Sleep Apnea
by Dr. Mehryar Issac Ebrahimi, DDS | Beverly Wilshire Dental Group
What Is Sleep Apnea?
Sleep apnea is a condition in which breathing repeatedly stops and starts during sleep. The most common form, obstructive sleep apnea (OSA), occurs when the muscles in the throat relax and partially or fully block the airway. This can lead to fragmented sleep, loud snoring, and reduced oxygen levels during the night, even if the person experiencing it isn't fully aware it's happening. Diagnosing sleep apnea requires a sleep study, typically ordered and interpreted by a physician or sleep specialist, since a dental exam alone cannot confirm the condition.
The Dentist's Role in Sleep Apnea Care
1. Recognizing Early Warning Signs
During a routine dental exam, Dr. Ebrahimi may notice physical indicators associated with sleep-disordered breathing, such as a scalloped tongue, worn teeth from grinding, or a narrow airway, and can discuss these findings with you and recommend a sleep evaluation when appropriate.
2. Providing Oral Appliance Therapy
For patients diagnosed with mild to moderate obstructive sleep apnea, or those who cannot tolerate a CPAP machine, a custom oral appliance may be prescribed by a physician and fabricated by a dentist. These devices are designed to reposition the jaw or tongue slightly to help keep the airway more open during sleep.
3. A More Comfortable Alternative for Some Patients
While CPAP therapy remains a standard treatment for moderate to severe sleep apnea, some patients find oral appliances more comfortable and easier to use consistently, which can be an important factor in treatment success.
4. Collaborative Care With Your Physician
Dr. Ebrahimi works alongside your physician or sleep specialist throughout diagnosis and treatment, ensuring that any oral appliance therapy is coordinated appropriately with your overall medical care.
5. Monitoring Your Bite and Jaw Health
Patients using an oral appliance need periodic dental follow-up to monitor the fit of the device and any changes to the bite or jaw joint over time, which Dr. Ebrahimi provides as part of ongoing care.
Common Myths About Sleep Apnea and Dental Treatment
Myth: "Snoring and sleep apnea are the same thing." Snoring is a common symptom, but not everyone who snores has sleep apnea, and not everyone with sleep apnea snores loudly. A proper diagnosis requires a sleep study rather than snoring alone.
Myth: "Only significantly overweight people get sleep apnea." While excess weight is a risk factor, sleep apnea can also occur in people at a healthy weight due to factors like airway anatomy, tonsil size, or jaw structure.
Myth: "A dentist can diagnose sleep apnea just by looking in your mouth." A dental exam can reveal signs that raise suspicion for sleep apnea, but a formal diagnosis requires a sleep study conducted or interpreted by a physician or sleep specialist.
Myth: "CPAP is the only effective treatment." CPAP is often the first-line treatment, particularly for moderate to severe cases, but oral appliance therapy is a recognized alternative for select patients, particularly those with mild to moderate sleep apnea or difficulty tolerating CPAP.
Myth: "Oral appliances work the same for every patient." Oral appliances are custom-fitted and adjusted based on an individual's anatomy and the specifics of their diagnosis. What works well for one patient may not be appropriate for another.
Myth: "If you don't feel tired during the day, you don't have sleep apnea." Daytime sleepiness is a common symptom, but some patients with sleep apnea don't recognize significant daytime fatigue, even though the condition is still affecting their sleep quality and oxygen levels overnight.
Frequently Asked Questions
Can my dentist diagnose sleep apnea? No, a dentist cannot formally diagnose sleep apnea. Dr. Ebrahimi can identify signs that suggest a sleep evaluation may be warranted and can refer you to a physician or sleep specialist for a formal diagnosis.
What are common signs of sleep apnea? Common signs include loud or frequent snoring, gasping or choking during sleep, daytime fatigue, morning headaches, and, in some cases, physical signs a dentist may notice such as tooth wear from grinding or a scalloped tongue.
How does an oral appliance work? An oral appliance is worn during sleep and is designed to reposition the jaw or tongue slightly forward, helping to keep the airway more open and reduce airway obstruction during sleep.
Is an oral appliance as effective as a CPAP machine? For select patients, particularly those with mild to moderate sleep apnea, oral appliances can be an effective treatment. However, CPAP is generally considered more effective for moderate to severe cases. Your physician can help determine the most appropriate treatment for your specific diagnosis.
Do I need a prescription for an oral appliance? Yes. Oral appliance therapy for sleep apnea typically requires a diagnosis and prescription from a physician or sleep specialist before a dentist can fabricate the device.
Will insurance cover an oral sleep appliance? Coverage varies by insurance plan and is often processed through medical insurance rather than dental insurance, since sleep apnea is a medical diagnosis. Our office can help you understand the process.
What happens during dental follow-up for an oral appliance? Follow-up visits typically involve checking the fit and function of the appliance, monitoring any changes to your bite or jaw joint, and coordinating with your physician regarding your ongoing treatment.
Concerned About Sleep Apnea?
At Beverly Wilshire Dental Group, Dr. Ebrahimi can help identify signs that may warrant a sleep evaluation and, when appropriate, provide oral appliance therapy in coordination with your physician. If you or a loved one snores loudly, wakes up feeling unrested, or has been diagnosed with sleep apnea and is exploring treatment options, we welcome the opportunity to discuss whether dental sleep medicine may help.
Sleep Apnea and Dental Sleep Medicine: How Your Dentist Can Help
Sleep apnea is often thought of as a medical condition alone, but dentistry plays a meaningful role in its management for many patients. At Beverly Wilshire Dental Group, Dr. Ebrahimi works alongside patients' physicians to help identify signs of sleep-related breathing issues and, when appropriate, provide oral appliance therapy as part of a broader treatment plan.