fatal.
Sleep Disordered Breathing is now identified and treated within a new field called Sleep Disorders Dentistry, airway assessment and Oral Appliance Therapy.
The airway is the primary location associated with sleep disordered breathing, it is the first place a dentist should look when trying to determine the existence of a problem. Examining the airway is crucial, and is accomplished through a technique called Acoustic Reflection Technology (ART).
ART is completely painless. It involves mapping a patient’s airway with soundwaves, drawing a real-time picture of its anatomical structure. It determines the airway size, collapsibility (how much it will relax during sleep) and its cross-sectional size. It is a quick process free from side effects, and the research assures a standard deviation of 7%, which is minimal.
Patients do not have to lay down when being tested because those suffering from sleep disordered breathing have smaller airways than normal subjects while seated upright and awake. Those who suffer from Obstructive Sleep Apnea defend their airway when in the supine (laying down) position, which makes it more difficult to see the airway’s potential for collapsability, so it’s better of they are tested while seated.
Further, airway assessment is important for the dentist to perform when he is fitting an oral appliance, what is called “titrating.” Guessing at oral appliance placement and positioning in the mouth can lead to over-titration, insufficient titration, and is even thought to possibly cause sleep disordered breathing.
Every patient has a different airway and requires specific titration. There is no”magic appliance” that works for everyone, and airway assessment is very, very important.