November 1st, 2010 |

Beginning early in my residency I have been interested and intrigued by the effect of compromised nasal breathing on the development of the facial form and the alignment of the teeth and bite. Much has been published in our orthodontic scientific papers about the shape of the palate, facial proportions and yes the difficulty of treating my patients when nasal breathing is compromised.
A lot of our interceptive treatments deal with dealing with the early detection of these facial changes and appliances that restore some of the effects. Appliances like expanders, headgears, herbst and face masks all have an orthopedic type correction intended when used as instructed.
Sometimes improving the airway by diagnosing and treating enlarged tonsils and adenoids is hugely effective in combination with the orthopedic appliances.
Recently more and more interest in the medical community about the effects of compromised airway and sleep disturbances (also known as sleep disordered breathing) is being studied. Conclusions are being reached that associate these sleep disturbances with ADHD, bed wetting, tiredness and a drop in cognitive levels. The levels of sleep apnea (stopping breathing for more than ten seconds on multiple times an hour and dropping of oxygenation of the blood) are being discovered in snoring children.
We continue to be sensitive to compromised airway symptoms in our younger patient population and vigilant in referring for consultation or testing of these Sleep Disordered Breathing findings. Dr. Serrano is board eligible with the Academy of Clinical Sleep Disorders Dentistry
In addition we have been treating our adult patients with Oral Appliance Therapy. Our patients usually have significant symptoms of sleep apnea and we confirm their clinical findings with either referral to a sleep center for overnight testing. Or we administer a much more convenient home test for confirming the diagnosis of Obstructive Sleep Apnea.
Our patients report the appliance therapy has literally changed their life as the symptoms of apnea are reduced.
If you are interested in being tested or treated for OSA ask for an exam.
http://www.sleepapnea.org/info/index.html
The Dangers of Snoring
Snoring is caused by the airway narrowing or even occluding during sleep.
What causes snoring?
Snoring is caused by a narrowing of the upper airway during sleep.
However, the most common cause of narrowing of the upper airway is a tongue muscle that becomes too relaxed during sleep. When relaxed, the muscle is sucked into the back of the throat with each breath taken.
Snoring occurs when air travels faster through a narrow tube than through a broad one. This rapidly moving air causes the relaxed soft tissues of the throat (tonsils, soft palate, uvula or excessive flabby tissue) to vibrate. It is this vibration that created the sound of snoring.
Is snoring harmful?
Problem snoring, in which the tongue is completely sucked against the back of the throat and blocks breathing, can pose serious health risks.
Symptoms of snoring:
Gasping, irregular or stopped breathing during sleep
Hypertension/high blood pressure
Diabetes
Morning headaches
Extreme daytime sleepiness
Memory deficit
Depression
Nighttime reflux/heartburn/GERD
Nocturia
Increased ricks factors for snoring:
Genetics
Gender (more common in men)
Large neck (>15.7” women, >16.9” men)
Obesity (BMI >30)
Diagnosis of hypertension
Excessive use of alcohol, sedatives and tobacco
Prevalence of snoring:
Sixty percent of men and 40 percent of women between the ages of 41 and 65 are habitual snorers. Snoring increases greatly once people reach the age of 35.1
Snoring is common in children aged 2 to 7, particularly at times of upper respiratory tract infection when the tonsils enlarge.2
Women in the third trimester of pregnancy commonly experiences problem snoring.3
Snoring is linked to:
Hypertension/high blood pressure
Strokes
Cardiovascular disorders
Diabetes
Obesity
Dementia
Depression
Reflux/heartburn/GERD
Nocturia
Insomnia
Nocturnal asthma/COPD
Impotence
1. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002.
2. Ali NJ, Pitson D, Stradling JR. Natural history of snoring and related behavior problems between the ages of 4 and 7 years. Arch Dis Child 1994.
3. Santiago JR, Noliedo MS, Kinzler W, Santiago TV. Sleep and sleep disorders in pregnancy. Ann Intern Med 2001.