Waking to use the washroom at night
Changes in mood
Someone has witnessed you stop breathing or gasping for air
Trouble focusing, concentrating, memory issues
Cannot remember dreams
Difficulty breathing through the nose, nasal issues, allergies
Cardiovascular disease, obesity, diabetes, stroke
Dr. Caroline takes her important role as a dentist seriously to identify sleep-disordered breathing due to the severe impact that it can have on children's development and, eventually, adult health. A sleep study is the best way to determine if there is a problem. That is why Dr. Caroline works with sleep physicians to help you get a diagnosis. There may be a dental solution to this medical problem!
A sleep apnea event refers to an incident where the child or adult stops breathing for a period of 10 seconds or more. This can occur several times in an hour throughout the night. It is usually caused by the relaxing of the throat muscles causing the tongue to fall back in the throat and block the flow of air into the lungs. The body wants to survive! It wakes the person up just enough to take a breath (micro-arousals) but, unfortunately, can go right back into an apnea event where the person does not breathe for several seconds again. The number and length of these events help to determine the severity of the disease.
During these events, the oxygen in the blood drops and this lack of oxygen can seriously affect the organs of the body, leading to physical symptoms and diseases, cognitive impairment, and a disruption of the normal sleep cycles. We lose out on a reparative sleep – the reason why we sleep at all!
Snoring occurs when the tissues at the back of the throat vibrate as the air goes by them. The airway may be narrow, and the tissues may be lacking tone, or there is excess tissue. It may also only occur in certain sleep positions, for example, while sleeping on your back. Not everyone that snores has sleep apnea, but everyone with sleep apnea snores!
Having an upper airway that allows oxygen to flow freely in and out of the lungs is necessary for the overall health, well-being, and development of the child. Narrow or blocked upper airway passages can make breathing more difficult. The resulting lack of oxygen can put a strain on the heart, lungs and brain and can cause developmental complications.
As a dentist, Dr. Caroline plays a vital role in identifying airway problems, screening for and noticing signs in the mouth and discussing symptoms with the parents.
Common Oral/Facial Signs:
Narrow dental arch
High roof of the mouth
Small throat space
Dark circles under eyes
Forward head posture
Asymmetry of face/jaws
Open mouth posture at rest
Chronic nasal, ear, and tonsil/adenoid issues
Open mouth chewing/sloppy eating
Appearance of ADD/ADHD behaviours
An airway that is repeatedly blocked can cause an increased heart rate and the loss of REM sleep. This constant strain on our internal organs can cause serious, dangerous health complications. Quite often, adults do not discuss sleep concerns with their physicians. A dentist is in a particularly good position to identify signs and symptoms early by evaluating the mouth and discussing the findings with their patients. Following the recommendations of the sleep specialist, Dr. Caroline is happy to discuss individualized treatment options for your sleep apnea/breathing disorder. Options may include CPAP, surgery to remove excess tissues or an oral appliance.
Should some of these signs not be addressed when younger, or circumstances have led to other issues, sleep-disordered breathing and sleep apnea can develop in adulthood. Dr. Caroline screens her patients for sleep issues and may recommend further information be collected to make an accurate diagnosis. This may include:
X-rays to evaluate the airway
A sleep study
Models of the teeth
A thorough head and neck examination
Photographs of posture and tooth relationships
Some Dental Signs in an Adult Mouth:
Narrow dental arches
Elongated soft palate and uvula
The tongue is large or has scalloped edges
Tooth wear from grinding
High palate (roof of the mouth)
Dr. Caroline has a keen interest in craniofacial (mid-face) underdevelopment and how it relates to sleep-disordered breathing. Working with the guidance of sleep physicians, she can help develop a treatment to meet the child’s unique needs with the goal of improving their overall health.
Should you not be able to wear a CPAP, Dr. Caroline will discuss options with you and your sleep physician.