By Melody A. Barron, DDS

If you talk to several people, many will tell you that they don't awaken feeling well rested, and that they are fatigued throughout the day. Many adults would love a nap every afternoon. There's a good chance this same group would say that they snore or wake several times during the night. Poor sleep and daytime fatigue are becoming rampant.

"We are a tired bunch of people!"

Sleep disordered breathing (SDB) as sleep apnea or snoring is extremely prevalent, yet often under- or undiagnosed. Sleep apnea is a disorder where a person stops breathing during sleep for 10 or more seconds, often several times per hour. These events are designated as obstructive, central, or mixed (central and obstructive). Our treatment affects obstructive apneas only. Snoring, which is a partial obstruction of airflow, is a common sign that airflow is compromised. Most people think snoring is a social problem, but it is really a health problem. Snoring can accompany sleep apnea or can be present on its own.

Although sleep apnea is preliminarily diagnosed by polysomnogram (PSG) by a certified sleep physician, trained and qualified dentists are vital in assessing where an airway problem exists and in providing care. Oral appliances are now standard of care for patients diagnosed with mild to moderate sleep apnea and patients who are CPAP intolerant. Dental professionals with the proper training are vital for this treatment role.

The technology and training used by the dentist to evaluate the airway are vital to determining where the problem occurs. Sleep Group Solutions offers the equipment and training necessary to assist the dentist's evaluation. This equipment and training have become a staple in my office, along with appropriate imaging.

The upper airway is evaluated for problems in the nasal airway, soft palate, and base of the tongue. The rhinometer and pharyngometer are vital in assessing these areas through the use of sonar waves. The tests search for evidence of nasal obstruction, narrowing at the soft palate, and collapse at the base of the tongue. Evaluating the airway allows the dentist to work in an interdisciplinary manner with the otolaryngologist, if the nasal airway or other aspects of the airway have significant obstruction. The dentist has the job of affecting the base of the tongue and the soft palate areas with oral appliances. This is the dentist's area, you know! We're not just tooth mechanics. We are doctors!

Dentistry's role in treating obstructive sleep apnea allows us to interact with a variety of physicians. I find this personally and professionally rewarding. We are also in the position to have a huge impact on the patient's total health. This treatment quite often completely changes a person's life from one of declining health, to one where he or she has more control over improving his or her health.

I don't expect every dentist will want to treat sleep apnea with oral appliances. But we should all at least be aware that snoring could be a symptom of this very serious health problem. Don't just treat the patient with a snoring appliance. Always require a sleep study before making an appliance so you are aware of what you're treating. Treating snoring and treating apnea are very different.

There are several comorbidities that can result from untreated sleep apnea. These include high blood pressure, GERD, diabetes, obesity, hormonal problems, polycystic ovarian syndrome in women, and impotence in men. You, the dentist, can be a hero for your patients by recognizing a serious health problem that can cause a significant decline in their health.

Melody A. Barron, DDS, is a graduate of the University of Tennessee College of Dentistry, class of 1992. Prior to attending UT College of Dentistry, Dr. Barron received her bachelor's of science degree in medical technology and had a 10-year career in a hospital medical laboratory. She has treated patients with general orthodontics since 1994. While attending further continuing education in general orthodontics, she became interested in the treatment of temporomandibular joint (TMJ) dysfunction, known as TMD. Dr. Barron attended a mini-residency followed by an advanced residency for therapy and treatment of the temporomandibular joint through the TMJ and Sleep Therapy Centre. She has also obtained hundreds of hours of continuing education. In her treatment of patients with TMJ dysfunction, she found that many of these patients also suffered from sleep disordered breathing or obstructive sleep apnea. Dr. Barron herself suffered from TMJ dysfunction for many years with debilitating headaches, and neck and back pain. Within her training to treat the dysfunction, Dr. Barron was diagnosed and treated successfully by Dr. Steven Olmos, who is the founder of the TMJ and Sleep Therapy Centres nationally and internationally. Dr. Olmos is now her mentor, and Dr. Barron is the owner and director of the TMJ and Sleep Therapy Centre of Memphis. She understands the disorder from the patient's point of view. Dr. Barron holds memberships in the following organizations: International Association of Orthodontics (IAO), American Academy of Functional Orthodontics (AAFO), American Academy of Craniofacial Pain (AACP), American Academy of Pain Management (AAPM), Academy of Dental Sleep Medicine (ADSM), and American Academy of Sleep Medicine (AASM). You may contact Dr. Barron by e-mail at office@memphistmj.com.

For more information on sleep disorder seminars in your area, please click here. Mention "WDJ" to receive a $150 discount when registering.