Rochester dentists Kurt Doolin and Jeff Haddad have successfully treated patients suffering from headaches and an array of jaw pain symptoms, categorized as temporomandibular disorders, for more than a decade. With growing clinical evidence connecting TMD to sleep breathing disorders, they are increasingly using proven TMD therapies garnered from individualized muscle tracking technology to successfully treat patients with mild to moderate obstructive sleep apnea as well.
“We have seen a significant increase in the number of patients we treat for combined obstructive sleep apnea-TMD since our practice began monitoring and treating sleep apnea five years ago,” Doolin said. “During that time, we have refined treatment approaches and the design of oral therapy appliances as new information, research and technology have become available.”
And indeed new information has become available. Recent data indicates an estimated 75 percent of people with TMD also have sleep breathing disorders, and 52 percent of people with sleep disorders have TMD problems, according to Haddad.
“Patients with TMD frequently have a destructive, worn-down bite which forces their lower jaw backwards,” Haddad said. “This backwards positioning can increase the degree of blockage of a person’s airway while they sleep, which leads to obstructive sleep apnea. Conversely, a person with an obstructed airway may clench and grind their teeth, which can wear down the teeth and deteriorate the bite, leading to TMD symptoms and pain. It’s a bit of the chicken or egg syndrome, but the patient isn’t concerned with which problem came first, they just want to feel better.”
As neuromuscular dentists, Doolin and Haddad have always focused on proper jaw alignment and muscle physiology for overall dental health, a guiding principle that puts them at an advantage in treating OSA.
“We use various tools, including advanced muscle tracking technology, to diagnose and treat obstructive sleep apnea,” Doolin said. “We also provide patients with a sleep monitoring device that records breathing and provides an Apnea/Hypopnea Index, which is a measurement of the severity of sleep apnea. The studies combine information on blood oxygen level and the number of times sleep is disrupted by low oxygen during sleep to help us determine a course of action.”
If mild to moderate OSA is diagnosed, the dentists provide a customized mandibular splint device for nighttime wear to move the lower jaw forward and hold the airway open. They then reevaluate their patients with the screening equipment in order to determine if the appliance is successful.
“If our screening device shows that a patient has severe sleep apnea, they will be referred for an evaluation with a sleep physician,” said Doolin, adding that sometimes a comprehensive dental and medical approach brings the best patient outcome.
Sally Shrock of Rochester is a patient who experienced symptoms of obstructive sleep apnea. She says her life was changed following OSA treatment.
“For the first time in years, I now sleep like a baby with very little snoring,” she said. “What a blessing that is for me and for my husband.”
Haddad cautions against self-treatment and says one-size-fits-most sleep apnea appliances can hurt, not heal.
“The proper approach to treating TMD and obstructive sleep apnea is with the use of precise muscle measuring and monitored therapy, not simply an oral appliance,” Haddad said. “The incorrect appliance can force patients into a headache/jaw pain spiral. We have treated patients in our practice who have been adversely affected by the use of over-the-counter, Internet ordered, or poorly made sleep appliances. When we made new, precisely measured sleep appliances based on their personal muscle physiology and monitored the outcome, their pain symptoms were relieved and their sleep issues improved with greater predictability.”
More at www.rochesteradvanceddentistry.com.