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Dental Tribune United Kingdom

W hilst dentists most commonly treat con- ditions related to den- tal diseases, we are also in an ide- al position to screen for and treat a range of sleep related breathing disorders, such snoring and mild obstructive sleep apnoea. Whilst many of our patients are able to adapt to these conditions in the milder forms, for others these sleep related breathing disorders are a source of great distress and in reality may have more serious medical and social implications, both for the person who snores and/or for the sleeping partner. Snoring and obstructive sleep apnoea are chronic conditions termed “sleep related breathing disorders”. Snoring is primarily caused by restricted air flow as we breathe. In a small number of cases the restriction occurs in the nose or as a result of an enlarged uvula, but more commonly snor- ing comes from the back of the throat in the area known as the oro pharynx or hypo pharynx. During sleep the tongue drops back and the muscles below the jaw relax. This leads to a restric- tion of air flow. As the air passes through the smaller aperture its velocity increases and the soft tissues vibrate, giving rise to the snoring sound. The snorer has to work extra hard to overcome the air resistance, often depriving the individual of vital oxygen. This places a strain on the respiratory and cardio vascular systems. In the case of obstructive sleep apnoea, the airway is tem- porarily cut off with total col- lapse of the tissues. Breathing momentarily stops. The carbon dioxide levels rise and the oxygen levels fall until the body’s natural emergency recovery kicks in, the pulse quickens and with a gasp the breathing recommences. This cycle of events is often described by the sleeping partner as: “the breathing stops and there are ter- rible pauses and delays followed by a choking gasping sound. This cycle is repeated throughout the night.” To the sleeping partner it can be most distressing, noisy and alarming. Few can tolerate this and often in desperation re- tire to another room. For the suf- ferer they may temporarily wake up, regain their breath and then go back to sleep. Dr Simon Ash, consultant orthodontist at Whipps Cross University Hospital has consider- able experience working within a multidisciplinary team help- ing patients with sleep related 25ClinicalAugust 1-7, 2011United Kingdom Edition Snoring and the dentist’s role Neel Kothari discusses ways to help patients with snoring issues page 26DTà Snoring can be a problem ‘Snoring and obstructive sleep apnoea are chronic conditions termed “sleep related breathing disorders’’’