Sleep disorders and orthodontic appliances

Snoring is a mild sleep disorder that can be a major burden, not so much for the person affected, but more so for their partners. Snoring alone is not a health hazard, however it can be an initial sign of a threatening sleep disorder.

There are many different types of severe breathing disorders associated with sleep. Dentistry can be of help with obstructive sleep apnoea. These disorders are among the most common sleep disorders, occurring in about 6% of the adult population.

Obstructive sleep apnoea

Obstructive sleep apnoea usually narrows the upper airways during sleep. The muscles relax and the tongue recedes, causing the already narrow airways to be completely blocked. The patient then randomly wakes up, after taking a few breaths in vain, with the result that their sleep is interrupted repeatedly every night. It is not possible to have a restful and deep sleep, any longer. This results in drowsiness during the day, causing reduced efficiency and increased risk of accidents, due to the possibility of microsleep during the day. In addition, many other serious health problems may occur.

Causes for sleep disorders

Narrowing of the pharynx due to the tongue falling back, is one of the main causes of obstructive sleep apnoea. The typical treatment for obstructive sleep apnoea is the use of the so-called CPAP device, where patients use a ventilator at night, with a mask. For mild to moderate cases, dentistry offers mandibular advancement appliances. These are removable devices that are placed in the mouth, before going to bed. With these, the lower jaw is pushed forward by 5-8mm, resulting to the tongue being displaced at the same time. The displacement causes the pharynx to widen in a way that the airways can no longer move.

How are sleep disorders treated?

In any case, patients that snore or have sleep-related breathing disorders should first consult a sleep specialist, usually a pulmonologist. The specialist can determine if there is a sleep disorder that can be favourably affected by a dental mandibular advancement appliance (advancement of lower jaw). In case this diagnosis is made, and then only, would it make sense to visit a dentist trained in manufacturing of such devices.

There are many different anterior mandibular advancement appliances. The most common are the Hinz IST device and the Thornton TAP device. Both devices are provided in our orthodontic practice. Generally, the patient can get used to both devices quite quickly. In most cases, snoring can be reduced to a degree that the partners can sleep next to each other again without any discomfort whatsoever. In mild cases of sleep apnoea, treatment could have very good results. Satisfactory results are possible, even in moderate cases.

A disadvantage of mandibular advancement devices is that in case of long-term use they change the position of the teeth and can cause occlusion (bite) disorders. For this reason, they are contraindicated in case many teeth have already been lost or the dentition is damaged by periodontitis.

Learn more about orthodontics in our blog.