People usually associate orthodontics — known today as the traditional braces or the modern, comfortable equivalent called Invisalign — with creating a beautiful smile. For some of our Sacramento patients, however, orthodontics represent an opportunity to stop a life-threatening disorder called sleep apnea, not just fix a set of crooked teeth. When patients suffer from sleep apnea, their breathing is restricted by the shape of the mouth, throat and tongue. This restriction dangerously lowers blood oxygen levels during sleep. By using the body’s own growth processes and the technology of Invisalign or other orthodontics, our dentists increase the room inside the mouth, significantly improving air flow and reducing the underlying causes of sleep apnea.
I do not promote extracting teeth when there is an arch discrepancy, but instead prefer to grow the arch using Invisalign.” — Dr. Brian Steele, DDS
A considerable number of studies determined that small jaw sizes can affect air flow, leading to or worsening cases of obstructive sleep apnea. Some of these sleep apnea patients with unusually small jaws received orthodontic treatment when they were children because of extremely crowded teeth. Not too long ago, the typical procedure for correcting crowding involved removing some teeth, usually bicuspids. While this technique provides more room on the jawbone, it does nothing to resolve the real problem — a jaw that is too small for a standard set of teeth. Dentists now realize that failing to address the underlying issue — an undersized dental arch — is a mistake. As dentists studied the connections between sleep apnea and orthodontics, they discovered that the removal of four bicuspids during a childhood orthodontic procedure is a strong indicator for problems with sleep apnea at any age.
Commenting on the matter of removing teeth for orthodontic purposes, our lead dentist Dr. Brian Steele reflects the newest thought on the problem of overcrowding: “I do not promote extracting teeth when there is an arch discrepancy, but instead prefer to grow the arch using Invisalign.” This process makes room for all the teeth and also creates space for another organ associated with sleep apnea — the tongue.
The tongue is often implicated in sleep apnea obstructions. Sleeping on the back causes the tongue to naturally fall downward due to gravity. With enough room in the mouth and at the back of the throat, this is seldom a problem. When space is limited, however, the tongue can actually fall back and block the air passage! This stops the flow of air, forcing the patient awake, and leads to the snoring or unsettled sleep common in sleep apnea.
Besides experiencing apnea episodes, patients with small mouths sometimes develop “scalloped tongue.” The tongue gets indentations around the edges from pressing against the back of the teeth. In a normal mouth, the tongue has plenty of space and makes minimal contact with the teeth. In a small oral cavity, the pressure of the tongue pushing against the teeth creates a malformed tongue, maloccluded teeth and a host of other problems: temporomandibular joint syndrome (TMJ), stress and tension disorders, issues with swallowing, and even teeth grinding. All of this can be avoided by increasing the size of the arch using orthodontics.
The Sacramento Dentistry Group offers the following dental solutions for sleep apnea:
Standard oral appliances simply address the snoring or sleep apnea symptoms by altering the position of the tongue, teeth or jaws in relation to each other. They do not change the underlying structural problems that lead to sleep apnea, but they provide fast relief.
The DNA appliance® system is a sleep apnea solution that widens the oral cavity, but does not necessarily simultaneously improve the bite. This therapy is best for patients with a satisfactory bite and smile.
The orthodontic solution, usually featuring Invisalign, has the advantage of increasing the size of the oral cavity and correcting the orthodontic problems commonly found in sleep apnea patients. The overcrowded and misaligned teeth that often indicate a small jaw and reduced air space are correctable with Invisalign. As an additional advantage for the patient, when used to primarily correct a sleep apnea diagnosis, the use of medical insurance, instead of dental coverage, may be possible. This generally means cost savings for patients, especially those without dental insurance or sufficient orthodontics coverage.
Every patient is different, and determining the best method for resolving a case of sleep apnea requires careful study, testing, consultation and examination. For those with certain types of malocclusions, the best solution, one that might free the patient from machines and oral appliances, is orthodontics. And the easiest way to perform an orthodontic procedure is with Invisalign. To find out if dentistry offers a solution for your case of sleep apnea, please request a free consultation with one of our Sacramento dentists. We look forward to providing you with a good smile and a good night’s sleep!