Pay attention to dental side effects during long-term oral appliance therapy

We understand how successful treatment of obstructive sleep apnea (OSA) can be. However, we need to pay attention to the potential side effects from long-term oral appliance use. If we are aware of these side effects, we can help educate our patients and prevent them from occurring and interrupting care.

What do we do as dentists to help?

I have read several studies that looked at the predictors of dental changes associated with long-term treatment with oral appliances in patients with OSA. From these studies I have found that yes, long-term use can lead to dental complications if we do not educate our patients.

Before you fit your patient for an oral appliance, ask them if they are willing to take at least two-minutes out of their morning to perform exercises. That’s all it takes. Just two minutes (maybe even less) a day to prevent further complications. And, of course, if they do notice any shifts in their teeth, it is important for them to keep you up-to-date. You can provide an adjustment to their treatment or offer other solutions to improve this change.

When you are fitting your patients for their oral appliance, let them know that it is important to perform daily exercises after removal of the device. By performing jaw exercises, it can help prevent the patient’s mouth from becoming stiff or sore. It can also help to prevent lock-jaw and other complications.

It is our duty as dentists to take care of our patients and that means proper education for daily exercises after removing the oral appliance each morning.

What are you doing to help your patients through the oral appliance process? Are you having them perform exercises? If so, what kind? I am interested in learning what everyone is doing to help their patients each step of this journey.

Sleep deprivation in the workplace poses a danger to workers

In South Carolina’s manufacturing ecosystem, sleep is directly tied to the bottom line. There are numerous studies across the country that have identified sleep deprivation as a safety hazard and a liability on a company’s finances. In a recent article, S.C. Manufacturing Extension Partnership (SCMEP) found that there were more than 5,000 manufacturing firms employing close to 250,000 men and women across the Palmetto State. To add to that, several ports were found to be processing more than $53 billion each year.

Negative impact of sleep deprivation

Researchers at the Journal of Occupational and Environmental Medicine found that fatigue-related productivity losses could end up costing South Carolina nearly $2,000 per employee a year! On top of that, sleep deprivation can lead to increased sick days, which results in more employees calling out of work and costing the company even more money lost.

As you know, during sleep stages three and REM, the body repairs damaged tissue while growing more. If these stages do not occur, white blood cells begin to diminish as inflammatory cells multiply. However, most people who suffer from a lack of sleep are not always aware they have an issue until they are diagnosed with one of its medical complications, such as diabetes.

CPAP isn’t always the best solution

Treatment of sleep apnea is key for improving sleep deprivation. And while most people assume CPAP machines are the best options, it has been shown that the compliance rate is only 40 percent, according to clinical director of True Sleep Diagnostics in Greenville, Ken Hooks. As a result, these patients might develop further complications associated with unsuccessfully treated sleep apnea.

This might then cause repeated sleep studies that don’t show a change in the condition. As dentists, we can use this to our advantage. The use of an oral appliance from your office is often less known than CPAP, but through its custom-design for the individual patient, it can be worn comfortably while sleeping to open the airway.

For South Carolina’s case, educating manufacturing workers on the success of oral appliances will be key. Let’s keep this in mind for future reference in showing just how important care is for our patients.

Effect of CPAP use on blood pressure in patients with sleep apnea

The use of continuous positive airway pressure (CPAP) therapy is the most commonly used treatment option for sleep apnea. While it can be a successful form of treatment, not all patients wear the mask throughout the night. However, a new study published in the Journal of Hypertension shows that use of the CPAP machine did have a long-term impact on a patient’s health by reducing blood pressure.

With this information, we can further look at the long-term impact of oral appliance therapy for the health of our patients and a reduction in blood pressure and hypertension. It is apparent that the use of treatment of sleep apnea is key in protecting patients and their health in the long-run.  

The impact of treatment

This study looked to evaluate the impact of long-term use of CPAP on clinic and ambulatory blood pressure (BP) in patients with resistant hypertension (RHT) and obstructive sleep apnea (OSA). It observed 66 patients with RHT and moderate/severe OSA, using CPAP for at least a year. Clinic BP and 24-hour BP were obtained before and after follow-up.

The results showed that the average use of CPAP treatment was five hours per night with 78 percent using it at least four hours per night. There was a significant reduction of 24-hour and daytime systolic ambulatory BP. And controlled BP increased from 39 percent to 57 percent.

It was concluded that the treatment of OSA with long-term use of CPAP significantly reduces BP among patients with resistant hypertension. This is especially true with uncontrolled ambulatory BP at the baseline. What this means is that treatment is essential in not only improving OSA, but hypertension and BP too.

And while this study does not cover oral appliance therapy, we can assume the same can be said for continued use of an oral appliance. This is definitely something we need to keep an eye on and look further into. But it is clear that treatment of sleep apnea is essential to overall health and well-being.

The Sleep Apnea Device Market has a Bright Future

I have some exciting news to share! The sleep apnea device market has a bright future and that’s great news for us dentists! So, what’s the outlook? Well, by 2020 it is estimated to reach a worth of about $5.3 billion. In the report “Sleep Apnea Devices Market by Product, Diagnostic (PSG, Pulse Oximeter), Therapeutic [CPAP, APAP, BPAP, Masks (Full Face Mask), Oral Appliances (Mandibular Advancement Device)], End User (Home Care Settings, Hospitals) – Analysis & Global Forecasts to 2020”, the major market drivers, restraints/challenges, and opportunities were analyzed and studied.

In the report, as presented by marketsandmarkets.com, the global sleep apnea devices market is studied for the forecast period of 2015-2020. As of 2015, the market was at $3.7 billion, but by 2020, the market is expected to reach $5.3 billion at a CAGR of 7.2% during the forecast period. With 2015 being the highest growth of the market, we will continue to see a growth spurt at the highest rate yet.

A Look at the Forecast

The regions for this study included the following areas:

  • North America
  • Europe
  • Asia-Pacific
  • The Rest of the World (Latin America, Central America, and Africa)

We saw North America with the largest share in the sleep apnea market in 2015, followed by Europe and Asia-Pacific. However, the European market has projections to grow at the highest CAGR rate during the target between now and 2020.

ResMed, a major player in the market, continues to observe a strong focus on innovation. Through such a rich pipeline of innovative products in the market opens up so many opportunities for treatment of sleep apnea.

Remain ahead of the game by providing the best treatment options for sleep apnea through oral appliance therapy. Together we can help our patients get a better night’s sleep. To learn more about sleep apnea and available treatment options, visit www.mpateldds.com. You can also view upcoming lectures to help you continue to learn more about this growing industry.