What can be killing you during your sleep? Maybe You!

February 21, 2011 by · Leave a Comment

At www.thegentledentist.com we are concerned about the overall health of our patients and one of the treatments we can team up with the physican is treating Obstructive Sleep apnea (OSA).  OSA is a chronic disorder where patients usually start off snoring and then during the deepest part of the snore will evolve to gasping for air after a period of time when no breathing is present.  This closure and obstruction of the air passage can create a number of problems with the patient:

  • Chronic sleepiness has been shown to increase traffic accident incidence.
  • High blood pressure.  Because the body senses a drop in oxygen in the blood stream it is critical for the adrenal glands to send a surge of adrenaline into the blood stream which increases the heart rate and increase blood pressure.  Over time this creates a lot of stress on the body and can lead to a heart attack.
  • Diabetes.  This high blood pressure can affect the way that blood sugars are metabolized in the body.
  • Impotence.  For men their sexual drive can be affected
  • Relations.  Because snoring keeps the family up at night the use of such a device can provide peace for all concerned.

Treatment:  The cPAP is a pressure filled mask that is plugged into the wall which runs a humidified air compressor which forces air down the trachea and into the lungs.  This has a quiet buzz and is like a Darth Vator mask.  Patients sometimes find it difficult to wear and decided to not wear it and end up being non complient. 

The oral sleep appliance is different in that it is much smaller and convenient to use.  Rather that forcing air into the lungs by pressure this oral appliance shifts the jaw forward and the soft tissues attached to the jaw open the air space.  By eliminating the cPAP things are more comfortable and much more compatible.  Keep in mind that the cPAP is the gold standard and is usually preferred by the sleep doctors but the problem is that the patients have a difficult time tolerating it.  It is important for the patient using the oral appliance go through a series of exercises during the morning after waking up.  This 10 minutes is important because it reseats the jaw back into where it needs to go and when doing so the bite is not affected. 

It is important for your dentist to have a good understanding of the occlusion (bite) and the TMJ (Jaw Joint).  If you have a cPAP and just can’t use it let us know about it.  If you have some of these symptoms mentioned above let us know so we can refer you to a sleep physician and order a sleep study.  Even though you may not think this is a problem you would be surprised to find out just how good you would feel with a good night sleep. 

If you have comments or questions and are in the Shelby Twp. MI area please call us up at (586)247-3500 or email me at DrAntolak@TheGentleDentist.com.

Filed Under: Dental Patient Testimonials, Dental Videos, General Dentistry, How to choose a dentist, Oral Conditions, Sleeping Disorders Tagged With: , , ,

How the dentist can save your life while you sleep.

February 21, 2011 by · Leave a Comment


At www.thegentledentist.com we are always interested in providing the most up to date care for our patients.  One of the most beneficial services we provide is the treatment of obstructive sleep apnea for our patients who stop breathing at night. 

Obstructive sleep apnea is a condition where one will encounter periodic episodes of losing their breath during sleep.  The airway can be restricted when there is too much soft tissue in the space and the patient will struggle at times to breathe, eventually taking a gasp of air after laboring to get in a breath for over 10 seconds.  Common risk factors are:

  • high BMI (body mass index).  Obesity is rampant in Americans due to a lack of exercise, fast foods and other factors
  • small size of the lower jaw- if the lower jaw is too small then the soft tissue is packed into a small space which can prevent adequate air from moving down the trachae.  In a larger lower jaw the tissue moves with the jaw and therefore space isn’t such a problem.
  • The chronic use of alcohol can relax muscles of the neck to the point where they collapse into closing the air space.

The gold standard in obstructive sleep apnea is the cpap machine.  This machine provides positive pressure forcing air down the trachea and into the lungs during the night .  The problem is that this is not very comfortable and is not well tolerated by the patient or the spouse.  The machine makes a rumbling noise which is from the compressor.  It is important to remain sleeping on the back with such a device because the mask needs space and if one rolled onto the stomach the mask would press against the face.

The oral appliance moves the jaw forward to open up the space.  Because the soft tissue is attached to the lower jaw, when it is positioned forward all of the tissue comes with it. 

The oral appliance can be adjusted to move the jaw forward but there are limitations on how far.  As the jaw moves forward it displaces the TMJ (tempro mandibular joint), the joint in which the jaw hinges on.  As the joint is moved there are some clicking and potential joint problems that can be be experienced and this is why your dentist needs to be aware of the workings of the bite and jaw joint. 

On Frank, this treatment has been very successful and compared with a cheap over the counter device it is a worth while investment (financially and health wise).

For more information please call Dr. Antolak, The Gentle Dentist at (586)247-3500 or email at DrAntolak@TheGentleDentist.com

Filed Under: Dental Patient Testimonials, Dental Videos, General Dentistry, Health Implications, Oral Conditions, Sleeping Disorders Tagged With: , , ,

Sleep Apnea Treatment in the Shelby Twp, Macomb County, Michigan

January 28, 2011 by · Leave a Comment


At The Gentle Dentist we try to have relevant dental information that can change the lives of those who live in the Shelby, Sterling Heights and Washington areas of Macomb County, Michigan.

Obstructive Sleep Apnea (OSA) is a Medical condition where the airway of a person is physically blocked and breathing is interrupted during sleep. Many times this is related to snoring, but when the snoring sounds stop and the person is struggling to get a breath in but can’t they eventually snort, partially waking up enough to breath again.  Obstructive Sleep Apnea is caused by the relaxation of the muscles of the throat during the sleep cycle. If there is more soft tissue present than there is room then it physically obstructs and closes off the wind pipe to where no breath can get in even though there is the physical exertion to do so.  What typically happens is that the snoring will be sporadic and then you can observe the sufferer struggling for breath and finally after about 10-60 seconds of attempting to breath in they finally make a loud sound and then catch their breath. Each time this happens it is called an “episode”.  Each episode encountered the person experiences a surge of epinephrine (adrenaline) which speeds up the heart, blood pressure  increases and constricts the blood vessels.

Effects of Obstructive Sleep Apnea: This psychological activity wakes the person up enough where they can breathe.  Unfortunately, during the night when one needs the rest they are constantly woken up which has a huge impact on daily living.  Not only is the person chronically exhausted but they may suffer from a host of chronic illnesses.  This sporadic breathing is associated with an increased risk of cardiovascular disease, stroke, high blood pressure, arrhythmia, diabetes, sexual dysfunction and sleep deprived driving accidents .

Obstructive Sleep Apnea Diagnosis: Mild sleep apnea is when there are 5-15 episodes per hour, Moderate from 16-30 and severe greater than 31 episodes per hour.  These readings and a proper diagnosis can only be made by a sleep physician at a sleep lab.  These sleep studies require the patient to spend the night and they are hooked up to many sensors and devices that accurately measure eye movement, blood pressure, blood oxygen, brain wave activity and respiration.  The “lab” looks just like a nice hotel room and is very comfortable.

People who are more at risk are as follows:  obesity BMI >30, large neck circumference (16 inch in women, 17 inch in men), enlarged tonsils and large tongue volume and small lower jaw. Some treatments involve lifestyle changes, such as avoiding alcohol or muscle relaxants, losing weight, and quitting smoking.  Because Detroit is noted for being the fattest city in America this information is pertinent for our community in particular.

Obstructive Sleep Apnea Treatment: After there has been a proper diagnosis from a sleep doctor there are modifications in life style and behavior which should be considered first which are mentioned above.  Next using a Continuous Positive Airway pressure (CPAP) is the gold standard.  This is a face mask that is hooked up to a small pump that provides humidified air which is pressurized to go into the lungs.  This is the best treatment, but there are many who don’t like using it because of the inconvenience, appearance and uncomfortableness.  Compliance is the most critical aspect of undergoing treatment and if the device works great but is not used there is no benefit.

An option that other dentists and we have in our Shelby Township dental office  is to provide an oral appliance that is used during the sleep. This device is custom made to fit your mouth and works by moving the lower jaw forward during sleep to open up the airway and provide more opening for air to flow down the trachea.  If you have taken CPR and remember when you grabbed the lower jaw and moved it forward in an attempt to get a breath in; this is the same concept.  The benefit of this device is that it is portable, is more comfortable and we find our patients more compliant using this device compared with the CPAP.

For more information on how to improve your sleep and life please give our Shelby Township dental office a call at (586)247-3500 or email me at DrAntolak@TheGentleDentist.com.

Dr. Antolak practices sedation, implant and general dentistry since 1987 in Shelby Township and in the Sterling Heights area and is a member of the Academy of General Dentistry, American Dental Association and the American Academy of Dental Sleep Medicine.

Filed Under: Dental Videos, General Dentistry, Health Implications, Sleeping Disorders Tagged With: , , ,
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