Corrective Jaw Surgery – My Journey to a Better Life

By: Christine Norgaard

They said it would be transformational. I admit that I was skeptical. They said my bite didn’t align. I couldn’t see it – my teeth looked straight. They said it would improve my breathing and sleep and possibly reduce my chronic sinus and ear infection problems. That’s when I started to pay attention. “They” are a talented and compassionate trio of dental professionals: Dr. Elizabeth Eggert is my primary dentist and started me on this journey, Dr. Brian DeVoe is my orthodontist, and Dr. Karl Andreasen is the oral surgeon. Together, they developed a comprehensive treatment plan. Now that I’m three years past the surgery, I can attest that it did greatly improve my overall health. Here’s my story.

Background and treatment plan

While I thought my teeth were straight, what I didn’t realize was how misaligned the top teeth were to the bottom teeth. When my teeth were closed (the bite), the top teeth completely covered the bottom front teeth. I had had teeth breaking which resulted in quite a few crowns over the years. When I saw photos of the inside of my mouth, I couldn’t believe the excessive wear that had occurred on those crowns because of my misaligned bite. From the photos, I could also see the extent of the wear on my other teeth.

With the teeth breaking down, Dr. Elizabeth told me that more teeth would likely break and result in more crowns if I didn’t make an adjustment to my bite. Because Dr. Elizabeth is also my daughter, she’s also aware of many other health issues I’ve had all my life, most of which were getting worse over the last 15 years. I’ve had allergies all my life which triggers asthma. The asthma was getting worse though, and I had a chronic cough from all the irritation. I was taking a lot of medications for allergies and asthma, but not getting much relief. Each breath felt like sandpaper inside my head and lungs. I had three or four horrible sinus or ear infections each year. My primary care physician even said he never sees adults with the severity of infections I had. He treated the infections but they kept coming back. They were typically limited to the right side of my head. There were times the congestion was so severe in my head that a shower sounded like rain falling on a tin roof. I always had pressure on my right side. I sought help from ENT specialists who simply said “you have a Eustachian tube dysfunction.” There were no solutions. I even had to quit the church choir after singing with that group for 20 years because I just didn’t have the breath support.

Other medical conditions I had, which I now know are NOT normal, include the fact that I have never been a good sleeper – everything would wake me up. I have mild hypertension and started taking a low dose drug for that. I had worsening acid reflux and while I was on a medication for stomach acid suppression, it became less effective and I’d additionally need five or more Tums a day to feel comfortable.

One day in 2014, one of my crowns popped off. Dr. Elizabeth told me I didn’t have many other options, I had to look into how I could correct my bite if I wanted my teeth to stop breaking down. So, I started with Dr. DeVoe who, shortly after, included Dr. Andreasen in the discussion. In reviewing the models of my bite and both 2D and 3D x-rays, they showed me how things were actually constructed in my mouth and my head. The 3-D x-ray showed the compression of my airway and the right side Eustachian tube. The airway was the size of a straw and Dr. Andreasen said that it should be more like the size of a nickel. He wanted me to have a sleep study to determine whether or not I had sleep apnea. I did – it turns out that I had severe sleep apnea and was apparently waking up over 30 times each hour. The sleep study doctor I saw said he was surprised I hadn’t experienced even worse health issues. He also told me that with the surgery Dr. Andreasen would recommend, there was a great success rate in ‘fixing’ the sleep apnea problems.

The x-rays also showed that my top jaw and teeth were canted or sloped down from the right side of my face to the left. That surprised me because it wasn’t visually apparent to me. Putting it all together and with the possibility of fewer ear and sinus infections, I decided I would opt for the corrective jaw surgery. They told me that the whole process would likely take 18-24 months including the orthodontics pre and post-surgery.

Orthodontic treatment

A week before my 60th birthday, I got my braces. Dr. DeVoe and his staff couldn’t have been better or more supportive. They told me what to expect. They were patient when a bracket would fall off (usually because I’d eaten something I shouldn’t have). I felt a little awkward starting braces in my 60’s but there were some visits where I was one of the younger patients in his office. Dr. DeVoe has a great eye for details. He gave me excellent explanations of what was happening in my mouth and answered all my questions. At one point, when the surgery was about a month away, it felt like nothing was aligned in my mouth. He said that was normal and that after the surgery, it would all be better and feel more natural. He was right. I had braces for nine months before the surgery and another eight months after the surgery for final ‘tweaking’ and to allow my jaws to heal.

I did alter my diet after I got the braces (and again after the surgery). I pretty much stopped snacking. It was generally a decision about whether or not eating something was worth all the extra effort to clean around my braces. It was amazing because my stomach issues got dramatically better. I no longer needed Tums. My primary care physician cut the prescription for my acid reflux drug in half. I felt better. I lost a total of 45 pounds from the day I got braces, through the surgery, to the date I had the braces removed. An unexpected, but wonderful side benefit.

The surgery

Formally, it is called a LeFort I osteotomy and bilateral sagittal split ramus osteotomy of the mandible. It is more simply called corrective jaw surgery. There are many medical reasons to consider this surgery. For me, both the upper jaw and lower jaw were moved forward. My upper jaw was also leveled to correct the cant from left to right. I had one small stitch on each side on the outside of my face which quickly healed and left no mark. There are a series of plates and screws now in my jaw bones. All of the surgical work was done on the inside of my mouth so there are no visible signs or scars.

The surgery was done at St. John’s Hospital in Maplewood under general anesthesia. I was hardly in the hospital 24 hours. I saw Dr. Andreasen several times over the first couple weeks. I felt exhausted for the first three days. There was discomfort – but I was able to tolerate it by taking four Advil every four hours. Within two weeks, I was taking only one Advil every 4-6 hours. I did some ice packs, but had very little swelling and not much bruising or discoloration. I remember how good a warm wash cloth felt on my face. On the fifth day, I inhaled through my nose, and couldn’t believe it! I had such a deep breath that I actually got dizzy. I had no idea that was what breathing could be like! It was easy – there was no feeling of sandpaper down my bronchial tubes!

The information brochure that Dr. Andreasen gave me was great and very helpful. It also laid out possible complications. It explains that the nerves are exposed during surgery and tingling or numbness may occur. As I healed, I experienced some of that, especially in the area under my nose and around my upper front teeth. It took a while for the feeling to come back. After three years, the area feels ‘different’ but not in an irritating way. For the first year after surgery, I found that I couldn’t tolerate the vibrations from my SonicCare toothbrush. It was too intense. Now though, no problem.

For the first few weeks, I ate a liquid or very soft food diet. No chewing. My jaw wasn’t wired shut though, it was stabilized by orthodontic rubber bands. Dr. Elizabeth gave me a recipe book of smoothies and smooth soups. This helped with nutrition and getting adequate protein. It was so exciting after a couple months to start adding back other soft foods like a muffin, scrambled eggs, or salmon that I could easily swallow without chewing. Four months after surgery, I could drink out of a straw again. It sounds like such a little thing, but it also meant that my muscles were coming back to normal.

I took just under two weeks off of work. Cost? I am lucky to have great dental and medical insurance. The surgery and hospitalization were covered under my medical plan. Other than standard co-pays and deductibles, I paid little out of pocket.

Three years post-surgery

 

Was it worth it? Absolutely! It’s hard to say what the biggest benefit was. The original intent was to fix my bite. That was easily met. The doctors are all pleased with the results. I have a lovely smile! You can see my bottom teeth now. Flossing is also easy with perfectly spaced teeth. I wear my retainer every night. I keep telling people that I had no idea breathing could be so easy. I have even been able to go back to my church choir. I can also tolerate the incense at church for the first time in my life. I can enjoy my fireplace and have campfires with the grandkids. My lungs no longer feel irritated. I haven’t had a sinus or ear infection in three years! While I still have some medications (my allergies didn’t go away), all of the dosages have been significantly decreased. All my allergy triggers are still there, but because my airway is larger, I have a greater tolerance before major irritation begins. My blood pressure is lower and controlled. I sleep through the night. This is something I had never known was normal, or even possible, before surgery. Everything they said has been true. I feel great. I thank Dr. Elizabeth, Dr. DeVoe, and Dr. Andreasen for their care and expertise. It has been transformational and I’m grateful for what this has done for me, my health, AND MY LIFE!

The Link Between Airway and Dental Issues

By: Dr. Elizabeth Eggert

At Eggert Family Dentistry, we recognize the importance of a thorough dental evaluation. When you or your child come in for an exam, we don’t just attend to your teeth and gums. We make it our business to examine your muscles, jaw, and airway as well. We want to ensure that your tongue is functioning properly, that you have a broad upper arch, are able to breathe easily through your nose, and are swallowing correctly.

Why are we so thorough?

Many people don’t realize that they’re struggling with airway issues because the bulk of the symptoms manifest themselves while we’re asleep. Also, the body is so good at adapting, sometimes what someone knows as “their normal” is necessarily the most “healthy normal.” Luckily, Dr. Elizabeth and Dr. Jeff understand the connection between a variety of dental problems and how they may be linked to airway issues. For example, all of these dental problems that we check for during a regular dental examination can be linked to airway issues:

  • Bruxism
  • Functional tooth wear and fracture
  • TMD/myofascial pain
  • Malocclusion
  • Erosion
  • Periodontal disease
  • Caries
  • Abfractions (severe gum tissue recession)
  • Impacted teeth
  • Orthodontic or orthognathic relapse

The intersection of dental issues and airway: A couple examples

Nocturnal bruxism, or teeth grinding, is not uncommon in children and some doctors will tell parents it “normal.” We now understand that often tooth grinding, especially in children at night, often occurs because of a restricted airway. In fact, the connection between bruxism and sleep-disordered breathing (SDB) is so strong that bruxism is now acknowledged as a clinical marker for SDB and children with this disorder should consider a sleep screening.

Upper Airway Resistance Syndrome (UARS) is another type of sleep disordered breathing. Unlike sleep apnea, patients with UARS typically don’t completely stop breathing, however, the resistance of air through the airway causes multiple micro-arousals throughout the night. This often creates fatigue because the body is never able to reach the deeper and reparative stages of sleep. UARS also causes more stress hormones to be released into the body as a mechanism to help the body maintain and airway. These extra stress hormones often lead to an increase of inflammatory markers and can be linked to inflammatory diseases like hypertension, diabetes, TMD, cancer, among others.

Fortunately, a thorough dental examination can help detect a wide variety of dental problems that may be caused by or contributing to airway issues and/or sleep disordered breathing. Our dental exams go above and beyond simply looking for cavities and help you achieve and maintain optimal wellness.

Want to learn more?

If you’re interested in the connection between dental problems and airway issues, we highly recommend these books:

Sleep Interrupted by Steven Park, MD
No More Allergies, Asthma or Sinus Infections by Dr. Lori Jones
Close Your Mouth by Patrick McKeown
The Oxygen Advantage by Patrick McKeown

If you are concerned that dental issues are causing airway issues for you or your child, contact Eggert Family Dentistry or give us a call at 651.482.8412!

The Effects of Airway Issues in Children

By: Dr. Elizabeth Eggert

From a professional teeth cleaning to preventative screening for cavities and other looming dental issues, recare visits at Eggert Family Dentistry are an important part of your child’s healthcare routine. We also recognize that airway issues can mean severe health problems for your child. On this account, one of the important components of your child’s recare visit is our thorough screening for any abnormalities of the head or skull or anything unusual with the positioning of the jaw, palate, tongue, throat, tonsils or adenoids that could lead to mouth-breathing and contribute in any way to an airway issue.

It all begins with how we breathe

Air that enters the lungs through the mouth as opposed to the nose isn’t warmed or humidified in the nasal cavity. This makes a person more prone to infection. Additionally, blood gas studies cite a 20% drop in oxygen levels and a 20% rise in CO2 levels, increasing exhaustion, due to mouth breathing. Long-term oxygen deprivation can result in hypertension, malfunctioning lungs and enlargement of the right ventricle of the heart.

Whereas nasal-breathing is recognized as imperative to good health, mouth-breathing has many negative effects on the body. When air hits the back of the throat, it causes the airway to dry out and lose its elasticity. This makes the airway more susceptible to collapsing. In the instance of a partial airway obstruction, children may exhibit snoring tendencies. When the airway is fully obstructed, children suffer from the dangerous effects of sleep apnea.

Signs and symptoms of airway obstruction in children

  • Snoring
  • Heavy/loud breathing
  • Struggling to breathe at night
  • Daytime mouth-breathing
  • Dry mouth in the morning
  • Bedwetting
  • Daytime sleepiness
  • Underweight
  • Attention deficit problems (fidgety, easily distracted, interrupts frequently)

ADHD

Oftentimes, airway issues in children leads to behavioral problems. This occurs as a result of restricted oxygen to the brain, leading to fitful sleep, increased daytime irritability, distraction and hyperactivity. Unfortunately, many children who experience these behavior problems are medicated for ADHD with Adderall or Ritalin and the serious nature of airway issues go undetected. In a 2014 article in ADDitude, an online journal subtitled Inside the ADHD mind, NuSomnea claims that 50 percent of children diagnosed with ADHD show behavior improvement after being treated for obstructive sleep apnea and they suggest that up to 7 million children have been misdiagnosed with ADHD when in actuality they’re struggling with sleep issues, sometimes as severe as obstructive sleep apnea.

Another serious consequence of airway obstruction in children is growth deficiency. Children struggling with airway obstruction will experience restricted levels of oxygen to the brain, reducing the amount of growth hormone their body secretes. These children will be underweight and shorter in stature than their peers and may experience a plateau in their growth trajectory.

If your child is due for a recare visit or if you are concerned that your child may be predisposed to airway issues, contact us or schedule an appointment with Dr. Elizabeth or Dr. Jeff at 651.482.8412 today!

Sleep Apnea in Children – An Overview

By: Dr. Elizabeth Eggert

There is a growing awareness about the dangers of obstructive sleep apnea. However, what most people don’t know is that sleep apnea affects adults and children alike. Early intervention for children who struggle with sleep apnea can greatly improve their quality of life and protect them from serious complications and risk of death. Fortunately, knowledge is power. When equipped with knowledge about what pediatric sleep apnea is, signs to watch for that indicate a problem, and awareness of risk factors that can contribute to sleep apnea, you possess the tools you need to intervene if a child you love is at risk.

What is sleep apnea?

Just like the name sounds, obstructive sleep apnea is an airway blockage. During sleep, the most common cause for apnea is when muscles in the back of the throat relax, the tongue and surrounding tissues migrate back into the throat, and therefore obstruct the airway.

Symptoms of pediatric sleep apnea

The symptoms of pediatric sleep apnea are very different than sleep apnea symptoms in adults. Whereas adults suffer primarily from incessant snoring and chronic daytime fatigue, children’s symptoms vary greatly. Children may or may not snore and may actually appear hyperactive during the day. Oftentimes, kids who struggle with undiagnosed sleep apnea are misdiagnosed with ADHD. Other pediatric symptoms include but are not limited to:

  • Restless sleep
  • Snorting, coughing or choking in their sleep
  • Mouth-breathing
  • Bedwetting
  • Sleep terrors
  • Learning problems
  • Behavior problems
  • Persistent fatigue
  • Poor weight gain and growth

Risk factors that can contribute to pediatric sleep apnea

There are numerous conditions that predispose a child to sleep apnea. Some of these risk factors include:

  • Obesity
  • Down syndrome
  • Cerebral palsy
  • Family history of sleep apnea
  • Airway blockages from tonsils and adenoids
  • Low birth weight
  • Neuromuscular disease
  • Sickle cell disease
  • Craniofacial abnormalities

When to see a doctor

If your child is a mouth-breather and consistently wakes up feeling tired or exhibits ADHD symptoms during waking hours, it’s a good idea to bring him or her into the doctor for evaluation. You may want to consider an appointment with an ENT who looks at sleep OR a sleep doctor directly.

If you’re concerned that craniofacial abnormalities are causing sleep apnea for your child, call Eggert Family Dentistry. Dr. Elizabeth or Dr. Jeff can evaluate your child’s teeth, jaw, tongue, and airway and make recommendations. Depending on your child’s age, Dr. Elizabeth or Dr. Jeff can fit your child with an in-mouth appliance – similar to an orthodontic retainer – which helps to maintain an open airway all night long.

Complications of untreated sleep apnea in kids and adults

When left untreated, sleep apnea in children can result in failure to grow and thrive, poor brain development, heart problems, and even death. If left untreated into adulthood, sleep apnea can decrease a person’s lifespan by up to 10 years, cause an increase in blood pressure, an increase in the risk of heart attack, stroke, type 2 diabetes, cancer, and dementia.

Needless to say, sleep apnea is nothing to mess around with. Eggert Family Dentistry is proud to be sleep apnea savvy, serving our patients with the knowledge, skills and resources to effectively screen for and often treat sleep apnea in both children and adults. If you’re concerned that someone you love is suffering from sleep apnea, give us a call at 651.482.8412 or contact us to set up an evaluation.

The Seattle Protocol: How Six Simple Steps Could Help You Sleep Better (and Even Save Your Life)

By: Elizabeth Eggert

The Seattle Protocol: It’s not an action flick coming soon to a theater near you. But it is something that could save you from a restless night’s sleep. At Eggert Family Dentistry, that’s something to get excited about!

The Seattle Protocol was pioneered by two intrepid dentists in the Seattle, Washington, area. The six-step process helps patients who struggle with obstructive sleep apnea or other sleep disordered breathing conditions like upper airway resistance syndrome. Sleep apnea is a condition where the epiglottis—the soft area at the back of the throat—or the tongue relax during sleep, obstructing the airway. Upper airway resistance syndrome is a condition in which your body is working so hard to keep your airway open, it creates an incredible amount of stress and releases high amounts of cortisol, creating excessive amounts of inflammation.

For some, thinking of sleep apnea conjures up visions of a restless night’s sleep and CPAP machines. While these are certainly the experiences of some patients with this condition, the Seattle Protocol can help many patients with sleep disordered breathing determine if an airway compromise is contributing to their ailments.

Seattle Protocol Step 1: Nose Breathing and Mouth Taping
The first step in the Seattle Protocol is to gently train your body to breathe through your nose, not your mouth. Breathing through your mouth during sleep can lead to snoring and dry mouth. The Seattle Protocol encourages nose breathing by adding a strip of paper tape vertically across the center of your lips. The light adhesive of the tape keeps your lips together but is easy and painless to remove.

Step 2: Temporary Splint for Lower Jaw and Mouth Taping
Once you’ve adjusted to the mouth taping, the second step of the protocol adds a temporary splint for your lower jaw while you sleep. Adding this splint increases the vertical dimension of your jaw and allows more airway space.

Step 3: Temporary Splint for Lower Jaw with Lower Jaw Pulled Forward and Mouth Taping
If adding the lower splint only isn’t giving you the restful sleep you deserve, we move onto the next stage of the protocol. In this step, we add an element that pulls your lower jaw forward. This realigns your jaw and increases your airway space not only vertically, but horizontally as well. This also can give your tongue more of the space it requires.

Step 4: Temporary Splint for Lower and Upper Jaw with Mouth Taping
With all steps of the Seattle Protocol, if you aren’t getting relief from the previous step, we move on. In this step, we remove the forward jaw posturing component and add a splint for your upper jaw. You then go to sleep with splints on your upper and lower teeth and your jaw is free to move. This stage allows for additional vertical height, opening up your airway, but without restricting the jaw muscles into any one strict position.

Step 5: Temporary Splint for Lower and Upper Jaw with Lower Jaw Pulled Forward and Mouth Taping
If you need to continue in the protocol, step five again adds a horizontal component by linking the upper and lower splints together and moving the lower jaw forward. The intent, as always, is to continue to open your airway more and more.

Step 6: Temporary Splint for Lower and Upper Jaw with Lower Jaw Progressively Pulled Forward and Mouth Taping
If you still aren’t getting that good night’s sleep, we move to the final stage of the Seattle Protocol. In this stage, we keep moving your lower jaw forward, incrementally, until you feel well-rested.

While there are six steps in the Seattle Protocol, you may not necessarily go through the entire process. The purpose of the protocol is to help us understand which step provides the best relief. Typically, the further you progress in the process, the more help your airway needs. If we find that you only get positive results in steps 4, 5, or 6, then looking at oral surgery options to expand your airway might be the best long-term solution. Luckily, here in North Oaks, we are able to set you up with some of the best local orthodontists and oral surgeons to manage your situation.

The Seattle Protocol is a gradual, gentle, and reversible process that helps us identify solutions for our patients with airway issues. It not only can help you get a better night’s sleep, but it can lead to an excellent path to better overall health and wellness. If you snore, spend your nights tossing and turning, have anxiety or depression, have acid reflux, or just simply feel tired all the time, call us to schedule a consultation, 651-482-8412. We may recommend starting with the Seattle Protocol to help improve your life!

Obstructive Sleep Apnea and How a Mandibular Advancement Device Could Help

Ever wonder why you’re still drowsy after a full night’s sleep, have a headache in the morning, or wake up in the middle of the night gasping for air? Alone, each one of these symptoms could mean you are sleep deprived, imbibed a bit too much the night before, or had a nightmare. But together, they (along with several other symptoms) may be a sign of a serious sleep disorder called obstructive sleep apnea.

What Is Obstructive Sleep Apnea?
Obstructive sleep apnea occurs when the tongue or throat muscles relax, partially or completely blocking the upper airway. This makes the chest and diaphragm muscles work harder to open the airway, which in turn taxes the heart. It also reduces the flow of oxygen throughout the body. Here’s a great overview of what obstructive sleep apnea is and why it’s a problem for your sleep quality, daytime alertness, and heart.

Unfortunately, many people with sleep apnea don’t realize they have the condition, at least not at first. Patients with sleep apnea may have fitful sleep. But the tossing and turning may not wake them up. All they know is that they have trouble waking up in the morning, have a headache, and are struggle to stay awake during the day. If that describes you, we encourage you to see your physician to get tested OR we can do many of the initial screenings right at our dental office!

An Oral Sleep Appliance Called a Mandibular Advancement Device Could Help
If you are diagnosed with obstructive sleep apnea, your doctor may recommend an oral sleep appliance. The official name of the appliance is a mandibular advancement device. We fit mandibular advancement devices at Eggert Family Dentistry and have been able to help many people with this life-threatening condition.

A mandibular advancement device positions the lower jaw slightly forward. Doing so also moves the tongue forward, reducing the chance of an obstructed airway. Take a look at how this type of oral appliance works:

If your doctor recommends a mandibular advancement device, give us a call to schedule your consultation. We’ll take impressions of your mouth so we can custom-design your appliance just for you. Once it’s ready, we’ll ask you to come into our office for a fitting so we can calibrate it so it’s comfortable and effective.

If you’re wondering if you may have sleep apnea, it’s time to make two calls: one to your physician and another to Eggert Family Dentistry. Contact us today to schedule your mandibular advancement device consultation.

Having Trouble Sleeping? Maybe it’s Time to See Your Dentist

By: Dr. Elizabeth Eggert

How often do you wake up in the morning feeling refreshed? If you frequently wake up unrefreshed and navigate your day in a haze, feeling like quality sleep is eluding you, you are not alone. In fact, according to a poll conducted by YouGov, only 1 in 7 Americans wake up feeling refreshed every day of the week. If you’re fed up with trying (yet failing!) to get consistent quality sleep maybe it’s time to call your dentist. That’s right – your dentist! At Eggert Family Dentistry, we recognize the frequent connection between sleeplessness and dentistry and we want to take some time to tell you about it!

When our patients complain about “bad sleep” we pay particular attention to their teeth and jaw. What state is their enamel in? If the enamel is worn down it’s either a sign that our patient is grinding their teeth in their sleep – a condition known as bruxism – or indicative of acid erosion, possibly from an airway issue. We also observe our patient’s jaw – does it seem properly aligned or is it misaligned which could lead to snoring or sleep apnea? Both of these conditions result in poor sleep both for our patient and perhaps their bedmate. If we suspect that snoring, sleep apnea, or other sleep disordered breathing is the culprit for you, we will ask you questions regarding your recent well-being: Do you ever wake up with a dry mouth? Do you suffer from insomnia? How often do you feel fatigued all day long? As well as many more that provide insight into what might be occurring for you.

An accurate diagnosis is imperative to successful treatment. Either Dr. Elizabeth or Dr. Jeff will proceed with a full clinical evaluation of your mouth. We examine your teeth, jaw, tongue, tonsils and airway and order x-rays for up-to-date images of your entire mouth structure. We may also recommend you take home our home sleep screening test which collects data in much the same manner as a professional sleep lab. Depending on the results, we may recommend you take your report to your MD for further testing. Whereas previously the only solution for sleep apnea was a CPAP machine – a loud, humming machine with an attached sleep mask that supplies a steady stream of humidified air through the patient’s airway all night long – many dentist offices now offer another, less-cumbersome solution. Similar to a sports or orthodontic retainer, at Eggert Family Dentistry, we facilitate the creation of a custom-fit oral appliance that properly sets the jaw for sleep and helps maintain an open airway all night long. Not only does this prevent sleep apnea but it is also an excellent solution for chronic snoring.

The effects of getting better sleep cannot be underestimated! From increased productivity during your waking hours to garnering more enjoyment from your daily life and experiencing more fulfillment in your relationships, quality sleep is foundational. 

If you are having trouble sleeping and would like to speak with a dental professional at Eggert Family Dentistry, we would love to connect with you! Give us a call at 651.482.8412 or connect with us online.

TMJ and Its Link to Headaches and Sleep Apnea

By: Dr. Elizabeth Eggert

Most everyone suffers from throbbing headaches at some point in their lives. But when headaches are chronic, it’s a cause for concern. Also, most everyone has now heard of sleep apnea, a serious condition in which the body pauses breathing or takes shallow, short breaths while sleeping, but is there a link between the two?

These conditions may seem unrelated, but new research has found a connection between chronic headaches and sleep apnea and TMJ disorder. The TMJ, or temporomandibular joint, connects your upper and lower jaws. When it is properly aligned, it works silently and seamlessly. When it’s not, it causes pain, soreness, and an off-center bite. People with severe TMJ disorder have trouble sleeping and can even experience lockjaw. Now, studies show TMJ disorder can cause more serious health concerns, too.

The Link between TMJ Disorder and Headaches
When the TMJ is not working properly, the muscles that stabilize the joint work overtime to support it. These muscles get fatigued, which leads to pain. If untreated, this pain can radiate from the jaw to the temples, back of the head, and down the neck, causing headaches. Sometimes this pain is subtle—maybe you feel a little foggy or have trouble concentrating. Other times, TMJ disorder can cause throbbing headaches or even migraines that are impossible to ignore.

The Link between TMJ Disorder and Sleep Apnea
Since the temporomandibular joint is so close to the sinuses and airways, TMJ disorder can affect breathing. A misaligned TMJ can cause improper tongue position that blocks the airway during sleep. A recent study of people with TMJ disorder found 75 percent of participants experienced sleep-disordered breathing (SDB).

Diagnosing TMJ Disorder
Most TMJ disorder patients we diagnose complain about soreness along their jawline, feeling a clicking or popping sensation when they open and close their jaws, headaches, and trouble sleeping. To help get you the right treatment, we look for the following symptoms:

  • Clicking and popping in the temporomandibular joint
  • Malalignment of the teeth and bite
  • Pain in your forehead, temples, neck, and back of the head
  • Head posture, especially where the head is in front of the shoulders rather than centered over the shoulders
  • Evidence of grinding teeth or clenching the jaw during the day or while sleeping
  • Snoring during sleep
  • Restless sleep

How to Treat TMJ Disorder and Prevent Headaches and Sleep Apnea
Once we’ve diagnosed you with TMJ disorder, we’ll discuss your options for treating it. Many patients benefit from an oral appliance, also known as a splint. There are different ways we design splints, but typically these devices are custom-made for you. When worn, they keep your bite in a better position and more comfortable alignment. They also protect your teeth from grinding and clenching. Essentially, they give your jaw muscles a break.

Some patients can eliminate headaches and sleep apnea symptoms by wearing an oral appliance. With a properly aligned jaw, the tongue can rest in a more natural position, clearing the airway. But if an appliance alleviates TMJ pain without solving your sleep apnea, we often have to delve in deeper, sometimes working through different trial splints before we know which is the best for you. We also most likely would work with your sleep and general doctor to make sure we are getting your apnea or other sleep disordered breathing under control.

If you’re experiencing jaw pain, headaches, or troubling sleeping, schedule a consultation with Eggert Family Dentistry. We’ll determine if you’re suffering from TMJ disorder or possibly sleep issues and recommend treatment to alleviate it.

Snore no More – An Easy Fix for a Great Night’s Sleep

By: Dr. Elizabeth Eggert

Snore no More – An Easy Fix for a Great Night’s Sleep

Snoring man. Couple in bed, man snoring and woman can not sleep, covering ears with pillow for snore noise. Young interracial couple, Asian woman, Caucasian man sleeping in bed at home.

We live in a society that is in critical need of sleep.

Sleep behaviors affect every aspect of your daily life. There’s nothing like a full night of rest to help you be ready to take on the world. Unfortunately, there are probably a lot of us out there that haven’t felt that way for a while.

If you’ve lost that spring in your step (and quite possibly your family is also feeling the fallout) take a look at your sleep habits. Are any sleep problems inhibiting your ability to get in seven to eight hours of restful slumber? Is your sleep problem – snoring?

It’s very easy not to take snoring seriously. It doesn’t really affect you unless, a) it wakes you up, b) your spouse moves into another bedroom to sleep, or c) no one wants to share a hotel room during the snowmobiling trip (yes, snoring can register at 80 decibels).

Snoring, however, is a disorder.

Snoring is a sound that occurs during sleep when soft (palatal) tissue in the upper airway vibrates as you breathe. Simple snoring, without obstructive sleep apnea, affects approximately 20% of the adult population, and is more frequent in males than females. [*See our blog Dental Help for Your Sleep Apnea to learn more about sleep apnea.]

Easy solutions to curb snoring include:

  • losing weight (if overweight)
  • exercising regularly
  • avoiding alcohol and smoking
  • avoiding sleep aids
  • sleeping on your side

But what do you do when the snoring continues?

First, work with a sleep center to determine that you don’t have sleep apnea. It’s far too dangerous to mess around with obstructive sleep apnea.

If it is just simple snoring, the best treatment involves the use of a jaw advancing prosthesis. This “dental appliance therapy” involves the use of a small device similar to a mouthguard or an orthodontic retainer. When worn during sleep, it prevents the airway from collapsing by bringing the jaw forward, elevating the soft palate, or retaining the tongue.

Dental appliances are an inexpensive and non-invasive way to bring peace and quiet to your household. Our patients have responded extremely well when using them.

Are you ready to learn more about treatment options for snoring? Give us a call today, 651-482-8412. We’ll set you up with an appointment to go through the records process with Dr. Elizabeth to gather the required information in determining if oral appliance therapy is the right solution for you. If you’re given the green light, models of your teeth will be sent to a lab, where an oral appliance will be made specifically to your tooth contours. During the appliance fitting, there’ll be adjustments made until you have satisfaction of the appliance’s fit and feel.

And then watch out.

All that extra sleep just may offer the health changes needed to put that spring back into your step! Not to mention how much better your family will be able to sleep too.

Dental Help for Your Sleep Apnea

By: Dr. Elizabeth Eggert

Dental Help for Your Sleep Apnea

Sleep apnea is a common sleep disorder where a person’s breathing will pause anywhere from seconds to a minute. This can happen even hundreds of times per night. “Apnea” means the absence of breath. Severity levels of apnea are defined, among other variables, by the number of episodes of apnea pauses per hour of sleep. Apnea may, or may not, involve snoring.

Sleep apnea affects adults, as well as children. More occurrences happen in men and people who are 40 to 60 years old, but many women and children are also suffering from sleep disorders like apnea. Other risk factors include race/ethnicity, family history, obesity, and smoking or alcohol use.

Symptoms may include:

  • Pauses or periods of breathing cessation
  • Choking or gasping after pauses
  • Excessive daytime sleepiness
  • Morning headaches
  • Irritability
  • Depression
  • Attention problems
  • Personality changes/mood swings
  • Sore throat/dry mouth upon waking

Treatment of sleep apnea depends on the severity of the condition. Treatment methods can include:

  • Breathing Devices (CPAP)
  • Dental Sleep Apnea and Snoring Appliances
  • Orthodontic Treatment
  • Surgery

Yes, there are dental devices that help sleep apnea.

Dental appliances may be an option for patients who cannot tolerate CPAP. These oral appliances are useful in correcting mild to moderate cases of obstructive sleep apnea and are effective in improving airflow. Custom dental appliances are designed to enlarge the airway and prevent the airway from collapsing. The devices typically cover the upper and lower teeth and reposition the lower jaw in an advanced position. Moving the mandible forward pulls the tongue forward and opens up the airway space.

Dental appliance use for sleep apnea can result in improved sleep patterns and the reduction of snoring frequency and loudness. Research shows high success rates with the use of dental devices relative to sleep apnea.

Prior to selecting any form of treatment, patients should undergo an initial evaluation by a board certified sleep specialist practicing in a center accredited by the American Academy of Sleep Medicine.  An overnight sleep study may be recommended, which will determine not only the severity of the problem but will also provide a baseline to measure any future treatment effectiveness. [Treatment measures for sleep apnea should be carefully determined as this sleeping disorder can lead to serious and sometimes debilitating consequences, including heart attack, high blood pressure, stroke, congestive heart failure or diabetes. There’s also a greater risk of driving incidents or work-related accidents.]

Are you ready to get sleep apnea under control? Once you have met with your sleep MD and have undergone a sleep study, we can set you up with an appointment to go through our records process with Dr. Elizabeth. During the records process, we will verify the health of your jaw and muscles and determine if a sleep apnea appliance might work for you. If appropriate, Dr. Elizabeth will work closely with your general health practitioner, sleep physician, and lab to design a sleep apnea appliance that is just right for you. Give us a call today.