Comorbidities Diagram

jwing11 — Thu, 05 Dec 2024 21:59:25 +0000

Obstructive Sleep Apnea (OSA) patients are at a higher risk for other serious health complications. When left untreated, snoring and sleep apnea lead to several significant chronic diseases or conditions, as well as many other health conditions.

OSA-comorbidities_000205-1

CPAP Treatment Reduces Inflammation

Jwing — Wed, 30 Aug 2017 21:16:34 +0000

Studies:

systemic inflamation article08302017

Bruxism

Richard Sellman — Thu, 17 Aug 2017 20:36:39 +0000

Think You Know Everything About Bruxism?

Think you know everything about bruxism think again

Avoid Permanent Side Effects of OSA

Richard Sellman — Thu, 17 Aug 2017 07:43:46 +0000

The Two Main Side Effects of Oral Appliance Therapy:

1. The teeth moving apart, resulting in spaces between the teeth

2. The lower jaw moving in to a different position that results in teeth not lining up anymore

Every night before bed you should tap your teeth together to make sure that your bite ALWAYS FEELS THE SAME BEFORE BED. If you feel that your teeth are not coming together the way they used to (usually meaning that your back teeth don’t touch as well), and this occurs for a day or two, GIVE US A CALL.

Before Bed Alignment Check

The Floss Check

Every night before bed you should FLOSS YOUR TEETH. The feeling of passing the floss between your teeth should ALWAYS FEEL THE SAME BEFORE BED, or at least it shouldn’t go from “difficult” (as in the spaces between the teeth are tight) to “easy” (as in the spaces are getting bigger). If you feel that a couple of nights in a row that the spaces between your teeth might be changing, GIVE US A CALL.

The Bite Check

Second, every night before bed you should CHECK YOUR BITE. You’ve probably never given it much thought, but your teeth fit together in a very specific way. You’ll immediately notice that in the morning after wearing your oral appliance that your bite will feel “weird” or “off.” This is to be expected, as your lower jaw is held in a different position all night long, and it takes a bit for your jaw position to return to normal. For most of our patients their jaw will go back to normal on it’s on within an hour or two.

*You can speed up the process of aligning your bite each morning with simple stretching exercises or using the “AM Aligner” that you were given.

*If you ignore these simple steps you could have permanent changes to your teeth or bite that may require correction at additional costs, or could result in damage to and/or pain in your teeth or jaws.

Should you have any questions at all, please call us.

(707) 292-6462 RICHARD SELLMAN, DDS

Side Effects of Oral Appliance Therapy

Richard Sellman — Thu, 17 Aug 2017 07:36:32 +0000

OAT therapy moves the lower jaw and the condyles of the jaw joint downward and forward, holding it that position while you sleep. This stretches open the airway and to keeps your tongue from falling back and blocking your airway.

Initial Side Effects

Initial side effects include jaw muscle, teeth and TMJ joint soreness. As your body adjusts to this nightly thrust the symptoms usually subside. The appliance is initially set at a tolerable 50% of your maximum protrusion in order to minimize this soreness. If needed, the appliance is slowly adjusted forward in order to open the airway and alleviate the symptoms of OSA.

Other Short Term Symptoms Include:
Excessive salivation
Dry mouth
Tooth and jaw discomfort
Temporary bite changes

Long Term Side Effects

Long term side effects can be a slight opening of the posterior teeth contacts caused by the force of protruding and holding the lower jaw forward at night and by a downward and forward movement of the rest position the lower jaw.

You may feel more contact on your front teeth and less on your back teeth. It is however usually less that a 1-2 millimeters after wearing your MAD for several years.

Most longtime users are OK with this as their health issues and symptoms of OSA have drastically improved.

Can Long Term Oral Appliance Use Cause TMJ?

Wearing a custom MAD does not cause TMJ. However, if you have symptoms of TMJ they should be evaluated and treated if severe, before wearing a custom oral appliance. Often people with OSA clench and grind their teeth while asleep and can cause jaw TMJ muscle soreness and premature wear of their teeth. This can be related to involuntary jaw thrusting during apnea events

What is an AM Bite Splint?

It is a thermoplastic material that is softened by heating, and fits over the lower front teeth. When the patient bites down normally on the back teeth, this imprints an impression of how their front teeth come together in a normal bite. It hardens up as it cools. Each morning Dr. Sellman’s patient’s will place the AM bite splint over their teeth after they take their appliance out. It will then exercise their jaw by biting into the AM splint for a few minutes, thus re positioning the jaw in the normal bite. This corrects the stretch in the muscles, moving the bite position forward after wearing the MAD all night.

Long Term Complications

Some patients experience potential complications such as:

Jaw pain
Permanent changes to your bite
TMJ symptoms

Long Term Effects of OSA on Cardiovascular Fitness and Psychomotor Performance

Jwing — Thu, 17 Aug 2017 01:21:09 +0000

Studies:

The long-term effects of mandibular advancement splint on cardiovascular fitness and psychomotor performance in patients with mild to moderate obstructive sleep apnea: a prospective study.

Sleep Screening Form

Jwing — Sun, 06 Aug 2017 16:35:50 +0000

1A. SSC Dental Sleep Screening Form NEW 1 2016

Different Types of Oral Appliances and How they Work

Richard Sellman — Sun, 06 Aug 2017 09:04:33 +0000

View various types of oral appliances and their applications.

Sleep Lecture OAT Appliances by Mechanism of Action PDF

Why is Sleep Apnea Dangerous?

Jwing — Sat, 05 Aug 2017 23:50:42 +0000

Besides depriving the body of deep (restorative) sleep and REM (dream) sleep, chronic sleep apnea is a potentially fatal condition. But you may be wondering how exactly sleep apnea is dangerous, even fatal.

During the night as the body is deprived of oxygen our heart rate slows down. During an apneic episode precisely when the body has run dangerously low on oxygen it sends off the alarm that it needs more oxygen and your heart begins to beat rapidly. Throughout the night this may reoccur over 100 times or more an hour. The constant slowing and speeding up of our heart rate puts a tremendous amount of stress on it.

A diagnosis of Obstructive Sleep Apnea (OSA) is determined by a Board Certified Sleep Physcian that has evaluated an overnight sleep study done for the patient.

Normal apneic events: 0-4 per hour.

Mild apneic events: 5-14 per hour.

Moderate apneic events: 15-29 per hour.

Severe apneic events: 30 or more per hour.

Snoring Versus Sleep Apnea – The Differences and Similarities

Jwing — Sat, 05 Aug 2017 20:45:52 +0000

Do you snore? Do you experience daytime sleepiness or wake-up feeling unrested? If you answered yes to either of these, chances are you are being robbed of oxygen repeatedly during the night but do not remember it upon waking. Besides the obvious dangers caused from lack of oxygen, the health risks associated with lack of proper rest are many, and can be fatal. So while you may think you are getting 8 hours of sleep each night, if you are being disturbed repeatedly as your body is fighting for oxygen, the truth is you’re no where near that 8 hours. It’s likely you’re not even getting half that since the only sleep that counts as “restorative” are those hours spent in the REM stage. Consequently, REM sleep is also the stage in which our muscles are most relaxed and when these episodes are likeliest to occur.

What Causes Snoring and Sleep Apnea?

Snoring and OSA (obstructive sleep apnea) both involve the soft tissue in the back of the throat becoming too relaxed. In the case of snoring the soft tissue, while not completely blocking the airway is in the airway path. As air hits the tissue with each breath it flaps, much like a flag does when the wind blows, causing the loud sound snoring is known for. But during apneic episodes the soft tissue collapses, causing a full or near full blockage of the airway, triggering gasps or choking in response to the bodies lack of oxygen. There are many things that can contribute to snoring and OSA. See the physical and non-physical contributors below.

Physical Contributors

thick neck circumference, or long narrow neck
excessive weight
nasal obstruction due to a deviated septum, allergies, or sinus problems
large tonsils/soft tissue
deviated septum
large tongue
small jaw bone
overbite, orthodontics with extraction of teeth
family history of snores
age

Non Physical Contributors

drinking alcohol
sleep deprivation
certain sleep positions
certain sleep aids or medications
smoking

And while snoring and sleep apnea aren’t always associated with one another, snoring over a long period of time is likely to evolve into apnea