Breakthroughs in dental sleep medicine are saving countless lives
- Bryan Stein
- 13 Feb 2020
Technology has come a long way in my lifetime. There have been countless innovations and helpful technologies to improve our lives. Dentistry is no different, and has been toe to toe on this technological bandwagon to improve how we do dentistry and how we help our patients lead happier and healthier lives.
Throughout this past decade, our profession has witnessed technologies that have transformed how the general dentist has been able to expand their scope of care. There has been a plethora of new and amazing devices. Today, we enjoy the convenience of intraoral cameras and digital impressions to help with communication and fabrication of appliances. Additionally, 3D X-ray machines and their diagnostic capabilities, digitizing implant dentistry, and the virtual planning and execution of orthodontic treatment with clear aligners have all contributed to fewer visits and better outcomes for patients.
When I graduated from dental school in 1994, I would have never imagined that I would be able to accomplish the scope of care and predictability that I can achieve today. Each innovation has allowed me to grow my practice to make all these new procedures and treatments more accessible to my patients.
One of the most exciting recent technological advancements has been in dental sleep medicine, which has far-reaching benefits for the general population. But first, let’s frame the problem it aims to address.
Obstructive Sleep Apnea (OSA) is a disease where you literally stop breathing in your sleep. It occurs when your muscles relax during sleep, allowing the soft tissue to collapse and block the airway causing a person to stop breathing countless times a night. Snoring, excessive daytime sleepiness, memory problems, irritability, fatigue, and insomnia are all signs that you are suffering from sleep apnea.
This chronic ailment – which is becoming more and more common in today’s population – can be a potentially life-threatening condition if left untreated. OSA increases the risk of diabetes, depression, impotence, and has a 2-3 times increased risk of heart disease, high blood pressure, and stroke. The risk of dying early is 3 times higher in people with this silent killer which affects about 25% of the population. A majority of these people go undiagnosed.
Traditionally, the prescribed treatment for Obstructive Sleep Apnea is Continuous Positive Airway Pressure (C-PAP) therapy. It involves sleeping with a face mask connected by tubing to a constantly running machine forcing air into the lungs. Although the C-PAP machine is effective, approximately half of patients do not like this treatment and therefore, do not use it.
Alternatively, with dental sleep medicine, dentists are able to help with Oral Appliance Therapy. It is an effective, non-invasive treatment option for snoring and Obstructive Sleep Apnea that can fit easily into your lifestyle. This dental appliance looks like a sports mouthguard and is worn only during sleep. It supports the jaw in a forward position to help maintain an open upper airway to allow air to get into your lungs in such a way that prevents sleep apnea and snoring.
This form of dental sleep medicine wasn’t taken too seriously initially because it involved a lot of guesswork with respect to the results it would achieve. That has all changed recently with the advent of the Matrix Plus and digital scanners.
The Matrix Plus (Zephyr Sleep Technologies based out of Calgary) is a game changer in my opinion. It uses Artificial Intelligence to help diagnose and treat people with OSA. Traditionally, testing can be done using a PSG (Polysomnogram) at a sleep lab or using a Home Sleep Apnea Test (HSAT). Many people shy away from going to a sleep lab as it is not only inconvenient, but uncomfortable to be tested in a strange environment. The Matrix is an easy to use HSAT with accessible testing right in the comfort of your home. It’s important to mention that an HSAT must be interpreted by a board-certified sleep physician in order to be diagnosed with OSA.
The Matrix Plus offers significant benefits to both patient and dentist by allowing a sleep physician to diagnose and to confidently prescribe treatment for OSA. The Matrix Plus is not only an HSAT to assist in diagnosis, it can also predict whether or not the patient is actually a candidate for oral appliance therapy and can even determine what the ideal forward position of the jaw is for the patient to achieve the most optimal result.
One of the major challenges has always been which patient will respond to treatment with an oral sleep appliance. This now gives us the ability to take out all the guesswork. Implementing the Matrix Plus into our sleep apnea workflow has given the sleep physician, the patient, and myself the confidence that an oral appliance is a good decision. As a result, we can minimize jaw joint and muscle issues while significantly reducing chair time and the number of visits for our patients.
Traditionally, to fabricate an oral appliance required molds that were taken with trays filled with impression material. Those days are over. No more gagging, unpleasant tastes, and messes. Not to mention this method was not always accurate, causing patients to retake the impression more than once. Capturing accurate full arch impressions and proper bite is essential to creating an ideal fitting oral appliance.
With obstructive sleep appliances, it is crucial to have an accurate fit and bite record in order to minimize improper positioning of the appliance, tooth shifting, bite changes and /or temporomandiblular joint issues (TMD). Digital impression and bite records eliminate the inaccuracies of the traditional impressions by accurately being able to capture all the information needed. It decreases clinical and lab errors, it requires fewer models, and provides a less porous appliance thereby reducing bacteria build up leading to early discolouration and bad odour.
The result is a healthier, more accurate, and comfortable fitting appliance that can last longer. And since the information is being sent digitally over the internet rather than by mail, the turnaround is significantly faster which translates to less patient visits. The result is a much happier and healthier patient.
I hope you are as confident as I am in how technology is creating a giant leap forward. For general dentistry, the innovations in dental sleep medicine is very promising. There is such a great need for increased awareness and diagnosis of this silent killer. I am hopeful that more dental professionals will embrace this growing field of dentistry and contribute to this serious health problem in order to help more people seek the treatment they truly need.
Comments 0
There are no comments
Add comment