Intuitive airway analysis meets appliance treatment planning
Erin E. Elliott, DDS
I just love to sleep, so it concerns me that millions of people aren't having the same restful experience that I so enjoy. However, it wasn't until I listened to a sleep dentist speak at a dental meeting in 2009 that I realized that I could be part of my patients' journey to improve the quality of their sleep.
The course that I took to train me for the specialty really opened my eyes to just how prevalent airway problems are. This wasn't just an obscure issue affecting a small group of patients, it was also an issue among my closest associates and family members.
Since beginning to offer dental sleep medicine, I've treated thousands of patients for sleep-disordered breathing, including potentially deadly obstructive sleep apnea (OSA). Many were initially surprised when the team and I first began asking questions about snoring and sleep problems along with those related to common dental signs and symptoms such as bruxing, scalloped tongue, and acid erosion.
Although ours is a general dental practice, since 2009, a large part of it has been devoted to this growing segment, mainly due to the expertise and reputation that we've carefully cultivated. Our first step is identifying patients who may have sleep-disordered breathing issues, including OSA. My entire dental team has been trained to identify the associated dental signs and symptoms. Next, because we upgraded to a Orthophos SL 3D system (Dentsply Sirona) with SICAT Air software in 2016, if we suspect a sleep-related problem-such as a narrow airway, deviated septum, or large turbinates-we can view the area in three dimensions and share our findings with the patient. Although dentists require a physician's diagnosis and prescription in order to fabricate a mandibular advancement device, such as the OPTISLEEP, to treat sleep-disordered breathing, we can send the patient home with a home sleep test (which must then be interpreted and certified by a qualified medical doctor) to help expedite the process.
We highly recommend the SICAT-generated OPTISLEEP appliance, which is non-bulky, metal-free, comfortable, adjustable, and custom-fitted. And because everything is done digitally, the entire process is streamlined and accurate with a quick turnaround time. In addition, those with OSA tend to have smaller mouths, more constricted arches, stronger gag reflexes, and larger tori, so they are happy that it doesn't require a mouthful of goopy impression material.
Because the dental office is the ideal place to screen patients for symptoms of disordered breathing, I would even urge dentists who choose not to incorporate this service into their practices to start talking to their patients and otherwise help them to receive life-improving and potentially life-saving treatment, so they too can enjoy a good night's sleep.
1. SICAT Air is the first software solution to facilitate a 3D analysis of the upper airway and support the treatment planning and creation of an OSA appliance.
2. Automatic segmentation of the upper airway in 3D allows the visualization of constrictions (highlighted in color) and other airway parameters, such as the smallest cross section and volume.
3. The airway comparison feature allows side- by-side analysis of possible changes between untreated and treated scans.
4. When combined with a Dentsply Sirona 3D x-ray system, the mandibular joints can be taken into account to minimize the risk of craniomandibular dysfunction.
About the Author
Erin E. Elliott, DDS
Post Falls, Idaho