Sleep Dentistry Professionals and Their Role in Dental Sleep-Related Conditions

Table of Contents

Dental sleep medicine is a field established around 25 years ago. This specialized branch focuses on diagnosing and treating sleep-related disorders in the oral cavity.  This blog will explain the various dental sleep-related issues and understand how sleep dentistry professionals can help prevent, assess, and manage these conditions. 

Defining Sleep Dentistry and Its Scope

Sleep dentistry encompasses the dental practices and procedures to manage sleep-related disorders and conditions. Unlike traditional dentistry, which primarily addresses oral health and aesthetics, sleep dentistry goes beyond the confines of the mouth. It involves understanding the complex relationship between oral health and sleep. Dental Sleep Medicine (DSM) was first described in 1999 by Lavigne and colleagues. It has an initial focus on snoring, obstructive sleep apnea (OSA), sleep bruxism (SB), xerostomia, hypersalivation, GERD, and orofacial pain. DSM is the study of oral and maxillofacial causes and consequences of sleep-related problems. It involves various oral healthcare providers (dentists, orthodontists, surgeons, and hygienists).

Dental Sleep-Related Issues

Lobbezoo et al. (2016) classified dental sleep-related conditions into five categories.

Sleep-Related Breathing Disorders

Sleep-related breathing disorders encompass conditions characterized by abnormal respiratory patterns during sleep. This can include interruptions in breathing, such as snoring or obstructive sleep apnea (OSA). This is where the airway is partially or completely blocked during sleep. Examples:
  • Snoring
Noisy breathing is caused by the vibration of tissues during sleep.
  • Obstructive Sleep Apnea (OSA)
Partial or complete airway blockage during sleep.

Orofacial Pain

Orofacial pain refers to discomfort or pain experienced in the mouth, face, jaw, or associated structures. It can result from various causes, including dental issues like toothaches, temporomandibular disorders (TMD), or headaches related to the orofacial region. Examples:
  • Dentoalveolar Pain
Pain originating from teeth or their supporting structures.
  • Temporomandibular Disorder (TMD) Pain
Pain associated with jaw joint dysfunction and surrounding muscles.
  • Headaches
Pain in the head region, often related to dental or jaw issues.

Oral Moistening Disorders

Oral moistening disorders involve disruptions in saliva production or distribution in the oral cavity during sleep. This can manifest as dry mouth (xerostomia), where there is reduced production of saliva, or hypersalivation, characterized by excessive saliva production. Examples:
  • Dry Mouth (Xerostomia)
Reduced saliva production leads to a dry mouth sensation.
  • Hypersalivation
Excessive production of saliva during sleep.

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease (GERD) is a chronic dental sleep-related condition where stomach acid flows back into the esophagus. In the context of sleep, GERD can manifest as symptoms exacerbated during sleep, potentially leading to dental issues like dental erosion due to acid exposure. Examples:
  • Iatrogenic Reflux
Resulting from a weak or damaged stomach valve (lower esophageal sphincter).
  • Obesity, Pregnancy
Conditions contributing to GERD.

Mandibular Movement Disorders

Mandibular movement disorders involve abnormal or involuntary lower jaw movements (mandible) during sleep. This category includes sleep bruxism, where individuals grind or clench their teeth during sleep. Abnormal movements of the orofacial region characterize other conditions like orofacial dyskinesia and oromandibular dystonia. Examples:
  • Sleep Bruxism
Involuntary grinding or clenching of teeth during sleep.
  • Orofacial Dyskinesia
Abnormal, involuntary movements of the orofacial region.
  • Oromandibular Dystonia
Involuntary muscle contractions affecting the jaw and mouth.

Risks and Causes

Sleep-Related Breathing Disorders

Risks Causes
  • Increased risk of cardiovascular issues.
  • Daytime fatigue and impaired cognitive function.
  • Airway blockage during sleep leads to interruptions in breathing.

Orofacial Pain

Risks Causes
  • Disruption of daily activities due to pain.
  • Sleep disturbances and decreased quality of life.
  • Dental issues (e.g., toothaches, TMD), headaches.

Oral Moistening Disorders

Risks Causes
  • Increased risk of cavities and gum disease.
  • Oral discomfort and difficulty swallowing.
  • Reduced saliva production (xerostomia) or excessive saliva production (hypersalivation).

Gastroesophageal Reflux Disease (GERD)

Risks Causes
  • Dental erosion and oral discomfort.
  • Aggravation of respiratory conditions.
  • Weak or damaged lower esophageal sphincter, obesity, pregnancy.

Mandibular Movement Disorders

Risks Causes
  • Tooth wear, jaw pain, and headaches (sleep bruxism).
  • Impaired jaw movement and muscle discomfort (orofacial dyskinesia, oromandibular dystonia).
  • Involuntary grinding or clenching of teeth (sleep bruxism), abnormal movements of the orofacial region.

Dentistry Practitioners in Treating Sleep Disorders

Sleep dentistry professionals possess unique skills and expertise to address the complex interplay between oral health and sleep-related disorders. Their responsibilities extend beyond routine dental care, requiring a holistic approach to patient well-being.

Specific Responsibilities

  • Conducting thorough evaluations to identify sleep-related issues and their impact on oral health.
  • Working with sleep physicians, pulmonologists, and other specialists to provide integrated care.
  • Developing personalized treatment approaches, including oral appliances, lifestyle modifications, and behavioural therapies.
  • Educating patients about the relationship between oral health and sleep and promoting proactive measures for prevention and management.

Diagnostic Tools and Treatment Procedures

Sleep dentistry practitioners leverage various diagnostic tools and treatment procedures to care for their patients effectively.

Diagnostic Tools

  • Polysomnography (PSG): A comprehensive sleep study conducted in a sleep clinic to monitor various physiological parameters during sleep.
  • Home Sleep Testing (HST): Portable devices that let patients assess sleep studies in the comfort of their homes. These tools aim to provide data for diagnosis.

Treatment Procedures

  • Oral Appliances: Custom-fitted devices designed to reposition the jaw and tongue, preventing airway obstruction in sleep apnea patients.
  • Night Guards: Protective devices worn during sleep to alleviate the effects of bruxism and prevent dental complications.
  • Behavioural Therapy: Strategies to modify sleep-related habits and address contributing factors such as poor sleep hygiene.

Case Studies and Patient Stories

To illustrate the impact of sleep dentistry on real-life scenarios, let’s explore a couple of case studies:

Snoring

Assessment Management
Studies focused on dentists recognizing snorers based on self-reported intensity/frequency. Oral healthcare providers treated snoring with Oral Appliance (OA) therapy in dental settings.

Obstructive sleep apnea (OSA)

Prevention Assessment Management
Identified factors contributing to OSA. Emphasizing cautious mandibular repositioning during orthognathic surgery. Utilized various questionnaires, including STOP-Bang, and diagnostic protocols like polysomnography (PSG) to evaluate OSA risk. Commonly used OA therapy and Maxillomandibular Advancement (MMA) surgery. Orthodontic interventions, weight loss recommendations, and technology-assisted assessments (e.g., home sleep study devices) were reported.

Sleep Bruxism (SB)

Assessment Management
Primarily performed by dentists using various diagnostic categories based on self-report, clinical examination, and instrumental assessment (EMG and PSG). Included occlusal splints, biofeedback, medication, and adjunctive therapies.  Treatment efficacy is evaluated through subjective and instrumental means.

Temporomandibular Disorders (TMD)

Assessment Management
Employed established diagnostic criteria (RDC/TMD, DC/TMD) and other guidelines for TMD diagnosis. Treatment involved occlusal stabilization splints and multidisciplinary approaches.  Efficacy is evaluated through self-report and clinical examination.
sleep denstistry

Seek Immediate Help with Sleep Dentistry Professionals

If you or someone you know is dealing with problems like loud snoring, trouble sleeping, or feeling tired during the day, it’s important to contact a sleep dentistry professional immediately. These experts can check things out, possibly with a sleep study, to figure out what’s going on. Thanks to advances in sleep dentistry, effective treatments like custom oral appliances can help improve your sleep and ease conditions like sleep apnea. Don’t wait – see a qualified sleep dentistry professional for a quick and accurate diagnosis. Call Westgate Dental Centre now.

Frequently Asked Questions

Symptoms may include loud snoring, choking or gasping during sleep, excessive daytime sleepiness, difficulty concentrating, and morning headaches. An in-depth evaluation by a healthcare professional is necessary for an accurate diagnosis.

  • Obese: Excess weight increases the risk of airway obstruction during sleep. This contributes to dental sleep-related conditions.
  • People With a Family History of Sleep Apnea: A family history of sleep apnea suggests a genetic predisposition. It raises the likelihood of being at risk.
  • Older Adults: Growing age is associated with a higher susceptibility to sleep-related issues.
  • Those With Craniofacial Characteristics: Certain jaw structures and facial anatomy can increase the risk of dental sleep-related conditions.

Yes, children can experience sleep-related breathing disorders. Enlarged tonsils and adenoids are common contributors. Identifying and treating these conditions early is crucial for proper development and overall health.

Oral appliances (mandibular advancement devices) reposition the lower jaw and tongue to prevent airway blockage during sleep. This helps reduce snoring and alleviate symptoms of sleep apnea.

Yes, lifestyle modifications can contribute to managing sleep-related conditions. This might include weight loss, positional therapy, and avoiding alcohol and sedatives before bedtime. These changes may be recommended alongside dental interventions.

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