International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 10, Issue 1, pp: (168-174), Month: April 2022 - September 2022, Available at: www.researchpublish.com
Obstructive Sleep Apnea and Braces Phusita Thanaunyaporn 1* 1
Bodindecha (Sing Singhaseni) School, Phlabphla, Wang Thonglang, Bangkok, Thailand 10310 DOI: https://doi.org/10.5281/zenodo.6901699
Published Date: 25-July-2022
Abstract: Obstructive sleep apnea (OSA) causes people to feel tired because they are not getting enough sleep. This is because they are constantly woken up by loud snoring and pauses in breathing while they sleep. Screening for OSA and referring patients at risk to sleep physicians is a service that orthodontists are well-suited to provide. In treating OSA, physicians (including advanced practice providers supervised by physicians) may prescribe orthodontic appliances or procedures to appropriately selected adults. A patient's orthodontic condition contributing to their OSA will determine which of three specialized dental appliances their orthodontist will recommend. First, braces and aligners can be used to treat misaligned teeth caused by OSA. As a non-invasive treatment option, oral appliance therapy is frequently prescribed to OSA patients. The recommended oral appliance is a customized, titratable mandibular advancement device (MADs) that permits progressive mandibular protrusion. Despite the superior effectiveness of CPAP in reducing OSA severity, recent studies have revealed that CPAP and MADs therapy have comparable health outcomes. This is likely due to greater nightly MADs compliance compared to CPAP therapy. OSA is, in the majority of cases, a chronic disorder. Because OSA is a complex disorder with multiple facets, the most effective treatments are comprehensive and interdisciplinary. The sleep team, which includes an orthodontist and a sleep dentist, should not be alarmed by the trial-and-error nature of OSA treatment. Keywords: Obstructive sleep apnea, sleep-disordered breathing, orthodontic sleep apnea, oral appliance titration.
I. INTRODUCTION Obstructive sleep apnea (OSA) presents symptoms such as drowsiness from lack of sleep due to continuous disruptions during sleep, which is caused by overly audible and (disruptive) snoring, and apnea when sleeping [1]. These actions lead to disintegrated and (nonrestorative) sleep and thus can affect quality of life, health, like heart issues, and daily tasks, like driving [2]. The characteristics of OSA are the decrease of oxygen saturation by the narrow airway affected by the reduced size of the airway completely, or partially [3, 4]. OSA in children and adults is one of the sleep-related breathing disorders managed by the dental practice field [5]. Dental treatment options can differ considering the causation of the apnea and age progression [2]. Treatments such as non-surgical maxillary expansion and orthodontic functional appliances may be given to children while the treatment procedures for adult patients may consist of oral appliance therapy (OAT), orthognathic surgery, and surgical or miniscrew supported palatal expansion [6, 7]. The importance of dentistry, especially orthodontics, regarding the management of these disorders about the possibility of having to do with both the oral cavity and systemic health are oblivious to a number of doctors and dentists [8]. This review article is an attempt to compile evidence-based relevant information on the role of orthodontists in the screening, diagnosis, and management of sleep apnea.
II. PATHOPHYSIOLOGY OF OSA Sleep apnea happens as a result of insufficient airflow, from the lack of space in a part of the upper airway, during sleep [9]. The effect of the reduced muscle tone is a repetition of total or partial collapse of the airway. While enlarged tonsils and/or adenoids is the most common cause of OSA in children, in adults, obesity, male sex, and advancing age is most commonly associated [10, 11]. People with OSA have impairment in the function of a muscle tongue, genioglossus muscle [12, 13]. This results in the prolapse of the tongue against the posterior pharyngeal wall, closing and blocking the airway, during the effort in relation to respiratory activities while sleeping [12, 14]. Obstruction in nasal airflow makes attempts to do respiratory related activities become harder and raise the negative pressure in the pharyngeal airway, the chances of the collapse of the airway increases as the outcome [15].
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