Powell Dental Group
Shelley D. Shults, FNP, MSN, DDS, D.ABDSM
Emily Hutchins, DDS
Joseph E. Touhalisky, DDS





39 Clairedan Drive
Powell, Ohio 43065

Snoring, Sleep Apnea & Appliances

Did you know that 23% of couples sleep in different rooms because of snoring?
Did you know that 2/3 of bed partnered adults say their partner snores?
Did you know that almost ½ of all adults snore?
Did you know that over 80 million people in the US snore?
Did you know that snoring isn’t sexy but it is a reality?
Did you know that Sleep Apnea is a Killer In the Night?

Ask yourself the following questions:

Do you snore?
Have you been heard from people in other rooms?
Have others told you that you breathe strangely at night?
Do you have a sore throat or dry mouth upon awakening?
Does your sleeping partner complain of your sleeping habits?
Have you been told you gasp or stop breathing when you sleep?
Do you have insomnia or trouble staying asleep at night?
Do you kick your legs in the night?
Do you awaken in the night to use to bathroom?
Do you have sleep paralysis or nightmares?
Do you have poor fitfull sleep?
Are you tired when you awaken or during the day?
Do you have broken, worn teeth and clench or grind at night?
Do you awaken with morning headaches?
Do you have jaw pain?
Do you fall asleep easily if watching a movie, reading or sitting quietly?
Do you have high blood pressure, heart disease or diabetes?
Have you been diagnosed with sleep apnea and can’t wear the CPAP?
Is it too embarrassing or disruptive to use the CPAP machine?
Does your machine stay under your bed or in the back of your closet?
Do you leave your machine at home when traveling?

If you answer “yes” to any of the above questions, continue to read further and consider an evaluation by a sleep team physician!

 

Millions of Americans suffer from sleep apnea. People with this disorder take shallow breaths or literally stop breathing for short periods of time while they are sleeping. Although many people have sleep apnea, it is difficult to detect because it only occurs during sleep when the patient is unaware. Usually a sleep study is performed to diagnose the condition. This may be done in the comfort of your own home or at a sleep center.

Obstructive Sleep Apnea (OSA) is the most common type of sleep apnea. This is when the airway is blocked or collapses, resulting in breathing pauses or shallow breathing. The pauses can range from seconds to minutes, and occur as many as 100 times per hour. The soft palate, velum, and tongue are structures of the mouth and throat that, during normal sleep, will relax without obstructing the airway. In people with OSA, these structures are either too large or relax too much, causing the airway to narrow or become completely blocked. The lack of air decreases blood oxygen levels, which in turn signals the brain to disrupt the person’s sleep; this is why the sleeper will often gasp suddenly after a pause in breathing.

The constant disruptions in breathing and sleep frequently cause sufferers to experience extreme daytime fatigue. Sleep apnea is a serious condition, and has also been commonly associated with the following (not inclusive):

  • Diabetes Mellitus
  • Hypertension (High Blood Pressure)
  • Stroke (CVA)
  • Heart Disease
  • GERD (Gastric Reflux)
  • Depression
  • Snoring
  • Motor Vehicle and Work Related Accidents
  • Premature Death

At Powell Dental Group, Dr. Shelley D. Shults, RN, DDS, D.ABDSM has received extensive training in studying the disease of Sleep Apnea, is a member of various professional organizations and is a pending Board Certified Dental Sleep Medicine Diplomate. Additionally, she treats TMJ (temporomandibular) disease that may complicate the treatment of obstructive sleep apnea. Dr. Shelley will review your medical history, perform a thorough intra & extra-oral evaluation, identify concerns, provide a simple questionnaire that is a risk assessment to identify possible OSA candidates, answer questions, coordinate a sleep study test if indicated (both in-home and overnight polysomnography), review various therapeutic treatments and assist you in obtaining effective therapy. Dr. Shelley Shults has treated snoring and sleep apnea with appliances since 2004. However, each patient’s case is individually planned for success as some patients are appropriate for oral appliances, some for PAP therapy, some for combination therapy and some for simple snore devices.

During the past decade, the treatment of sleep disorders has greatly evolved and usually involves a multi-disciplinary approach. Extensive training and experience from Dr. Shelley’s medical and dental background allows her to be your advocate in obtaining proper unbiased therapy. We have partnered with sleep physicians, oral surgeons, ENT surgeons, sleep psychologists, and together, we will assure that you receive affordably appropriate therapy, will monitor your treatment and progress, will coordinate and maximize insurance benefits on your behalf, and ultimately improve your overall health and wellness.

Snoring

Although occasional snoring is usually harmless, chronic snoring can be a sign of sleep apnea or other medical conditions. The physical blockage of air through the mouth and nose is what causes snoring, and the actual sound comes from the vibration of the throat’s walls. Things that contribute to the obstruction of airflow include blocked nasal passages, poor muscle tone in the structures of the mouth and throat, and excess fat deposits around these structures.

In some cases, snoring can indicate upper airway resistance syndrome (UARS). Unlike sleep apnea, people with UARS do not stop breathing at any point or have decreased blood oxygenation. What they experience is a decreased airflow when breathing in. The airway narrows and breathing becomes more difficult, which is why the disorder is often accompanied by snoring. People with UARS share some of the same symptoms as those with OSA, yet will test negative with sleep testing. Specialized tests including measuring changes in the pressure in the esophagus are usually needed to diagnose UARS.

Most simple snoring cases respond well to simple oral appliances that can be worn during sleep only. These appliances are comfortable, safe, effective and usually provide overwhelming positive feedback from both the patient and bed partner. Diminishing the snoring habit can greatly diminish chronic sore throats, diminish nocturnal sounds that interrupt sleeping of others, and improve interpersonal relationships that were disrupted from snoring. We are amazed at the positive feedback and excitement that is reported from the patient and partner when the relationship returns to a peaceful night of sleep.

 

Oral Appliances

Initially, the dentist will want to conduct tests in order to investigate, diagnose, and pinpoint an accurate diagnosis and a suitable treatment. It is necessary to thoroughly evaluate health of the oral structure, teeth, bone, muscles, jaw joint, mobility and movement capabilites, health of the jaw disc, tooth position and relationship of upper and lower jaws, oral, breathing & sleeping habits, current dental restorations, history of attempted therapy, swallowing habits, oral and claustrophobic associations, and medical concerns (especially GERD). The dentist can offer many different treatment options which depend largely on the exact diagnosis and the health of the patient. The dentist may advise the patient to halt some habits that aggravate sleep apnea such as smoking, alcohol consumption, and tranquilizer use and sleep positioning.

Sleeping masks were traditionally used to keep the patient’s airways open while they slept, but nowadays there are some less intrusive options. Dental devices that gently tease the lower jaw forward are very effective in preventing the tongue from blocking the main air passage. These dental devices are gentle, easy to wear, and often help patients avoid unwanted surgeries.

Only a few of the many devices available are pictured. Your dental sleep specialist will review and recommend an appropriate device for you.

Instruction Sheets for Appliance Care

Care and Use of the Morning Repositioner
Care and Use of the SomnoMed MAS
Care and Use of the E.M.A.

Read about Home Sleep Testing

 

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