Praxis Medica (Jan 2018)
Obstructive sleep apnea from the dentist point of view: The very first experiences
Abstract
Obstructive sleep apnea (OSA) is the most common respiratory sleep disorder and present the occurrence of a minimum of five interruptions in breathing and/or the decrease in ventilation for more than 50%, minimum duration of 10 seconds, during one hour of sleeping (apnea/hypopnea index -AHI) with the existence of daytime and nighttime difficulties. The diagnosis of sleep-disordered breathing is made by polysomnography testing in specialized centers. Depending on the type and severity of the disorder different therapeutic modalities are available: hygienic-dietary regimen and lifestyle, use of oral appliances (OA), noninvasive ventilation with continuous positive airway pressure (CPAP)through a mask during sleep time and surgical approach to upper airways. CPAP is a gold standard in sleep apnea syndrome treatment, especially in severe forms of OSA.A therapy of choice for mild to moderate obstructive sleep apnea and at the same time an alternative treatment for CPAP intolerance are oral appliances. A mandibular advancement device and a tongue-retaining device are in use. Simplicity, portability, lack of noise, independence from a power source, and potentially lower cost, bring potential advantages over CPAP. By increasing the volume of upper airways, the number of obstructive breathing events is being significantly reduced, and arterial oxygen saturation is being improved. A close cooperation and surveillance by medical doctor and dentist is required, from the correct choice and drafting of oral appliance, through initial patient's accommodation to treatment, to long-term follow-up of therapeutic effect in sleep medicine laboratories.
