Possible symptoms include mandibular joint disorders, chronic headaches, neck pain, tinnitus, migraines, dizziness, restricted mouth opening and difficulty swallowing, and even malpositions, such as pelvic obliquity. Symptoms in the mouth include ground down teeth, cervical defects, a sunken masticatory plane, inflammation of the periodontium (periodontitis) and missing supports in the posterior region.
Interdisciplinary therapy is provided, combining splint therapy, grinding therapy, physiotherapy and medicinal therapy.
At our dental practice we only prepare repositioning splints. In order to facilitate therapy of the causes, the neuromuscularly relaxed position of the lower jaw has to be registered.
Dental implants are becoming more and more a standard service of modern dentistry. As the basis of a prosthetically sophisticated procedure, they represent a reliable alternative to periodontally or endodontally pretreated abutment teeth. This way, supports which are no longer in place, can be restored. I took the two-year postgraduate course and obtained the “Master of Science in Oral Implantology” at the Deutsche Gesellschaft für Implantologie (DGI) in order to consolidate and further develop my more than a decade of experience as dentist active in implantology.
These include tooth bleaching, tooth-coloured filling techniques, e.g. composite fillings or CAD/CAM-produced ceramic inlays, veneers, fully ceramic partial crowns and bridges and orthodontic corrections of malpositioned teeth in adulthood, using the almost invisible IN-LINE method.
The systematic treatment of existing periodontitis is an imperative prerequisite for all further-going treatments, such as implantation and dentures. Regular professional dental cleaning sessions are vital for the success of therapy for periodontitis.
The therapy for masticatory tinnitus comprises the establishing and long-term stabilisation of a neuromuscularly relaxed lower jaw position using splint therapy, grinding therapy or prosthetic construction of the masticatory plane.
General dental medicine
These days, modern techniques and materials allow us to maintain our teeth for longer. In the past, the treatment of complicated roots and jaw infections originating from the tooth often used to lead to the loss of teeth.
It is important to differentiate between OSAS and a central apnoea with its completely different cause. In the event of a central apnoea different processes in the body lead to respiratory arrest. The following text deals with obstructive sleep apnoea (OSAS) syndrome only.
It causes a temporary respiratory arrest and insufficient ventilation of the lungs. This results in an increasing carbon dioxide content in the blood and, in turn, a waking response in the affected party (micro arousal). The decreasing hypoxaemia (oxygen saturation) triggered at the same time leads to an insufficient oxygen supply in the tissue of the body and the brain.
In most cases the arousal does not cause the affected party to awaken consciously. Merely the bodily function, such as the pulse and the release of stress hormones, increase. The sequence of sleep phases also changes, the recovery and regeneration functions of the night’s sleep being considerably reduced.
The consequences of obstructive sleep apnoea syndrome (OSAS) are wide-ranging and can make for a high health risk, for instance:
- Daytime fatigue with microsleeping
- Cardiovascular disorders, such as cardiac arrest, apoplexy, high blood pressure, cardiac failure with an impact on life expectancy
- Dizziness when getting up in the morning
- Headaches and / or oral dryness when waking up
- Urination during the night, more frequent urgency to urinate during sleep (nocturia)
- Night sweats
- Concentration problems and even memory disorders
- Depressive malaise
- Erectile dysfunction, impotence
- Restless sleep
- There is a suspected connection to disorders, such as tinnitus, hearing loss, stomach ulcers, type-2 diabetes mellitus
The first means of therapy for OSAS is a “continuous positive airway pressure” machine (CPAP device). A nasal mask or a full-face mask is connected to the bellows of the CPAP machine by a hose. This generates negative pressure in the upper airway, keeping it open and preventing an obstruction.
In many cases the affected party is unable to sleep with this type of mask. A mandibular advancement splint for the lower jaw can then be used to hold open the airway in a simple manner.
The lower jaw is shifted forwards by a matter of millimetres, thus preventing the collapse of the pharyngeal muscles. The airway remains free. This way, many patients are able to avoid having to sleep with the cumbersome mask of the CPAP machine. The affected parties sleep through peacefully and comfortably and the mandibular advancement splint saves them from the serious health consequences of sleep apnoea in the most simple manner.
Advantages and disadvantages of a mandibular advancement splint for therapy of obstructive sleep apnoea:
- Prevents snoring
- Small and compact and can be inserted almost invisibly, even when travelling
- Does not restrict sleeping on one’s side
- The splint can be inserted and removed easily
- Individual customisation prevents an overload of the jaw joint and the teeth
- The functionality of self-adjusted snoring splint sets is limited and there is a risk of overloading the teeth
Please note that primarily patients with a minor to moderate sleep apnoea can benefit from this type of splint. In case of a very pronounced sleep apnoea other therapy concepts may be necessary.
Contact us and we will be happy to provide you with individual consultation and answer all your questions on the matter.
The respective specialist associations also provide information on this subject:
Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (German Sleep Society): www.dgsm.de
Deutsche Gesellschaft zahnärztliche Schlafmedizin (German Society for Dental Sleep Medicine): www.dgzs.de
Individual prophylaxis and professional dental cleaning
Professional dental cleaning is an important maintenance therapy after periodontitis therapy has been carried out. Without it and without optimised oral hygiene by the patient, stabilisation and long-term healing of chronic periodontitis is not possible.
Regular cleaning and the cooperation of the patient are also important for a stable implant result. Lingering plaque deposits on implants can lead to inflammation of the gums and subsequent osseous implant loss, peri-implantitis, similar to periodontitis on the tooth.