Snoring Isn't Sexy Toronto
Snoring isn't sexy - Neither is cardiovascular disease, high blood pressure, diabetes, stroke, depression and even erectile dysfunction. Nor are the accidents caused by the drowsy driving related to sleep apnea. And now a new study has shown that loud snoring itself can have devastating consequences. An article published in March, 2008 stated that loud snorers had 40% greater odds of having hypertension, 34 % greater odds of having a heart attack and 67 % greater odds of having a stroke than people who did not snore.
It doesn't matter if you are a man or woman (although men do snore more), or young or old or thin or heavy, snoring and sleep apnea can affect everyone - even young children! Snoring can be a sign of obstructive sleep apnea. It's not just unsexy. It's unhealthy. But you're not alone, which is why we've created this resource.
Dentistry now plays a critical role in the recognition and management not only of snoring but also obstructive sleep apnea.
Snoring can be a hazard to your health, but it is treatable.
About Dr. Stern
Dr.David J. Stern Graduated from The University of Toronto in 1989. For the last 19 years,Dr.Stern has maintained a General Dentistry private practice in the Greater Toronto Area. Dr.Stern is a Member of The Ontario Dental Association (O.D.A), The American Academy of Cosmetic Dentistry (A.A.C.D), The Canadian Sleep Society (C.S.S) and The American Board of Dental Sleep Medicine(A.B.D.S.M)
Dr.Stern has been treating patients for Snoring and Obstructive Sleep Apnea, in conjunction with Medical Doctors, for the last thirteen(13) years,and is a Diplomate of the American Board of Dental Sleep Medicine.
Snoring
Snoring is the sound of obstructed breathing during sleep. Sometimes snoring can be harmless, but generally it is a danger sign that indicates a serious problem which progresses from upper airway resistance syndrome (UARS) to OSA.
SnoringSnoring occurs when the structures in the throat are large and the muscles relax enough during sleep to cause the airway to narrow and partially obstruct the flow of air. As air tries to pass through the partially collapsed airway, the throat structures vibrate causing the sound we know as snoring. Large tonsils, a long soft palate and uvula, certain jaw formations and excess fat deposits contribute to the collapsibility of the airway.
Obstructive Sleep Apnea (OSA)
Obstructive sleep apnea occurs when the airway completely collapses during sleep and airflowNormal Airway stops entirely. Since no air can be drawn into the lungs, the oxygen level in the blood drops which eventually signals the brain to partially awaken in order to stimulate the throat muscles to open and clear the obstruction. This usually happens with a loud gasp or choking sensation. Once the airway is open, breathing and sleep can resume. However, the relaxing Obstructed airwayinfluence of sleep affects the throat muscles as before and this process starts again and continues over and over all night. People with OSA experience disrupted sleep and periodic drops in oxygen levels each night. This is associated with cardiovascular disease and excessive daytime sleepiness. The condition known as upper airway resistance syndrome (UARS) lies midway between snoring and true OSA. People who suffer from UARS suffer many of the symptoms of OSA but do not really have OSA.
I Can't Wear my CPAP
Now there is an effective way to control snoring and obstructive sleep apnea without resorting to cumbersome CPAP devices. A small device, similar to an orthodontic appliance, can be an alternative to cumbersome CPAP machines and, in some cases, be the first choice for treatment of mild to moderate obstructive sleep apnea.
CPAP problems
Continuous Positive Airway Pressure (CPAP) is generally considered the mainstay of treatment for obstructive sleep apnea. However, in almost half of the cases where it is prescribed, it is poorly tolerated or simply rejected due to its cumbersome and intrusive nature.
Other objections include:
* Inconvenience
* Nasal Congestion
* Sinus Problems
* Skin Irritation
* Claustrophobia
* Mask Leaks
Overview of Oral Appliance Therapy
Oral appliances have been in use for over 20 years to effectively treat snoring and obstructive sleep apnea. Currently, over 40 different appliance designs are available to specially trained dentists for this use. Many scientific studies have been published that demonstrate the effectiveness of these appliances when utilized by trained and experienced sleep-disorders dentists.
Oral appliances are placed in the mouth much like an orthodontic retainer or an athletic mouth guard. They are utilized during sleep to prevent the collapse of the tongue and soft tissues in the back of the throat so that the airway stays open during sleep. The appliances promote adequate air intake thereby helping to provide normal sleep for those who suffer from snoring and/or obstructive sleep apnea. Oral appliances can be used alone or in combination with CPAP or after surgery. Determination of proper therapy can only be made by joint consultation between your sleep-disorders dentist and your sleep physician.
Types of Oral appliances
Of the many appliances available today, each falls under one of two categories based on mode of action. The first and largest category is that of the “mandibular repositioning device”. By far the majority of all appliances in use today fall into this category. These devices serve by gently repositioning the lower jaw forward during sleep. The second category is that of the “tongue retaining device”. These appliances are seldom used but can be very effective for many people, especially those with few or no teeth or jaw joint problems. Tongue retaining devices function by protruding the tongue forward during sleep.
Appliances used in our office
- TAP -Thornton Adjustable Positioner
- Silencer
- Klearway
The Thornton Adjustable Positioner (TAP®) oral appliance is a mandibular advancement device composed of two separate arches (maxillary and mandibular) containing an advancing mechanism which permits unlimited advancement of the lower jaw. The arches are custom fit to a patient's models. The advancing mechanism is engaged and the screw mechanism in the upper tray is then turned to advance the mandible until the patient begins to feel any discomfort in the temporomandibular joint or in the facial muscles (maximum mechanical protrusion which is an average of 2.5mm beyond maximum protrusion). The advancing screw is then turned back until patient is comfortable.
The Silencer Professional is a laboratory fabricated fully adjustable oral appliance for the treatment of sleep apnea and snoring. The appliance features a titanium precision attachment, which controls the anatomical settings of the appliance. It is capable of anteroposterior adjustment as well as vertical adjustment through a range of 10mm, in both dimensions. The design of the precision attachment also allows lateral movement of the mandible which respects and protects the TMJ. The titanium Halstrom Hinge? is made of implant grade titanium and carries a five-year warranty.
There are three component materials in the Silencer. The body of the appliance is constructed of elastamer,a pliable material which offers the patient a much greater degree of comfort than harder acrylic materials. For additional support, to the dentition as well as the temporomandibular joint, hard acrylic "bite pads" are placed in the molar regions. A commercially pure titanium articulating component grants the appliance the many adjustment characteristics that make the Silencer unique - kind to the tissues, the teeth, and the temporomandibular joint.
FDA Approval: Approved for both snoring and OSA
Date of FDA Approval: Nov 29, 1995
FDA Registration Number: K954530
Klearway â„¢ is a fully-adjustable oral appliance used for the treatment of snoring and mild to moderate Obstructive Sleep Apnea. Fabricated of thermoactive acrylic resin, Klearway becomes pliable for easy insertion and confirms securely to the dentition for an excellent fit while significantly decreasing soft tissue and tooth discomfort. Small increments (0.25mm) of forward lower jaw advancement are initiated by the patient under the direction of a dentist and this helps avoid rapid jaw movements that can cause significant patient discomfort. The appliance does not encroach on tongue space.
Once warmed under hot water and inserted, the acrylic resin hardens as it cools to body temperature and firmly affixes itself to both arches. Lateral and vertical jaw movement is permitted which enables the patient to yawn, swallow, and drink water without dislodging the appliance.
A total of nine articles about the Klearway appliance are available for review by dentists and/or physicians.
FDA Approval: Approved for both Snoring and OSA
Date of FDA Approval: May 25, 1995
FDA Registration Number: K950763
The EMA® - Custom appliance is a simple, patient-friendly oral appliance created for noninvasive treatment of snoring and OSA. The primary treatment mechanism of opening the bite and gently moving the mandible forward is achieved with the use of interchangeable elastic straps that offer varying degrees of mandibular advancement. The flexibility of these elastic straps provides unsurpassed lateral movement and overall TMJ comfort. The 2 mm thick pressure formed bases offer orthodontic retention (resulting in no tooth movement) and maximum anterior tongue space because there are no projections in the palate.
The Elastic Mandibular Advancement (EMA®) appliance uses elastic force to advance the mandible. Hand plastic trays are pressure formed to the patient's models and utilize the undercut areas of the teeth for retention. This insures that there will be no movement of the patient's teeth. Bite planes are used to open the bite. Mandibular advancement is achieved with different length straps. The elastic pull can also be adjusted to suit the patient's musculature. The straps provide complete lateral movement.
The EMA® - Custom is available only to dental professionals
FDA Approval: Approved for both Snoring and OSA
Date of FDA Approval: Sept. 29, 1997
FDA Registration Number: K971794
Hide EMA
Contact
There are many ways to communicate with Dr. Stern. Please choose the method most convenient to you.
Mailing Address
Dentistry In Oakridges
13291 Yonge Street, Suite 102
Richmond Hill, ON L4E 4L6
Telephone
Phone: 905-773-3306
Fax: 905-773-1722
Email Dr. Stern
dentistryinoakridges@hotmail.com
Practice Web Site
http://www.dentistryinoakridges.net
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