B. Gail Denko, DMD PC, Dental Sleep Medicine. Specializing in the treatment of patients with snoring and obstructive sleep apnea.
“Anyone can escape into sleep, we are all geniuses when we dream, the butcher's the poet's equal there.”
Emile M. Ciora
Side Effects
Jaw advancement
Jaw advancement with only anterior contact
Opening spaces between
the teeth
Methylmeth allergy
Blood blister from tongue retaining device
Oral appliances are far from benign.
Short term side-effects are common and easily corrected.These include:
• excessive salivary flow
• dry mouth
• joint pain
• tooth pain
• muscle pain
• dislodgement of ill-fitting crowns and fillings (If an appliance can remove a restoration, then the restoration required replacement).
• loosen teeth
• further damage periodontally involved teeth.
Long-term problems include labioversion of the mandibular teeth, linguoversion of he maxillary teeth and repositioning of the mandible in a downward and forward direction. Research by Christopher Robertson, BDS, PhD shows that tooth and jaw movement continues unabated through out a 3 year follow-up period.
Long-term changes can lead to a Class III occlusal scheme, spacing between the teeth which can exaccerbate periodontal problems, and alterations in a patients profile. Be aware that most patients are unaware of changes in their dentition until they are quite pronounced.
Close follow-up is necessary. The ADSM guidelines call for monthly follow-up initially, recall every 6 months for two years and annual evaluations for as long as the patient wears an oral appliance.
Dentists play an important role in the team approach to the treatment of obstructive sleep apnea.
Physicians, dentists, psychologists, and respiratory therapists all pool their knowledge to treat each patient appropriately and effectively.
Dentists who are specifically trained in aspects of sleep medicine and have a command of multiple appliance modalities are of great help to physicians in treating patients with sleep disordered breathing problems.
AVALABLE OFFICE HOURS:
9:00 t o 5:00 (Mon)
9:00 to 5:00 (Wed–Sat)
12:00 to5:00 (Sun)
CALL 617.964.4028
in Massachusetts
317.842.9866
in Indiana
The National Center on Sleep Disorders Research, can provide you with sleep education materials. As well as publications on heart, lung and blood research:
Two Rockledge Center, Suite 7024, 6701Rockledge Drive, MSC 7920, Betesda, MD 20892-7920
(P)301.435.0199 /
(F) 301.480.3451
www.nhlbi.nih.gov/about/ncsdr/
Information about sleep disorders may be obtained from NHLBI:
NHLBI Information Center
P. O. Box 30105, Bethesda, MD 20824-0105
(P) 301.251.1222 / (F) 301.251.122
www.nhlbi.nih.gov/