A dentist can help a patient who snores, as the underlying cause often involves the anatomy and positioning of the oral and jaw structures. Snoring is the sound produced by the vibration of soft tissues in the throat when the airway partially collapses during sleep. Dentists evaluate the mouth, jaw, and upper airway for factors contributing to this noise, focusing on screening for sleep-disordered breathing and providing specialized therapy.
The Dentist’s Role in Screening and Assessment
A dentist’s examination includes assessing the patient’s risk for airway obstruction during sleep, extending beyond routine dental checks. The process begins with a detailed medical and sleep history, asking about symptoms like chronic fatigue, morning headaches, or gasping witnessed by a partner. They may use standardized questionnaires, such as the Epworth Sleepiness Scale, to gauge the severity of daytime sleepiness, a common symptom associated with breathing issues.
The clinical examination focuses on the soft tissues and bony structures of the mouth and throat. Dentists look for specific anatomical features that may predispose a person to airway collapse, such as a large tongue, a small lower jaw, or a high-arched palate. They also inspect the teeth for signs of bruxism, or teeth grinding, which is sometimes linked to the body’s attempt to reposition the jaw to open the airway. Identifying these physical markers and correlating them with symptoms allows the dentist to act as a crucial screener for sleep-related breathing problems.
Oral Appliance Therapy: How Devices Work
The primary treatment provided by dentists for snoring is Oral Appliance Therapy (OAT), which uses custom-made devices worn while sleeping. The most common of these are Mandibular Advancement Devices (MADs), which are similar to a sports mouthguard but cover both the upper and lower teeth. These appliances connect the jaws and are designed to hold the lower jaw (mandible) in a slightly forward position.
Repositioning the mandible physically increases the space in the oropharynx, the area behind the tongue and soft palate. Moving the jaw forward also engages and tightens the muscles and soft tissues that line the upper airway. This tightening prevents the soft tissues from collapsing inward and vibrating as air passes over them, which produces the sound of snoring. Since MADs are custom-fitted and often titratable, they offer a comfortable and non-invasive way to manage simple snoring.
Snoring vs. Obstructive Sleep Apnea
It is important to distinguish between simple snoring, which is primarily a noise disturbance, and Obstructive Sleep Apnea (OSA), a more serious medical condition. Simple snoring occurs when air flow is partially restricted, causing soft tissue vibrations. In contrast, OSA involves repeated episodes where the airway fully collapses, causing breathing to stop for ten seconds or more, sometimes dozens of times per hour.
These breathing pauses in OSA lead to a drop in blood oxygen levels and cause the brain to briefly awaken the person to restore normal breathing, disrupting the natural sleep cycle. Untreated OSA carries significant health consequences, including an increased risk for high blood pressure, stroke, heart disease, and type 2 diabetes. While snoring is a common symptom of OSA, the presence of breathing pauses, choking, or gasping distinguishes the more serious condition.
When Collaboration with a Sleep Specialist is Necessary
Dentists cannot definitively diagnose Obstructive Sleep Apnea (OSA); that requires a formal sleep study, or polysomnography, supervised by a sleep specialist. When screening suggests a patient may have moderate to severe OSA, a referral to a sleep physician is the appropriate next step for a confirmed diagnosis. The physician determines the severity of the condition and outlines the overall treatment strategy, which may include Continuous Positive Airway Pressure (CPAP) therapy.
If the diagnosis is mild to moderate OSA, or if the patient cannot tolerate the CPAP machine, an oral appliance fabricated by the dentist becomes a viable alternative treatment. In these cases, the dentist and the sleep physician work together. The dentist provides the custom device, and the physician conducts follow-up sleep testing to confirm the appliance is effective. This multidisciplinary approach ensures the patient receives coordinated care, optimizing management of their sleep-related breathing disorder.