Obstructive sleep apnea (OSA) is being diagnosed more often today, but it’s not because the condition itself is suddenly exploding. It’s because awareness, risk factors and diagnostic access have all made detection more common. 

Awareness has come about due to public health campaigns and conversations between patients and healthcare professionals. People now realize that waking with a headache or snoring so loud it sends partners to the guest room is not normal. 

Risk factors such as obesity, sedentary lifestyle, aging and increased alcohol use can contribute to the likelihood of developing OSA, as the airway relaxes, changes or loses muscle tone. 

Because OSA is a condition that can happen because of obstructions from the sinus, tongue and throat, it may be first noticed by a dentist. A patient’s inability to tolerate x-rays or dental procedures could be a red flag for airway dysfunction. The size and shape of a person’s jaw and dental arches also affects how much room the tongue and airway have; which further connects dentistry and orthodontics to OSA. A narrow upper jaw, a receding lower jaw or a bite where the teeth don’t align properly can push the tongue further back into the throat, especially during sleep when muscles relax. That narrowing can contribute to snoring, mouth breathing and OSA.

A Continuous Positive Airway Pressure (CPAP) machine is the first-line treatment. It delivers pressurized air into a mask worn over the nose or mouth. This constant airflow keeps the airway open, allowing for uninterrupted breathing and improved oxygen intake. This is important because untreated OSA increases the risk of heart disease and stroke. Unfortunately, only half of patients prescribed CPAP can tolerate wearing it; making compliance impossible. 

As an alternative treatment, a qualified dentist can make a mandibular advancement device. Maxillofacial surgery and orthodontics are additional solutions to improving the airway.  

There are at-home sleep apnea tests and laboratory sleep studies to diagnose OSA, but as a first step, a dentist can send a patient home with a high-resolution pulse oximeter to screen for respiratory disturbances and oxygen desaturation during sleep. Patients who have a high number of respiratory disturbances or significant oxygen desaturations should then complete a sleep study reviewed by a physician. 

Those with a narrow arch, crowded teeth or a bite issue who also experience snoring or mouth breathing may want to seek orthodontic therapy for treatment. However, it’s crucial that specific evidence in the form of a proper airway-focused evaluation is done. This typically involves specialized imaging (e.g., CBCT scan) and possibly a sleep study, not just a standard orthodontic consultation.

Airway dysfunction is a multidisciplinary issue and should include input from a dentist and/or orthodontist and oral surgeon, along with a physician who specializes in ear, nose and throat and/or a sleep medicine specialist.

Ottesen Family Dentistry is located at 1536 John Sims Parkway, Niceville, FL. For more information about Dental Sleep Medicine, call 850-279-6657 or visit NicevilleDental.com.