Dr. George Tsangaroulis has a special interest in Dental Sleep Medicine—collaboratively treating Obstructive Sleep Apnea (OSA) or Sleep Disordered Breathing with Physicians and Sleep Specialists, using Oral Appliance Therapy, otherwise known as Mandibular Advancement Devices. Since many people are unaware or undiagnosed, our dentist routinely screens patients, both adults and children, for Obstructive Sleep Apnea by looking for clinical signs in the head, neck, mouth, and teeth. Do you suffer from obstructive sleep apnea? Obstructive Sleep Apnea (OSA) is the most common sleep disorder affecting over 18 million people in the United States. It has been linked to excessive tiredness, depression and reduced resistance to infection. Obstructive Sleep Apnea is characterized by loud or heavy snoring interrupted by the stopping of breathing for more than 10 seconds. Under diagnosed and frequently dismissed as harmless yet annoying snoring, OSA is a very dangerous condition. If you or a loved one snore loudly at night, please have a sleep study done to rule out this potentially fatal condition. The word “apnea” literally means “without breath.” What causes OSA? During sleep muscles relax, including those that control the tongue and throat. The soft tissue at the back of your throat can sag, narrowing the airway. Incoming air then makes the tissue at the rear roof of the mouth, the flap of skin hanging from the palate (uvula) and the throat vibrate. This makes a sound we know as snoring. Load snoring can be a sign of OSA. This is where the airway becomes blocked completely and breathing stops. The brain then detects the lack of oxygen and prompts the person to arouse momentarily to draw a breath, but consequently sleep is extremely fragmented and of poor quality. These incidences can happen many times per hour and hundreds of times in a night’s sleep. Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, sleep apnea may be responsible for job impairment and motor vehicle crashes. Fortunately, sleep apnea can be diagnosed and treated. Treatment Options Sleep Apnea Oral Appliance Therapy is a completely non-invasive and painless CPAP alternative for mild to moderate OSA. It is a custom made mouthpiece that you wear while you sleep. It is similar in size to an orthodontic retainer or a sports mouth guard. It is very comfortable, easy to wear, and easy to travel with. It could also be used as an alternative for those who have severe sleep apnea and travel frequently, or generally struggle to comply with daily CPAP wear. The oral appliance works by maintaining the patency of the upper airway by increasing its dimension and reducing collapsibility. This works to reposition the lower jaw, tongue, soft palate, and uvula. The oral appliance is very discrete, allowing you to close your lips so it is not obvious you are wearing it. What will the dentist do? Dr. Tsangaroulis will thoroughly examine your teeth and mouth to confirm your oral health status, as well as ensuring you are an appropriate candidate for the appliance. If obstructive sleep apnea is suspected, he will then refer the patient to the appropriate physician for further evaluation and prescribe the appropriate sleep test whether it’s home or hospital based. The physician along with Dr. Tsangaroulis will work together as a team to properly educate the patient and recommend what is best or what will fit the patient’s needs. If Oral Appliance Therapy is desired, dental impressions are taken at the next visit and then sent to the laboratory where the appliance is made. Once it is custom made for you, Dr. Tsangaroulis will instruct you on how to insert, remove and care for your appliance.