Dental Sleep Practice: Summer 2016

Page 28


Airway, Bruxism and Craniofacial Pain: What’s the Connection?


he majority of dentists are not well versed in sleep medicine and related disorders. Studies have shown that many dentists were not able to recognize the risks of sleep apnea, let alone manage patients with oral appliances.1 By understanding the connection and interrelationship between the airway, bruxism and craniofacial pain, you open your practice to more areas of diagnosis and treatment that will help your patients live healthier, happier lives. A Look at Sleep Disordered Breathing (SDB) – the Airway

Dental practices are in a unique position to identify patients at risk for SDB. Intra oral findings can be highly suggestive of such a condition (see figure). Once testing has been completed to evaluate a suspect compromised airway, the diagnosis may contain a combination of diagnostic details. A respiratory effort related arousal (RERA) is scored

26 DSP | Summer 2016

by Mayoor Patel, DDS, MS

when a series of breaths with an ever-increasing respiratory effort against a narrowed upper airway terminates with arousal from sleep before criteria for a true apnea or hypopnea event are met. Upper airway resistance syndrome (UARS) is the condition of excessive sleepiness associated with 10 or more RERAs per hour. Obstructive apneas and hypopneas are characterized by repetitive periods of complete (apnea) or partial (hypopnea) airflow reduction. The events must be at least 10 seconds in duration in association with respiratory efforts, and they usually end with arousal from sleep.

Understanding Bruxism

Bruxism is a term used to describe gnashing and grinding of the teeth that occurs without a functional purpose.2 Whether it is due to a nervous habit, stress or with no known cause, bruxism can cause a lot of damage to your patient’s teeth. In 2005, sleep bruxism

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