A restful night is more than a luxury — it’s a foundation for good health. When breathing is interrupted during sleep, the body can suffer cumulative stress that affects mood, memory, heart health, and overall quality of life. An estimated 25 million adults in the United States have obstructive sleep apnea (OSA), and far more struggle with disruptive snoring. At the office of Brian Howe DDS, Family Dentistry, we evaluate dental contributors to sleep-disordered breathing and work with medical partners to help patients sleep more safely and soundly.
Obstructive sleep apnea is a condition in which throat tissues partially or completely block the airway during sleep, causing repeated breathing pauses. These interruptions — called apneas and hypopneas — reduce oxygen flow and fragment the sleep cycle, preventing restorative deep sleep. While OSA is the most common form, other types such as central sleep apnea have different causes and require distinct medical evaluation.
The mechanics are straightforward: when the muscles that support the soft palate, tongue and pharynx relax too much during sleep, the airway narrows or collapses. This can happen occasionally in healthy individuals or repeatedly in people with anatomical or physiological risk factors, including excess soft tissue in the throat, a large tongue, certain jaw structures, or nasal obstruction.
Because OSA varies in severity, its health consequences range from daytime fatigue and impaired concentration to elevated blood pressure and increased cardiovascular risk. Recognizing the condition early and coordinating appropriate care reduces long-term complications and improves overall well-being.
Many people first notice sleep apnea because of loud, persistent snoring or because a bed partner witnesses pauses in breathing. Nighttime symptoms can also include choking or gasping episodes, restless sleep, or frequent awakenings. Some individuals may not be aware of these events themselves, so information from a partner or family member is often essential for detection.
Daytime consequences are equally important to recognize. Excessive daytime sleepiness, difficulty staying alert while driving or working, morning headaches, and trouble concentrating are common complaints. Mood changes such as irritability or depressive symptoms can also arise, and these patterns may worsen over time if the underlying sleep disturbance is not treated.
Sleep apnea is frequently associated with other medical conditions, including high blood pressure, metabolic concerns like diabetes, gastroesophageal reflux, and certain cardiovascular problems. Because of these links, a multidisciplinary evaluation that includes both medical and dental perspectives can be especially valuable.
Diagnosis typically begins with a clinical evaluation and screening questionnaires to estimate risk. From there, a formal sleep study — either an in-lab polysomnography or a monitored home sleep test ordered by a physician — determines whether sleep apnea is present and gauges its severity. These tests measure breathing patterns, oxygen levels, and sleep stages to guide treatment planning.
Dental professionals play a complementary role in the diagnostic process. During a comprehensive oral exam we assess jaw position, dental arch relationships, tongue size, and signs of tooth wear that can indicate nighttime clenching or grinding. In some cases, digital imaging or CBCT scans are used to evaluate airway anatomy and support collaborative decision-making with your sleep physician.
Clear communication between your dentist and medical providers ensures that test results and clinical findings are interpreted together. This team approach helps identify the safest, most effective therapy tailored to a patient’s anatomy, symptoms, and lifestyle.
Treatment for sleep apnea is individualized and often involves coordination between sleep medicine specialists, ENT doctors, and dentists trained in dental sleep medicine. Continuous positive airway pressure (CPAP) is a common and effective medical therapy that uses a pressurized airflow to keep the airway open during sleep. For many patients, especially those with mild to moderate OSA or those who cannot tolerate CPAP, oral appliance therapy is a proven dental alternative.
Oral appliances are custom-made devices that reposition the lower jaw or stabilize the tongue and soft tissues to reduce airway collapse. Worn at night much like a protective mouthguard, these appliances can decrease the frequency of apneas and reduce snoring. Selecting the right device involves careful evaluation of dental health, bite relationships, and airway anatomy to balance effectiveness with comfort and long-term oral stability.
Other treatments — such as positional therapy, weight management strategies, or referral for surgical consultation — may be appropriate depending on the underlying causes. Throughout treatment, ongoing follow-up and collaboration with your medical team are essential to monitor symptoms, adjust care, and measure outcomes objectively.
A custom oral appliance begins with precise impressions or digital scans of your teeth and an assessment of your bite. Fabrication focuses on creating a device that is both effective and comfortable; materials and design are selected to minimize strain on the jaw while keeping the airway open. Proper fit and alignment are critical, so the initial fitting is followed by incremental adjustments known as titration.
After the appliance is delivered, routine follow-up appointments evaluate symptom improvement and check for any side effects, such as changes in tooth position or jaw discomfort. Periodic assessment — often including objective testing or home monitoring — helps determine whether therapy is adequately controlling breathing events or if further adjustments are necessary.
Long-term success depends on adherence, regular maintenance, and professional oversight. Our team emphasizes education on device care and schedules ongoing reviews to preserve dental health and maximize the appliance’s therapeutic benefit. With thoughtful design and careful management, many patients experience meaningful reductions in snoring and daytime sleepiness and regain restorative sleep.
If you suspect sleep-disordered breathing or have been diagnosed with sleep apnea and want to explore dental treatment options, the team at Brian Howe DDS, Family Dentistry can help coordinate care with your medical providers and offer personalized oral appliance therapy. Contact us to learn more about how we assess, treat, and monitor sleep-related breathing issues and to discuss whether dental sleep medicine may be a good fit for you.
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder in which the upper airway repeatedly narrows or collapses during sleep. These interruptions, called apneas and hypopneas, lower blood oxygen levels and fragment the sleep cycle, preventing restorative deep sleep. Over time, untreated OSA can contribute to daytime sleepiness, impaired cognition, and increased cardiovascular risk.
OSA is distinct from central sleep apnea, which involves a failure of the brain to signal breathing muscles, and from simple snoring, which may not include breathing pauses. Severity is measured by the frequency and duration of events during a sleep test, and treatment decisions are based on symptoms, test results, and individual health factors. Early identification and appropriate evaluation help lower the chance of long-term complications.
Nighttime clues often include loud, chronic snoring, witnessed pauses in breathing, choking or gasping episodes, and restless sleep. Many patients are unaware of these events and rely on reports from bed partners or family members to recognize a problem. Nighttime symptoms may also include frequent awakenings and nonrestorative sleep.
Daytime effects commonly include excessive sleepiness, difficulty concentrating, morning headaches, and mood changes such as irritability or depressive symptoms. These functional impairments can affect safety at work or while driving and reduce overall quality of life. Because sleep apnea can coexist with other medical conditions, a comprehensive evaluation is important when these signs appear.
Risk factors for OSA include excess soft tissue in the throat, a large tongue, certain jaw or dental arch structures, and nasal obstruction that can narrow the airway during sleep. Other contributors include obesity, male sex, older age, and a family history of sleep-disordered breathing. Lifestyle factors such as alcohol use and sedative medications can worsen airway collapse at night.
Medical conditions like hypothyroidism and certain neuromuscular disorders may also raise risk, and OSA frequently coexists with high blood pressure, type 2 diabetes, and cardiovascular disease. A targeted clinical evaluation that reviews anatomy, symptoms, and medical history helps determine individual risk and guides appropriate testing and referrals.
Diagnosis usually begins with a clinical evaluation and validated screening questionnaires to estimate a patient’s likelihood of having OSA. Definitive diagnosis requires objective sleep testing, which may be performed as an in-lab polysomnography or with an ambulatory home sleep test ordered and interpreted by a physician. These studies measure breathing patterns, oxygen levels, and sleep stages to quantify the severity of disordered breathing.
Dentists can contribute important clinical findings from oral and airway examinations that inform the diagnostic process, but a medical sleep specialist interprets sleep studies and establishes a formal diagnosis. Collaborative communication between dental and medical providers ensures that test results and clinical observations are reviewed together to develop a safe, effective treatment plan.
Dental professionals assess craniofacial anatomy, dental occlusion, tongue size, and signs of nocturnal teeth grinding that may indicate sleep-disordered breathing. They can provide airway-focused examinations, take digital scans or CBCT images when appropriate, and identify dental factors that influence airway stability. This dental perspective complements medical evaluation and helps determine whether an oral appliance may be a suitable option.
When oral appliance therapy is recommended, the dentist custom-fits, titrates, and monitors the device, checking for fit, comfort, and dental changes over time. Dentists also communicate with sleep physicians to review objective outcome measures and coordinate follow-up care. The team-based approach enhances patient safety and maximizes the likelihood of successful treatment.
Oral appliance therapies are custom-made devices worn during sleep that reposition the lower jaw or stabilize the tongue and soft tissues to reduce airway collapse. Most commonly they advance the mandible slightly forward, which increases upper airway space and reduces the frequency of apneas and snoring. Appliances are made from durable materials and are designed to be comfortable for nightly use, similar to a sports mouthguard.
These devices are particularly effective for patients with mild to moderate OSA or for individuals who cannot tolerate continuous positive airway pressure (CPAP). Effectiveness depends on proper fit, regular use, and ongoing adjustments known as titration; periodic objective assessment is recommended to confirm that the appliance is controlling breathing events adequately.
A custom oral appliance program begins with a thorough dental and airway evaluation, followed by impressions or digital scans of the teeth and bite records to ensure an accurate fit. The laboratory fabricates a device tailored to the patient’s anatomy, and the initial delivery includes instruction on insertion, removal, cleaning, and safe overnight use. Early follow-up appointments are scheduled to assess comfort and make incremental adjustments to improve efficacy.
Throughout therapy, the clinician monitors for symptom improvement and potential side effects such as jaw soreness, changes in bite, or tooth movement, and makes adjustments as needed. Objective follow-up—often coordinated with the treating sleep physician—helps determine whether the appliance is sufficiently reducing apneas and hypopneas or if alternative therapies should be considered. Long-term success relies on adherence, regular maintenance, and periodic professional reviews.
Common short-term effects can include mild jaw discomfort, salivation changes, and transient tooth or gum sensitivity as the mouth adapts to the device. Some patients experience gradual dental or bite changes with long-term use, which is why routine dental monitoring and periodic occlusal assessments are important. Most side effects are manageable with timely adjustments and appropriate device design choices.
Oral appliances are not universally effective for all patients, and their ability to control sleep apnea depends on individual anatomy and disease severity. Severe OSA is often best managed with CPAP or combined therapies, and patients should undergo objective outcome testing to confirm that the chosen treatment sufficiently reduces breathing events. Shared decision-making between the patient, dentist, and sleep physician helps balance benefits and limitations.
Care coordination typically begins with a medical diagnosis from a sleep specialist and a referral when oral appliance therapy is being considered. Dental providers share findings from oral and airway examinations, imaging, and device titration notes, while physicians provide sleep study results and clinical recommendations. Clear, timely communication ensures that both perspectives inform treatment planning and outcome assessment.
Follow-up often involves joint review of symptom reports and objective measures such as repeat home sleep testing or in-lab studies when indicated. This collaborative approach supports safe, evidence-based care and allows for adjustments—whether modifying an appliance, optimizing CPAP, or exploring adjunctive treatments—based on measurable outcomes and patient preferences.
If you suspect sleep-disordered breathing or have been diagnosed with OSA, begin with a comprehensive medical evaluation and discussion with your sleep physician about appropriate testing. If oral appliance therapy is a potential option, schedule an airway-focused dental examination to assess dental health, jaw relationships, and anatomical features that influence airway patency. This combined evaluation helps determine candidacy and tailor treatment choices to your needs.
At Brian Howe DDS, Family Dentistry our team coordinates care with medical providers, performs detailed oral and airway assessments, and explains the benefits, limitations, and follow-up required for dental sleep medicine. Collaborative planning and objective outcome monitoring help ensure the chosen therapy is safe and effective for each patient’s unique situation.
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