Centrl Connecticut Orofacial Sleep Medicine has been in business since 2008. It is the only dental sleep practice in the area that is medically supervised for treatment of orofacial pain, headache and sleep-related breathing disorders. It is becoming increasingly clear that oro-facial pain and sleep are associated in a reciprocal fashion. These connections should be recognized by dentists as important diagnostic and management considerations.
Diagnostic Testing
Our office offers polysomnograms, MediByte HST, snoring and sleep apnea evaluations with the lowest dosage radiation available in medicine today. The information obtained from these tests is shared with the patient’s physician for their approval prior to the procedure being performed.
The reciprocal association between orofacial pain and sleep is influenced by multiple biological and psychosocial factors. Therefore, dentists must be aware of this interplay and be competent in the related diagnostic challenges.
This presentation will explore the screening for snoring, UARS and sleep-disordered breathing and review the role of dentists in the management of patients with these disorders. The importance of a comprehensive chairside assessment and the need for a close collaboration with medical doctors specializing in sleep medicine will be highlighted. This is essential to ensure that patients receive the best possible care. Moreover, dentists who are knowledgeable about these diseases will be able to better identify and refer patients in need for a full PSG evaluation.
Oral Appliance Therapy
While CPAP is the most widely used treatment for sleep apnea, oral appliances (also called dental sleep devices) are equally effective and often more comfortable to wear. These appliances move your lower jaw and tongue forward, which opens your airway and prevents blockages to improve breathing.
These appliances are available from many Oral and Maxillofacial Surgeons who have completed specialty training in the field of Orofacial Pain and Sleep Medicine. The most common type of appliance is the mandibular advancement device.
The mRNA device is designed to promote an open bite and reduce the anterior resorption of the maxilla (upper teeth). In addition, it has been shown in multiple studies to putatively resolve OSA by combined maxilla-mandibular correction and addressing craniofacial deficiencies. (See Singh GD, Chapman C and Preble M. Changes in 3D Midfacial Parameters after Combined Atlas Orthogonal and Biomimetic Oral Appliance Therapy.)
Sleep Study
The most accurate way to measure your obstructive sleep apnea is with a sleep study. This test usually takes place over the course of one night. You will report to the sleep lab at 8pm where a technician will come and get you ready for your test.
The reciprocal associations between oro-facial pain and sleep disorders, notably snoring and sleep bruxism, are of interest to dentists. The concept of dental sleep medicine has subsequently emerged with the aim of helping these patients improve their quality of life.
Our team is trained in the use of a variety of diagnostic testing including Polysomnograms, MediByte HST, pharyngometry and MATRx. Additionally we offer a CPAP triage and multiple sleep latency tests. A CPAP is used to treat patients with obstructive sleep apnea. The CPAP is worn on the nose during sleep to prevent obstructed breathing. A CPAP also can help patients who have complex sleep apnea syndrome which is an advanced form of obstructive sleep apnea.
Surgery
For patients with a physical obstruction in their upper airway, surgical care may be needed to alleviate symptoms of snoring and sleep apnea. This can be accomplished through palatal expansion, uvulopalatopalatoplasty (UPPP), maxillofacial osteotomy or a chin implant. Our office works with a number of oral surgeons in the region to provide these services.
Central Connecticut Orofacial Sleep Medicine provides a comprehensive approach to TMD, headache and dental sleep disorders. Upon referral, all new patients are evaluated with cranial nerve function testing and a detailed examination of the head, neck and facial muscles. A CT or MRI and blood tests, if necessary, are also ordered for proper diagnosis. The goal is to help dentists recognize those patients who can be treated conservatively and those who should be referred for a specialist. It is also to add practical treatment modalities to a dentist’s armamentarium.