Orthodontists Help Put Sleep Apnea to Rest


A breakthrough oral appliance could help some of the more than 20 million people in the United States and Canada who suffer from obstructive sleep apnea (OSA). This alarming disorder causes patients to stop breathing during sleep. OSA might be responsible for high blood pressure, strokes and heart attacks. But many people are no more aware of their apnea than of their snoring, a symptom of the dangerous condition.

And OSA sufferers, once diagnosed by a physician who specializes in treating sleep disorders, might be surprised that their treatment might involve an orthodontist.

OSA until fairly recently has been treated either through surgery on the uvula and soft palate or by a pump that forces air into the nose, keeping the airway open. Nasal pumps are used to treat most patients in North America, but many are unwilling to wear them every night.

Orthodontists have helped develop several appliances to hold the jaws in optimum positions during sleep. They keep the airway open by providing a stable forward position for the lower jaw and tongue.

A New Appliance Patients Can Adjust

Dr. Alan A. Lowe, professor and head of the Department of Clinical Dental Sciences at the University of British Columbia in Vancouver, invented a unique appliance that allows the patient to move the jaw forward in quarter-millimeter increments over time until snoring and other symptoms (for example, daytime sleepiness) decrease.

"If you move the jaw too far forward too quickly, the patient may experience significant jaw discomfort," says Dr. Lowe. Patients may feel less restricted, because Lowe's appliance also allows for some vertical and lateral jaw movement. "Patients may yawn, swallow and even drink water without removing it," notes Dr. Lowe, also an American Association of Orthodontists (AAO) member with a private orthodontic practice in Vancouver.

The appliance is relatively unlikely to disengage itself, according to Dr. Lowe, author of an article on the subject recently published in the American Journal of Orthodontics and Dentofacial Orthopedics. Once warmed under a hot faucet and inserted, the acrylic elastic resin contracts as it cools to firmly affix itself to both dental arches.

Until recently, the gold standard of diagnosis for OSA has been expensive overnight monitoring in the hospital. But researchers are now working on a cheaper, easier way to screen those who need monitoring. Orthodontists analyze X-ray films of the head to evaluate airway size, a technique that preliminary results show is 80 percent effective in classifying those with obstructive sleep apnea.

Patients who snore and think they may be suffering from obstructive sleep apnea must first be diagnosed by a sleep physician, cautions Dr. Lowe.

Free Information Available from the AAO

For the names of AAO-member orthodontists in your area, or for free brochures about a number of orthodontic topics, call 1-800-STRAIGHT (1-800-787-2444). Or write the AAO at 401 N. Lindbergh Blvd., St. Louis, MO 63141-7816.

Anyone considering orthodontic treatment for themselves or for a loved one also can take advantage of the "Smile Bank," the AAO's free computer-imaging program. If you have a color picture of yourself with a big, toothy grin, send it to the AAO, c/o "SMILES," and you'll receive a free photo showing how your smile might benefit from orthodontic treatment. (NAPSI)

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