A dentist with experience in sleep medicine can build a comfortable oral plate which is fitted to the upper and lower arches of the mouth. This device can control obstructive sleep apnea and snoring.
For many years, snoring was considered a normal phenomenon. Today we know that snoring is an important symptom of serious illness. An obstruction of the airways may be responsible for snoring. This is due to muscle relaxation during sleep. A decrease in size of the airways causes a blockage, soft tissue vibration and, consequently, snoring.
Collapse of the airways causes respiratory arrest or apnea. Obstructive sleep apnea (OSA) affects between one and five adults, of whom 80% are still undiagnosed. Men are usually more affected; however, after menopause, women are equally affected. Snoring and sleep apnea significantly affect the quality of sleep of the individual and the partner.
The consequences of sleep apnea include high blood pressure, obesity, diabetes, depression, impotence, fatigue, lack of concentration, memory loss and increased risk of heart attack, also precipitating road accidents.
Despite decades of research, there is no simple and effective treatment for individuals suffering from these conditions. Losing weight is always advised. This will have an immediate effect, increasing the size of the airways and improving the symptoms. There are only two recommended and documented therapies on sleep apnea:
■ Continuous Positive Airway Pressure (CPAP) is considered first-line therapy for individuals with severe sleep apnea and also for those with known cardiovascular disease. CPAP consists of a face mask covering the nose and/or mouth, connected by a tube to an air pump. During sleep apnea, this equipment produces a positive pressure that keeps the airway open.
■ Mandibular Advancement Device (DAM) is another effective therapy, mainly for mild to moderate snoring and sleep apnea. The DAM is a device fitted by the dentist and customised to the patient’s mouth arches, used during sleep. The device advances the jaw, increasing breathing space and reducing the tendency for airway collapse. This device reduces or eliminates snoring and sleep apnea.
The pulmonology department of the HPA Health Group, under the responsibility of Dr. Carlos Glória, provides sophisticated methods for the diagnosis and treatment of sleep apnea. Dr Raquel Silva is one of the dentists working in the department of dentistry of the group and one of the few dentists in Europe with accreditation in oral sleep medicine. Prof. Dr. Armin Moniri, otolaryngologist, who also works at the HPA Group, has a doctorate in sleep apnea, and another option in a multidisciplinary approach for the diagnosis and treatment of apnea.
By Dr. Raquel Silva
Dr. Raquel Silva is a dentist at the HPA Health Group – H. S. Gonçalo in Lagos and HPA in Alvor. She has a European Accreditation in Oral Sleep Medicine