Last week I attended the 20th anniversary meeting of the American Academy of Dental Sleep Medicine. The three day event was, as usual, filled with great interaction and presentations. I have to tell you that listening to scientific research is not my favorite thing in the world, but important. The topics varied from Effects of Mouthpiece Use on Gas Exchange Parameters during Steady State Runs in College Males and Females to TMD and
Nocturnal Bruxism to Pharmacology of Sleep Disorders Medications, to Risk Factors Associated with Sleep Related Breathing Disorders, to name just a few. Guess what, even the thought of Pharmacology makes my head hurt – thank goodness there are people who love this stuff.
Given all of the meetings and presentations, it is impossible to summarize all that was learned or even what I was left wondering about; however there were a couple of key items that made a strong impressionon me. First, it is not normal for a child to snore. If you have a child that snores, at minimum I would have an evaluation done by an ENT (ear, nose and throat physician.) Secondly, there is a growing amount of evidence that routine snoring is pathologic and progressive and should not be ignored. There was preliminary research presented that demonstrated physiologic changes that occur in the soft tissue of the throat that are destructive and possibly irreversible. Basically, if snoring vibrations cause local nervous lesions in the upper airway, this trauma repeated night after night, could explain the progressive nature of the disease. In essence, snoring may cause Obstructive Sleep Apnea. Thirdly, I have long known that snoring and sleep apnea appliances can cause bite changes, but now there is a growing amount of evidence that CPAP can also alter the bite.
The bottom line to all of this is that the more you know the more you realize that you don’t have all of the answers – nobody does. The treatment of snoring and sleep apnea is a rapidly growing area in dentistry. It is not nearly as simple as you might think and equally important is that it is not as simple as many dentists are led to believe by the marketing materials that every dentist receives on a weekly basis.
I have been in the private practice of general dentistry since 1983 and it is still amazing how much more there is to know. The old adage, “The more you know, the more you don’t know,” is so true. I guess the continual challenge is what keeps this fun and exciting.
If I can help you or someone you know with their snoring or untreated sleep apnea (a.k.a. my CPAP is in the closet and no way am I ever wearing it) please let me know.
Joe Gatti, DDS