Mark Hodge, DMD
Treatment of obstructive sleep apnea (OSA) has been a hot topic within the dental profession the past few years, and with good reason. Since dentists are one of the most-visited health-care providers, they are often the first to discover the signs of this potentially fatal condition.
Not Just a Risk to the Patient
Dentists may treat OSA by using oral appliances to help adjust the position of the mandible and tongue so that the airway remains open. The potential health risks of sleep apnea extend beyond the individual, and actually place countless others at risk. This extended risk to society has prompted the Federal Motor Carrier Safety Administration to mandate sleep apnea testing for commercial truck drivers and the Federal Aviation Administration to adopt new sleep apnea guidelines for commercial pilots.
OSA carries significant, extended health risks (e.g., sleep deprivation, high blood pressure, diabetes, heart disease) and can reduce life expectancy by 20%. Obstructive sleep issues are reported to affect as many as 18 million Americans, according to the National Sleep Foundation. In addition, the Harvard Medical School Division of Sleep Medicine estimates that the economic impact of moderate to severe sleep apnea in the U.S. could be as high as $165 billion. Our profession is uniquely positioned and qualified to offer hope to these individuals and help reverse this negative health trend.
Obstructive Sleep Apnea Often Begins in the Mouth
To understand the scope of our impact, let's dive a bit deeper. What is the root cause of OSA? In many cases, it stems from improper jaw growth and facial development during childhood. A lack of proper dentoskeletal development will contribute to improper airway function and improper overall individual development. Imagine the airway implications for children with crowding issues that reduce available tongue space, a Class II Division 2 malocclusion that traps the mandible into a retruded position, or even a pseudo Class III malocclusion where the maxilla has failed to follow the normal downward-and-forward growth pattern. Failure to treat such conditions early can cause childhood obesity, juvenile diabetes, and behavior disorders (e.g., ADD, ADHD). Too often these airway-affecting issues go undiagnosed and untreated, when treatment can easily be initiated by a general dentist for children as early as 4 years old. As soon as the potential for a dentoskeletal or airway problem is present, that is the best time for treatment.
In a 2013 Frontiers in Neurology article, the authors discussed a study of 300 infants from birth to 24 months and found that only 9% of the subjects had normal (i.e., nonvaulted, non-narrow) hard palates, normal breathing during sleep, and normal development.4 From this, we can infer that 91% would have benefited from some level of interceptive therapy. This article concludes that pediatric OSA in non-obese children is a disorder of oral-facial growth. This places the opportunity and responsibility for intervention in the hands of dentists.
This is an excellent opportunity to make an early positive impact by using interceptive orthodontics. Effective treatment options employ a combination of lab-fabricated appliances and flexible, functional appliances from Ortho-Tain and Myobrace. With improved airway development and proper sleep, an ideal height and growth curve can be maintained through childhood into adulthood. Furthermore, a proper airway and proper sleep habits will improve cognitive development and academic performance, two factors that could indeed change a child's destiny.
Lifetime Care, Lifetime Impact
At Heartland Dental, we use the term "lifetime care" frequently. We are committed to supporting dentists in providing the least amount of dentistry necessary to have the biggest long-term impact. Interceptive orthodontics is a perfect example of lifetime care. We encourage supported dentists to think about what the lives of their young patients are like today and what they will be like at age 76. In emphasizing lifetime care, we offer a number of educational opportunities in interceptive orthodontics so that supported doctors and teams can learn how to best identify the warning signs of improper dentoskeletal development.
With all the life-changing problems that can be potentially avoided by preventing OSA, interceptive orthodontics (more than any other dental procedure) could easily offer the greatest lifetime health benefit to young patients as individuals, and to the overall health and well-being of this nation's next generation of adults.
Mark Hodge, DMD,obtained his degree from the Michael Cardone, Sr. School of Dentistry at Oral Roberts University. Having a deep passion for orthodontics, Dr. Hodge facilitates orthodontic initiatives within Heartland Dental supported offices. He is also part of Invisalign's teaching faculty and vice president of the American Academy of Cosmetic Orthodontics.