Airway Dentistry

Serving Brentwood, Belle Meade and Green Hills Areas of Nashville TN

When you think of a dentist, you probably think of cleanings, fillings, and all things related to teeth. Certain dentists offer services in airway dentistry—a growing specialty of dental science that studies the shape and structure of the mouth, and how that impacts breathing. Dr. Brian Devine, an airway-centric dentist serving Nashville, Green Hills, and Belle Meade, is proud to offer his services at TMJ and Airway Associates of Nashville.

What is airway dentistry?

airway dentistry

A practitioner of airway dentistry can identify the relationship between the mouth and throat, and their effect on breathing. The unique, specialized training of an airway dentist makes them one of the ideal professionals to identify a sleep breathing disorder such as obstructive sleep apnea. While only a sleep specialist can make an official diagnosis of sleep apnea, an airway dentist can use their expertise to screen and treat the disorder.

What can you expect when seeing an airway dentist?

While an airway dentist also has the qualifications to perform general dentistry services, this specialization focuses on the warning signs of a sleep breathing disorder. If you’re already experiencing some of the symptoms of such a disorder, or a loved one has noted symptoms such as snoring, clenching and grinding at night, or mouth breathing, then the staff of TMJ and Airway Associates of Nashville can help. 

The field of airway dentistry is growing. In October of 2017, the American Dental Association issued a policy statement regarding the role of dental science in treating sleep-breathing disorders. The policy underscored the importance that dentists play in screening for sleep breathing disorders, noting that dentists often are the first medical practitioners to identify its symptoms. The policy also advised dentists who detected signs of a sleep breathing disorder should refer those patients to a physician or sleep specialist for an official diagnosis. Moreover, it recognized dentists as the best-trained, most-qualified health care providers to treat sleep apnea through oral appliance therapy. This is excellent news because sleep apnea doesn’t always require a CPAP machine to treat it. TMJ and Airway Associates of Middle Tennessee offers a more convenient treatment option for sleep breathing disorders.

How do airway issues impact sleep?

Sleep breathing disorders may develop due to various reasons, such as:

  • Soft tissue blocking the airway
  • Relaxation of the throat muscles
  • Temporomandibular joint disorder (TMJ disorder)
  • Overweight individuals
  • Anxiety
  • Depression
  • High blood pressure
  • Improper oral rest posture

When you try to push air around this obstruction and continue breathing, this causes a vibration in the airway. That vibration also produces the sound you hear when snoring.

Obstructive sleep apnea is one of the most well-known, and most serious, varieties of sleep breathing disorders. For a person with sleep apnea, this airway blockage causes breathing to cease completely—if only for a few seconds. Other conditions, such as Upper Airway Resistance Syndrome (or UARS for short,) do not interrupt breathing but do disrupt the normal patterns of breathing.  

Snoring, UARS, and sleep apnea all classify technically on the spectrum of sleep breathing disorders. Both UARS and sleep apnea disrupts REM sleep. Standing for Rapid Eye Movement, REM is the deepest stage of sleep and is crucial to the rejuvenation of the body as well as the mind. If REM sleep is interrupted, it has an impact on both your physical and mental health.

Your airway-centric dentist in Nashville, Dr. Brian Devine, is going to ask you some questions to determine if you have an airway disorder

Do you breathe through the mouth? You may not think that how you breathe matters, but in reality, breathing through the mouth is not natural. Our ancestors breathed through the nose and reaped the health benefits of doing so. The air they breathed was warmer and more humid. Nasal breathing produces more nitric oxide, a natural killer of harmful bacteria, and also encourages higher oxygen levels as well as a better balance between oxygen and carbon dioxide in the body. When you breathe through the mouth, that air contains more microbes and other harmful particles. Meanwhile, oxygen levels are lower. Learn more about the potential negative impact of mouth breathing, and how we can treat this issue at TMJ and Airway Associates of Nashville.

Do you snore? As mentioned earlier, snoring occurs when the muscles of the throat vibrate against the wall of the pharynx as you attempt to push air around the soft tissue obstruction in your airway. You also may snore if the tongue does not have enough room in the mouth, and slides back into the airway. According to the National Sleep Foundation, there are about 90 million snorers in the United States, and it’s estimated that half of them have sleep apnea. Obviously, you’re not going to know if you snore because you’re asleep when it happens, so this information typically comes from your partner, loved one or roommate. A professional sleep study also would indicate whether you snore or experience an airway obstruction while sleeping.

Have you been diagnosed with sleep apnea, or do you show signs of the disorder, such as stopping breathing while asleep? When you have sleep apnea, each time that your breathing is interrupted, this is referred to as an apneic event. One of these events may be as brief as 10 seconds, or it could last several minutes or longer. The brain sends signals to the body to resume normal breathing, but doing so disrupts the sleep cycle, depriving a sleep apnea sufferer of restorative sleep and rejuvenation. Furthermore, these apneic events may occur as many as 100 or more times per hour in an individual with a severe case of sleep apnea. Imagine your brain waking up that many times a night.

Do you sleep poorly or wake up often during the night? Your body’s sympathetic nervous system activates when signaling the body to resume breathing. Stress hormones such as cortisol are released, and the heart rate increases to arouse you out of deep sleep into a lighter stage—or waking completely. That said, many people dealing with sleep apnea never consciously wake up from an apneic event, although their sleep partner may hear them making choking or gasping sounds while asleep.

Do you often feel fatigued or sleepy during the day? Living with untreated sleep apnea leads to chronic daytime fatigue, no matter how early you go to bed or how much sleep you get (or think you’re getting). This is because someone with sleep apnea doesn’t spend enough time in the REM sleep cycle.

Do you frequently experience difficulty breathing through your nose? Whether it be due to nasal congestion from allergies, a deviated septum, nasal polyps, or sinus trouble, if nasal breathing is difficult, a person often will convert to mouth breathing instead. Regularly breathing through the mouth increases your likelihood of snoring, which is considered the No. 1 warning sign of a sleep breathing disorder.

Do you often have a forward head posture? This head position is characterized by a hunched neck or upper back. Forward head posture is especially common among mouth breathers and is often linked to hyperactivity of the neck muscles. Neck muscle overexertion could lead to cervical changes that have a range of potential impacts—including temporomandibular joint disorder.

Do you have a tongue-tie or any other tongue problems affecting the way you eat, swallow, or speak? Everyone is born with a lingual frenum—a thick band of tissue attaching the tongue to the floor of the mouth. If this band of tissue is too short or thick, it is known as a tongue-tie, restricting the range of motion of the tongue. This can lead to a host of problems, such as hindering facial and jaw development. This hindered development increases the likelihood that soft tissue will collapse in the airway during sleep.

Do you suffer from a chronic sore throat or cough? Both of these issues are linked to sleep apnea as well as gastroesophageal reflux disease (aka GERD). Most people who suffer from GERD experience worse symptoms at night.

Do you have a deviated septum or some other type of nasal damage? You might have been born with a deviated septum or sustained one as the result of a facial injury. Either way, an injury of this type can make breathing through the nose more difficult, increasing your vulnerability to developing a sleep breathing disorder.

Next, your airway dentist can perform a clinical evaluation. What does this entail?

Multiple studies have shown that an enlarged neck elevates the risk of the soft tissue collapses that occur during an apneic event. This is considered to be a circumference of more than 16 inches in women or 17 inches in men. Therefore, neck circumference will be taken. Also, a visual assessment of the tongue and airway, and oral rest posture, are helpful. The dentist also will be looking for airway obstructions such as enlarged tonsils. Other diagnostics may include X-rays to assess the size of the airway, and jaw positioning.

Airway dentistry in Nashville

Dr. Brian Devine is excited to bring the specialized services of airway dentistry to his patients. If you’d like to be seen by an airway dentist in Belle Meade or Green Hills, or you can answer yes to any combination of the questions listed above, schedule a consultation at TMJ and Airway Associates of Nashville today by calling (615) 329-1854.

We serve patients in Middle Tennessee, including Belle Meade and Green Hills.

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