Brighter Smiles: Breathing is Important – Part 2

Last week I introduced Part 1 of “Breathing is Important”. For this week’s column to make the most sense, I would encourage you to read that column first. It can be found at www.thetowncommon.com.
In case you don’t have a chance to read it, here is a brief recap: I have been involved in treating patients with sleep apnea for a few years. These are patients who have been diagnosed with sleep apnea or Upper Airway Resistance Syndrome (UARS) by a sleep doctor. Some patients are referred who have mild-moderate sleep apnea as first-line treatment, and others are unable or unwilling to use a Continuous Positive Airway Pressure (CPAP) machine.
There is clear evidence that sleep disordered breathing affects more people in more ways than was thought in the past. As the research continues, more people will be able to be helped to breathe and sleep better. It is healthier to breathe well.
Although there are many people with obstructive sleep apnea who need treatment, there are many others who have the same signs and symptoms as people with apnea and poor sleep, but they “pass” a sleep study. Many of these people may have UARS, which is a lower-level sleep breathing disorder. The treatment options are often the same, including weight loss, CPAP, or dental sleep orthotics.
In most cases, sleep related breathing disorders start early in development, and progress throughout life. It’s actually an evolutionary/developmental problem. Jaw development in humans has weakened. Our prehistoric ancestors had bigger jaws because they breast fed longer, and had to really chew the things they ate. They never needed their wisdom teeth taken out because their jaw was plenty big enough to accommodate them.
Dentists have an extremely important role in helping to identify sleep breathing disorders in all phases of life, especially in children, where most of these problems begin. Identifying them early can allow intervention through orthodontics and other non-invasive therapy, and completely change the course of development, leading to a life of better breathing and better health.
Because adults have stopped growing, we are stuck treating the problem, usually for the remainder of life. Treating this however, can increase quality and length of life for many patients who have a sleep breathing disorder. Identifying and treating airway issues, both early in life and in adults, as well as offering more advanced resolutions as research continues, is where medicine and dentistry must grow together.
Sleep apnea is the end stage of this breathing disorder. Currently, treatment for those with sleep apnea is typically either the “gold standard” of CPAP, wearing a dental sleep orthotic, Inspire (hypoglossal/tongue nerve stimulation), or major surgery to fix the anatomy that is causing this progressive disease. Medicine’s goal, however, should be to identify and treat airway issues early in life, so this end stage disease is never achieved.
You would be amazed at some of the things that are potentially related to breathing issues, such as ADHD, developmental issues, memory problems, TMJ pain, poor quality sleep, snoring, and a host of other things. While research in this area is ongoing, there is plenty of scientific evidence already out there to support this information. Breathe well.
Dr. St. Clair maintains a private dental practice in Rowley dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com