Orofacial Myofunctional Disorder and Its Effect on Breathing

By: Dr. Elizabeth Eggert

Oxygen is essential for life. Without it, we wouldn’t survive, and without an adequate amount of it, our bodies don’t function properly. We breathe in oxygen through our nose and mouth. From there, oxygen enters our bloodstream and moves into every cell of our bodies, affecting every organ and system. However, certain factors can inhibit our body’s ability to access ample oxygen, which can, in turn, affect our overall health in some major ways.

One primary culprit of inadequate oxygen is Orofacial Myofunctional Disorder or OMD. Alarmingly, 38% of the population is affected by OMD. Let’s take a few minutes to learn what OMD is, causes and symptoms of OMD, and the importance of nasal breathing for optimal health.

The Basics of Proper Breathing

Breathing is part of the parasympathetic nervous system, and for most people, it occurs naturally, without much thought.

As a result, you may not realize there is a right way and a wrong way to breathe, and improper breathing lends itself to some serious problems.

When the face, mouth, and jaw structure as well as the soft tissue structures and tongue placement are aligned and functioning as intended, proper breathing is effortless, and our bodies get the oxygen they need. However, when one or more components of the orofacial structure are misaligned or not working properly, breathing is compromised and can negatively affect a person’s health.

Habits and Issues That Can Cause Orofacial Myofunctional Disorder

Taking charge of your health and your children’s health can, in many ways, minimize the risk of OMD.

Thumb-sucking is a developmentally normal and healthy reflex that helps babies self-soothe and fall asleep. However, if this reflex becomes a habit and continues past the age of one, or definitely into the toddler years, it can exert too much force against a child’s developing front teeth and cause a high and narrow palate. Over time, it can train a child’s tongue to anchor down and forward instead of resting on the roof of the mouth. Ultimately, it can lead to OMD and affect speech and breathing.

Extended use of pacifiers, bottles, and sippy cups can have the same negative effects on a child’s mouth and facial development, resulting in impaired speech and restricted airflow.

According to the Mayo Clinic, up to 10% of babies are born with ankyloglossia, also known as a tongue tie. If not corrected, ankyloglossia, which affects the position and movement of the tongue, can make it difficult to close the lips properly, speak without a lisp, and breathe properly. In other words, a tongue tie can affect oral posture and lead to OMD. If you think your child has a tongue tie, Dr. Elizabeth Eggert and Dr. Jeff Eggert would be happy to assess your child in our office and advise if surgery would be the best course of action to avoid a cascade of future health issues.

Nail-biting, bruxism, and tongue, lip, and cheek-sucking are other habits proven to cause muscle and structural disorders of the face, mouth, and jaw. If you struggle with these bad habits, behavior modification, a custom night splint, or other interventions may help preserve proper alignment and function, minimizing the risk for OMD related issues.

Neurological deficits and developmental delays—causes out of a person’s control—can also lead to OMD.

Read Lizzie’s story here and see how Dr. Elizabeth Eggert detected early signs of OMD and, together with Lizzie’s parents, pursued early treatment to help set her up for a lifetime of health!

Symptoms of Orofacial Myofunctional Disorder

Some of the most common symptoms of OMD include:

  • Tongue thrust
  • TMD
  • Headaches
  • Sleep-disordered breathing/sleep apnea
  • Fatigue, anxiety, or depression
  • Lisp
  • Drooling
  • Difficulty swallowing
  • Mouth breathing

In addition, people with OMD often present with a sluggish face and weak, parted lips, a tight chin, and a facial grimace.

Improper Orofacial Structure Can Lead to Mouth Breathing

Let’s take a closer look at mouth breathing.

When the face, mouth, or jaw is misaligned or working improperly, nose breathing can be difficult. Because of our inherent need for oxygen, our bodies will do whatever is necessary to get proper airflow. That’s why both children and adults with OMD often resort to mouth breathing, especially when they’re asleep.

Mouth breathing is inferior to nasal breathing because air that passes through the mouth isn’t filtered like air through the nose. The nasal cavity also humidifies air before it enters the lungs. Additionally, our bodies take in more oxygen when we breathe in through our noses, and our nervous systems shift into a more parasympathetic state, reducing oxidative stress.

Health Implications Beyond the Mouth

Why is mouth breathing a big deal?

Over time, mouth breathing can permanently alter the position of the jaw, tongue, and lips, move the tongue low and forward to facilitate airflow, and lead to malocclusion—an uneven bite.

Poor oxygen and higher oxidative stress can affect children’s cognition, behavior, and academic performance and lead to hyperactivity. Left untreated, it can also lead to high blood pressure, diabetes, heart disease, and stroke in adults.

Clearly, Orofacial Myofunctional Disorder is nothing to take lightly. If you believe you or your child is dealing with OMD, schedule an appointment with Dr. Elizabeth Eggert or Dr. Jeff Eggert at Eggert Family Dentistry. They will assess your mouth, face, and jaw and determine if everything is working properly. If they conclude that OMD is present, they will help you create a plan for the best path forward. This could encompass one of many interventions, including a night splint, dental or orthodontic treatment, a custom Myobrace® appliance, or behavior modification. Give our office a call today at 651.482.8412!

Which Splint is Right for You?

By: Dr. Elizabeth Eggert

When it comes to dental health, particularly addressing issues related to your bite, splints or also known as “dental appliances” can be a game-changer. At Eggert Family Dentistry in North Oaks, MN, Dr. Jeff Eggert and Dr. Elizabeth Eggert offer a variety of splints designed to cater to your specific needs, ensuring you receive the best care possible. Understanding the different types of splints available and their benefits can help you make an informed decision about your dental health.

Splints Available at Eggert Family Dentistry, Explained!

One of the splints offered is the anterior deprogrammer. This appliance is designed to temporarily disengage the bite, allowing the muscles of the jaw to relax. It’s particularly useful for diagnosing bite problems and can provide relief from muscle pain caused by bruxism (teeth grinding). If you experience frequent headaches or jaw pain, an anterior deprogrammer might be recommended to help alleviate these symptoms and to determine if your bite is a contributing factor.

TMD Splint

For those dealing with temporomandibular joint disorder (TMD), TMD splints or orthotics are an excellent option. These splints are custom-made to fit your mouth and are designed to reposition the jaw to a more comfortable position, reducing stress on the TMJ. Patients with TMD often suffer from jaw pain, clicking or popping sounds, and difficulty in opening their mouths fully. A TMD splint can help reduce these symptoms by providing a stable and balanced bite.

Another specialized appliance is the Tanner appliance, which is used for treating bruxism and in designing a new bite.  The Tanner appliance is a full lower arch anatomical splint. It is the best adjusted version of a TMD splint and it often is worn only at night. This appliance helps us to determine where the muscles sit in a comfortable position and analyze the tooth position there.  Often after wearing a Tanner appliance, you will have a great idea of how the positioning of your teeth affects your overall health and well-being and it helps us plan for a new bite so you can enjoy the improved effects day in and day out!

For those who need a more flexible solution, softguards offer a comfortable and adaptable option. Made from a softer material, these guards are ideal for light bruxism. They are especially useful for patients who may not tolerate harder materials well or those who need a lot more support for their joints over their muscles. If you experience occasional teeth grinding or clenching, a softguard may provide the necessary protection without discomfort.

Essix

Essix retainers are another versatile option, primarily used to maintain tooth alignment after orthodontic treatment. These clear, thin, removable retainers are comfortable and virtually invisible, making them a popular choice for post-orthodontic care. If you’ve recently had braces or other orthodontic work done, an Essix retainer will help keep your teeth in their new positions. For some people, it can help protect teeth from the effects of bruxism, but typically, for moderate to heavy bruxism, the retainers will wear out quickly.

For more comprehensive protection, custom fit occlusal guards (also known as night guards) are highly effective. These guards are tailored to fit your mouth precisely, providing robust protection against moderate and severe bruxism. They are made from durable materials and are designed to withstand significant grinding and clenching forces. The downside to a standard occlusal guard is that if the bruxism is caused by an airway compromise, by wearing the occlusal guard, the airway collapse may be more significant while wearing the appliance because it helps to keep your muscles relaxed. Therefore, an accurate diagnosis of why you are bruxing is important.

The Seattle Protocol is an innovative approach to diagnosing and treating TMD and related issues where airway compromise is suspected. This protocol involves a series of diagnostic steps and treatments, including the use of various trial splints to find the most effective solution for each patient. By systematically evaluating different treatment options, Dr. Jeff Eggert and Dr. Elizabeth Eggert can pinpoint the best appliance to best improve your airway, which should improve any signs or symptoms you are having from sleep apnea. If you find yourself waking up tired or experiencing frequent sleep interruptions, the Seattle Protocol is a suitable option to explore.

Finally, for patients suffering from diagnosed mild or moderate sleep apnea, a mandibular advancement appliance can be a lifesaver. This device works by holding the lower jaw forward, keeping the airway open during sleep. If you suffer from obstructive sleep apnea, this appliance can significantly improve your sleep quality and overall health by reducing snoring and apneic events and associated risks. You will find your sleep quality will improve significantly because your body can get the oxygen it needs!

How You Can Get Help

At Eggert Family Dentistry, Dr. Jeff Eggert and Dr. Elizabeth Eggert utilize a comprehensive evaluation process known as the Records Process to determine the best splint for your needs. This process involves a thorough examination of your bite, jaw function, and overall oral health. By analyzing this data, they can recommend the most appropriate splint to address your specific issues. Whether you need relief from TMD, protection from bruxism, or help with sleep apnea, Eggert Family Dentistry will guide you through each step, ensuring you receive the best possible care tailored to your needs.

Choosing the right splint can make a significant difference in your dental health and overall well-being. At Eggert Family Dentistry, you can trust that you will receive personalized, expert care designed to meet your unique needs. Call us today! 651-482-8412!

The Impact of Teeth Grinding on Your Oral Health: Risks and Consequences

By: Dr. Elizabeth Eggert

Clenching or grinding your teeth — also known as bruxism — is common, but that doesn’t mean it’s something you should ignore.

While some consequences of bruxism are simply annoying, others are more serious and can negatively affect your oral health. Let’s take a few minutes to dive into the impact of teeth grinding, signs to watch for, serious consequences that can occur, and how to treat and prevent it.

Understanding Teeth Grinding and Its Causes

Teeth grinding can affect children and adults alike. Small children are notorious for grinding when they’re cutting baby or permanent teeth, but they generally grow out of it. Not everyone grows out of bruxism, however, and adults often report their sleeping partners grinding so loudly it actually wakes them up out of a sound sleep!

While you might think of bruxism occurring only when you’re asleep (sleep bruxism or SB), it can occur just as frequently during your awake hours (awake bruxism or AB). In either case, the person generally doesn’t realize they’re clenching or grinding their teeth and often attributes their symptoms to the wrong causes.

Teeth grinding — and the uncomfortable side effects of it — generally has one of several root causes: improper alignment of teeth; stress, anxiety, anger; caffeine consumption, alcohol consumption; tobacco use; prescription medications; or airway issues.

Stress

Stress affects the human body in a variety of ways. It causes surges of adrenaline and cortisol, as well as increased heart rate and breathing.

When this happens, our bodies shift from “rest and digest” mode into “fight or flight” mode, and our muscles tense up and prepare for action. This tension is often noticeable in our neck, shoulders, and hips. Our jaw muscles often tense up too, and we grind unconsciously to cope with the pressure.

Caffeine

We love coffee and other foods and beverages with caffeine because they give us energy. But they’re also a muscle stimulant and can increase muscle activity in the jaw, resulting in grinding.

Tobacco

Just like caffeine, tobacco is a stimulant and increases muscle activity in the jaw.

Alcohol

drug abuse and dental health

Not only does alcohol consumption affect our sleep patterns, but it actually alters the neurotransmitters in our brain. Consequently, jaw muscles can overcompensate and become tense, resulting in grinding.

Also, if not properly managed, alcohol consumption can lead to dehydration, which makes our mouth dry and can lead to teeth grinding.

Airway Issues

Sleep disordered breathing can result in teeth grinding. If you’re having a difficult time breathing at night, you may unconsciously move your teeth around or grind them to open up your airway. This also occurs during the day, unconsciously. For example, if your body feels that your airway is more “open” with your jaw in a position that puts more stress on your teeth, but less stress on your airway, your body will choose to keep your airway open over keeping pressures off your teeth.

Prescription Medications

Some prescription medications, including antidepressants and psychiatric meds, can alter neurotransmitters in the brain and cause jaw tension and teeth grinding.

Tip: If you suspect you’re grinding your teeth as a result of a prescription medicine, talk to your prescribing doctor to see if your dosage can safely be adjusted or if there is another medication choice you can try.

Impact of Teeth Grinding: Signs and Symptoms

Do you think you or your loved one might be dealing with bruxism? Here are some signs to watch for:

  • Tooth damage: chipped, worn down, fractured, or loose teeth
  • Tooth sensitivity
  • Headaches or earaches
  • A jaw that clicks or doesn’t open and close smoothly
  • A sore jaw
  • Irritated cheek tissue
  • Tongue indentations
  • Gum recession
  • Gingivitis
  • Damaged dental work

Tip: If you catch yourself clenching or grinding, place the tip of your tongue on the roof of your mouth behind your top teeth. This will automatically unclench your teeth and relax your jaw. This isn’t a permanent fix but can help provide relief from jaw tension in the moment.

Preventive Measures and Lifestyle Changes

You and your loved ones don’t need to live with the uncomfortable and potentially damaging effects of teeth grinding.

Successful treatment of bruxism addresses the root cause: If the root cause is physiological, dentistry, orthodontia, or airway treatment could help; If the root cause is stress, managing it is imperative. In other words, there are several effective treatment options! Let’s take a closer look:

Splint/Occlusal Appliance

In order to protect your teeth from chipping, cracking, or wearing down during sleep bruxism, Dr. Elizabeth Eggert or Dr. Jeff Eggert can create a custom in-mouth appliance, or splint. This splint will fit your teeth perfectly, protect their surfaces, and absorb bite force. There are different ways to design splints based on your individual needs. Dr. Jeff and Dr. Elizabeth are happy to help you determine which might be best!

Dental Restorations

When teeth grinding has been undetected or left untreated for a long time, teeth can become permanently damaged.

If needed, Dr. Elizabeth Eggert or Dr. Jeff Eggert can create crowns or veneers for your teeth to restore their strength and integrity and improve the appearance of your worn-down teeth. Properly shaping the teeth can also help relieve extra pressure on your jaw.

Orthodontia

If Dr. Elizabeth or Dr. Jeff determines that the root cause of bruxism is due to severely misaligned teeth or jaw bones, they will refer you to an orthodontist for a consultation or sometimes we can even do the orthodontics in our office with Inivisalign. Braces and other orthodontic interventions can widen your palate, realign teeth, and reposition the jaw, correcting your bite. They can even help with breathing issues!

Treatment for Airway Issues

If Dr. Elizabeth Eggert or Dr. Jeff Eggert suspects that sleep disordered breathing is a factor for you, they will schedule an evaluation and discuss possible treatment options, including the reputable Seattle Protocol.

Botox

If the grinding is persistent and the effects are severe, Botox injections can provide temporary relief.  Botox is a neurotoxin that can be injected and has been found to temporarily relax muscles and reduce nerve signals in the jaw that lend themselves to teeth grinding.

De-Stressing Techniques:

If you’re under significant stress and it’s the likely cause of your teeth grinding condition, pursuing de-stressing techniques, such as therapy, breathwork, stretching, and journaling, can help reduce stress or help you manage it better. These interventions can also help alleviate overall body tension and stress-induced pain.

If you’re dealing with symptoms of teeth grinding, we’d encourage you to schedule a bruxism evaluation appointment with Dr. Elizabeth Eggert or Dr. Jeff Eggert. Give our office a call at 651.482.8412 to schedule your appointment.

The Impact of Healthy Childhood Habits on Airway and Oral Health

By: Dr. Elizabeth Eggert

In many ways, the stage for lifelong health is set in childhood. Often overlooked amid the busyness of parenting, mouth-breathing can affect your child’s airway and oral health and affect their quality of life. As a parent, you are your child’s biggest advocate. That’s why we want to take some time to educate you on the topic of airway and oral health, including signs to watch for and what you can do if you suspect your child’s airway is compromised.

Contributing factors that affect airway and oral health

While it may be necessary during allergy season or when fighting a head cold, long-term mouth-breathing will result in airway issues or sleep-disordered breathing.

Certain malformations such as crooked, misaligned teeth, improper jaw alignment, a narrow palate, and abnormalities of the head or skull can also make nasal breathing difficult. Children who deal with these challenges often unknowingly default to mouth-breathing. Interestingly, sometimes it’s a matter of what comes first – the chicken or the egg, because in children who mouth breathe, their development will occur in a more vertical pattern, resulting in the malformations noted above. This also makes things more difficult the longer we wait for intervention.

When your child breathes through their nose, their body filters toxins and debris through the nose’s cilia. Nasal breathing also helps the body produce nitric oxide, which makes it easier for the lungs to absorb oxygen. Plus, nasal breathing warms and humidifies the air in the nasal cavity, keeping the tonsils and adenoids moist and healthy.

Mouth-breathing, on the other hand, dries out tonsils and adenoids, making them irritated and inflamed and exacerbating breathing issues. A dry airway is also more prone to collapsing, and will cause childhood sleep apnea.

Additionally, mouth-breathing deprives your child of oxygen by up to 20% and increases CO2 levels in their blood.

Over time, stressors resulting from mouth-breathing can even lead to hypertension, heart disease, diabetes, lung malfunction, and enlargement of the right ventricle of the heart.

How do I know if my child is a mouth-breather or dealing with an airway obstruction?

When a child is mouth-breathing, their mouth is drier and doesn’t have adequate saliva to protect their teeth and gums against damaging bacteria. The increased presence of bacteria often results in more plaque, tooth decay, and gum disease. Generally, if the lips are apart, breathing is occurring through the mouth instead of through the nose.

  • Some additional signs that your child may be mouth-breathing as opposed to nasal breathing include:Snoring
  • Poor speech
  • Halitosis
  • Dry lips
  • Bedwetting
  • Fatigue/dark circles under the eyes
  • Insomnia
  • Brain fog
  • Academic struggles
  • ADHD symptoms
  • Forward head posture (bent neck)
  • Sleeping with their neck extended

The role of healthy childhood habits on airway and oral health

Fortunately, as a parent, you’re not a helpless bystander when it comes to detecting airway issues in your child…or when it comes to helping prevent them. There are many healthy habits you can help your child develop that will decrease their risk.

If you notice your child mouth-breathing, encourage them to breathe through their nose instead. Sometimes, children continue to mouth-breathe long after a cold or allergies have subsided. Consider teaching your child relaxing nasal breathing techniques they can practice during the day and while they’re falling asleep at night. Always think “tongue up, lips sealed, breath goes in through the nose.”

Encourage your child to eat healthy and stay hydrated. Healthy food is an important part of keeping your child’s immune system strong. Proper hydration ensures adequate saliva production, which keeps your child’s oral biome healthy.

Make sure your child gets plenty of sleep. Just like healthy food, good sleep helps strengthen weak immune systems and keeps healthy immune systems strong!

Make sure your child stays active. Physical activity strengthens the respiratory system.

Encourage your child to brush and floss their teeth every day. It reduces the buildup of bacteria in your child’s mouth that could irritate their airways.

The importance of regular recare visits

Last but certainly not least, perhaps the most important thing you can do to help your child prevent airway issues and ensuing long-term health issues is to schedule regular recare visits at Eggert Family Dentistry! We recommend starting your child’s recare visits before their first birthday! Our recare visits are thorough! We go above and beyond simply looking for cavities and cleaning your child’s teeth. In addition to cavities, we look for various dental problems that can be linked to airway issues or sleep-disordered breathing. These dental problems include:

  • Bruxism
  • Functional tooth wear and fractures
  • Erosive tooth wear
  • TMD/myofascial pain
  • Malocclusion, especially anterior open bite and crossbite
  • Facial development
  • Periodontal disease
  • Abfractions
  • Impacted teeth
  • Orthodontic or orthognathic relapse

If Dr. Elizabeth Eggert or Dr. Jeff Eggert is suspicious your child is struggling with airway issues or sleep-disordered breathing, they may suggest a myobrace appliance, which is kind of like a mouthguard, to correct their bite and facilitate nasal breathing. In some cases, they will refer your child to an ENT.

Being proactive is key. When you partner with Dr. Elizabeth Eggert or Dr. Jeff Eggert for your child’s dental care, they help your child grow up healthier and have an optimal quality of life. At Eggert Family Dentistry, we recognize that airway and oral health are critical for lifelong physical health and self-esteem and set your child up for academic and athletic success throughout childhood, adolescence, and adulthood. Call us today at 651.482.8412 to set up your child’s next recare visit in our office!

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
  • The Chronic Cough Enigma by Dr. Jamie Koufman
  • No More Allergies, Asthma or Sinus Infections by Dr. Lori Jones
  • Close Your Mouth by Patrick McKeown
  • The Oxygen Advantage by Patrick McKeown

Seattle Protocol Therapy – Molly’s Story

By: Dr. Elizabeth Eggert

How did this start?  

Molly came to us with questions during her recare appointment.  She had recently had a sleep study done with her doctor and had been diagnosed with Mild Sleep Apnea.  She was given a CPAP (Continuous Positive Airway Pressure) machine to try, but wanted to know her other options as the CPAP wasn’t working out that well for her.  CPAP therapy is the “gold standard” treatment for sleep apnea, but due to the high air pressure needed to prevent the collapse of the airway, some patients find that they just can’t tolerate the therapy.  Molly knew about the Seattle Protocol from our blog articles and wanted to know more.  

Molly suffered from acid reflux and had severe demineralization and decay with her teeth.  She told us she never really slept well and had been taking Ambien for 15 years to help with her sleep issues.  Despite the medication, she still found that most afternoons or evenings she needed a nap to help combat her excessive fatigue.   

What did Molly want?

Molly wanted to sleep better.  She didn’t want to be so fatigued.  And, she wanted something more comfortable than the CPAP option for her sleep issues.  We talked to Molly about the possibility to undergo the Seattle Protocol to see if using a nighttime appliance could help her sleep better.  The Seattle Protocol is a six-step process that runs patients through different types of appliance options to see what is the most non-invasive appliance/splint to improve sleep.  Typically at one of the six stages, patients will feel better and the symptoms they have from sleep-disordered breathing or sleep apnea will improve significantly.   With the Seattle Protocol, each step builds upon the last, but patients don’t necessarily need to complete the entire process as the purpose of the protocol is to determine the phase that provides the best relief of symptoms.

What was involved?

We did a comprehensive evaluation of Molly’s bite and function to be sure that having her wear a nighttime appliance wouldn’t trigger any joint, muscle, or teeth issues for her.  Then, we started Molly with the first phase of the Protocol – Nose Clearing and Mouth Taping.  The purpose of mouth taping is to keep your body breathing through your nose, which is the most healthy way to breathe.  Mouth taping should only be done under a doctor or dentist supervision, however.  Molly did well with the mouth taping and then we worked her through the Protocol using the myTap appliance.  The different stages of the Protocol involve different parts of myTap.  

Moving through the stages of the Protocol, Molly reported that she was sleeping better and napping less.  She found the Stage 3 version of the myTap appliance to be the most effective for her.  In this stage, the patient wears a lower arch appliance that holds them in a more forward position.   

Molly tried stages 4 and 5 as well, but really felt the most comfortable and the most rested in the Stage 3 appliance so we took impressions of her mouth and had a Mandibular Pull Forward appliance fabricated to custom fit her mouth.       

What does Molly think now?

Molly loves her nighttime appliance.  She has been wearing it nearly 3 years now and doesn’t want to go back!  She reports, “It has just made such a huge difference in being able to function in everyday life.  I used to have to take an hour nap every day, but don’t have to anymore.”  Molly has had no issues with her teeth or bite changing, as this can be a real side-effect of traditional sleep apnea appliances.  She finds her appliance very comfortable.

Molly notes that it might be easy to perceive the Seattle Protocol as being a “great inconvenience,” but she wants to assure people that “IT JUST IS NOT!”  Getting used to mouth taping and having an appliance in her mouth were something new, but Molly is so glad she did it because “I couldn’t tolerate the CPAP and my appliance is just SO much better!”

She was very happy to work with Dr. Elizabeth Eggert and liked the attention she paid to having a shared goal.  If you have sleep issues, Molly would recommend you have a conversation with the team at Eggert Family Dentistry. 

“The entire team is amazing!”

How Mandibular Advancement Appliances Can Improve Oral Health

By: Dr. Elizabeth Eggert

When you’re diagnosed with obstructive sleep apnea (OSA), your doctor may first prescribe CPAP therapy — you know, the face or nose mask attached to a machine that you have to wear at night. However, while CPAP therapy is extremely effective, many people can’t tolerate sleeping with it on every single night.

That’s why oral sleep appliances -– also known as mandibular advancement appliances — are also used to treat sleep apnea. In fact, they have an 80% compliance rate over the CPAP’s 40%. 

We fit mandibular advancement appliances at Eggert Family Dentistry and have been able to help many people with OSA improve their sleep, oral health, and overall quality of life.

What is a Mandibular Advancement Appliance?

A mandibular advancement appliance (MAA) is a device that can be custom-fitted to a person’s mouth, and works by temporarily moving the jaw and tongue forward. This adjustment reduces throat constriction and opens up the airways, effectively preventing snoring and sleep apnea. 

Benefits of Using a Mandibular Advancement Appliance

You probably already know that sleep apnea causes a myriad of health issues, most notably cardiovascular problems. But did you know that your sleep apnea also wreaks havoc on your dental health? People with sleep apnea also are more likely to experience TMD, bruxism, and dry mouth. Luckily MAAs can reduce and relieve each of these symptoms. 

1. Relief from Tooth Grinding and Clenching

Many people who suffer from sleep-disordered breathing also grind their teeth or clench their jaw during sleep. This can lead to a host of dental problems, including tooth sensitivity, worn-down enamel, and even tooth fractures. MAAs can help alleviate these issues by positioning the lower jaw in a more forward position, which reduces the likelihood of grinding or clenching. The thought is that since the body can breathe better, the jaw doesn’t have to move around, trying to find the best position for air exchange.

2. Reducing Dry Mouth

People with OSA often sleep with their mouth open in an attempt to get more oxygen, which leads to dry mouth. Because saliva plays an important role in reducing the amount of plaque on your teeth, dry mouth can cause or accelerate tooth decay. Using an MAA will open up the airway and improve breathing, which will reduce the need to breathe through the mouth during sleep. This will reduce all dry mouth symptoms and keep tooth decay under better control by maintaining the proper amount of saliva in your mouth. 

3. Reducing the Risk of Gum Disease

Gum disease is a common oral health problem that can lead to tooth loss if left untreated. People with sleep-disordered breathing are at an increased risk of developing gum disease, as the reduced oxygen flow to the gums can make them more susceptible to infection. By improving breathing and oxygen flow, MAAs can help reduce the risk of gum disease and promote overall oral health.

4. Improving Overall Sleep Quality and Quality of Life

Finally, the most important benefit of using an MAA is improved sleep quality, which can have a positive impact on your quality of life in general. Poor sleep quality has been linked to a range of health problems, and by improving breathing and reducing sleep disturbances, MAAs can help promote your overall health and wellbeing.

Want Better Sleep, Healthier Teeth, and a Higher Quality of Life? 

If you have sleep apnea and would like to be fitted for a mandibular advancement appliance, Dr. Jeff Eggert or Dr. Elizabeth Eggert can help! After hearing from your medical doctor and doing an assessment of your bite, we can custom-design your device by taking impressions or digital scans of your mouth. Once the device is ready, we’ll ask you to come into our office for a fitting so we can make sure it’s comfortable and effective. Contact us or call us at 651-482-8412 today to schedule your mandibular advancement device consultation!

Sleep Apnea Treatments: Mandibular Advancement Appliances vs. Traditional CPAP Therapy

By: Dr. Elizabeth Eggert

Obstructive sleep apnea (OSA) is a common sleep disorder that affects 18 million people around the world. It is characterized by pauses in breathing during sleep, which can lead to snoring, daytime sleepiness, and other health problems. 

There are several treatment options available for sleep apnea, but two of the most popular are Mandibular Advancement Appliances (MAAs) and Continuous Positive Airway Pressure (CPAP) therapy. While both of these treatments can be effective, they work in different ways and have different benefits. 

Let’s explore the differences between MAAs and CPAP therapy and help you determine which treatment option may be best for your individual needs.

Sleep Apnea Treatment Options 

First, let’s take a look at all of the treatment options that patients are given when first diagnosed with OSA: 

  1. Lifestyle changes: Losing weight, quitting smoking, avoiding alcohol and sedatives, and sleeping on your side may be recommended to improve sleep apnea symptoms.
  2. Oral appliance therapy: This involves wearing a mouthguard-like device (like an MAA) that helps to reposition the tongue and jaw to keep the airway open during sleep.
  3. Continuous Positive Airway Pressure (CPAP) therapy: CPAP therapy involves wearing a mask at night that is attached to a machine. This machine delivers air pressure to keep the airway open during sleep.
  4. Surgery: In some cases, surgery may be recommended to remove excess tissue in the throat or to reposition the jaw.

You and your doctor will be able to review your unique situation to determine which of these solutions is right for you. 

While lifestyle changes can treat more mild cases of sleep apnea, they won’t be able to completely relieve symptoms of more severe cases. On the opposite end of the spectrum is surgery: this sleep apnea treatment is usually saved for the most severe cases of OSA. 

The middle ground, then, is where Continuous Positive Airway Pressure (CPAP) therapy and Mandibular Advancement Appliances (MAAs) lie. These are the most popular treatment options among people with sleep apnea. While both treatments can be effective treatment options, they work in different ways and have different benefits.

Benefits of CPAP Therapy 

Continuous Positive Airway Pressure (CPAP) therapy is:

  • Highly effective: CPAP therapy is considered the most effective non-surgical treatment option for sleep apnea.
  • Produces immediate results: CPAP therapy can provide immediate relief from symptoms of sleep apnea, such as snoring and daytime sleepiness.
  • Can be used for any level of sleep apnea: CPAP therapy can be used to treat all levels of sleep apnea, from mild to severe.
  • Helps improve overall health: CPAP therapy can help improve blood pressure, reduce the risk of heart disease and stroke, and improve overall quality of life.

However, because of the cumbersome nature of the CPAP machine, many people have a difficult time sticking to it over an extended period of time. It’s also difficult to travel with so many people don’t use their CPAP machine during vacations or trips. 

Benefits of Mandibular Advancement Appliances

While CPAP therapy is extremely effective, many people can’t tolerate sleeping with the discomfort of the face or nose mask night after night. That’s where Mandibular Advancement Appliances (MAAs) come in: MAAs have an 80% compliance rate over the CPAP’s 40% compliance rate. 

In addition to being easier to stick to as a treatment modality, Mandibular Advancement Appliances are: 

  • Comfortable: MAAs are often more comfortable to wear than CPAP masks, as they are custom-made to fit the patient’s mouth.
  • Portable: MAAs are small and easy to travel with, making them a convenient treatment option.
  • Non-invasive: MAAs do not require surgery and can be easily adjusted by Dr. Jeff Eggert or Dr. Elizabeth Eggert.
  • Effective for mild to moderate sleep apnea: MAAs are often recommended for individuals with mild to moderate sleep apnea who are unable to tolerate CPAP therapy.

Ultimately, the best treatment option for sleep apnea will depend on your specific needs and preferences. Your doctor can help determine the most appropriate treatment option based on the severity of your condition, medical history, and other factors. 

Think You Could Benefit from a Mandibular Advancement Appliance? 

At Eggert Family Dentistry, we custom-fit mandibular advancement devices for patients with Obstructive Sleep Apnea or other Sleep Related Breathing Disorders. Call us today at 651-482-8412 to schedule a consultation during which Dr. Jeff Eggert or Dr. Elizabeth Eggert can discuss this treatment option with you and answer any questions you may have. Once we’ve decided an MAA is right for you, we can custom-design your device and then calibrate the finished product to make sure it’s comfortable and effective. Contact us to schedule your appointment today! 

Treating Sleep-Disordered Breathing: 4 Benefits of the Seattle Protocol

By: Dr. Elizabeth Eggert

Some patients who come to us with chronic dental problems also present airway patency issues. Simply put, airway patency is the ability of a person to breathe, with airflow passing to and from the respiratory system through the oral and nasal passages.

When a person experiences difficulty breathing, especially at night, this can 1) negatively affect one’s oral health, and 2) continue to damage the teeth even after restorative dental procedures have been completed. 

So, what does that mean for patients of Eggert Family Dentistry? It means that before beginning any restorative dental treatment, we need to identify and address these airway patency issues using a process called the Seattle Protocol. 

The Seattle Protocol

The Seattle Protocol is a six-step process that helps patients with symptoms of sleep-disordered breathing and other conditions determine whether a compromised airway is contributing to their ailments. 

Each of the six steps builds upon the last to open the airway as much as possible, but patients don’t necessarily need to complete the entire process to identify the solution. The purpose of the protocol is to determine which step provides the patient the most relief of symptoms.

Here is a brief description of the six steps of the Seattle Protocol:

  1. Nose Breathing and Mouth Taping: During this stage, you will gently train your body to breathe through your nose, not your mouth.
  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.
  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 add an element that pulls your lower jaw forward.
  4. Temporary Splint for Lower and Upper Jaw with Mouth Taping: If you aren’t getting relief from the previous step, we remove the forward jaw posturing component and add a splint for your upper jaw.
  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.
  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.

As we said before, the goal of the Seattle Protocol is to open the airways as much as possible so that your breathing is no longer restricted. You can find a full description of each of the six steps here.

The Benefits of the Seattle Protocol

The main benefit of the Seattle Protocol is to determine a good position to help control your sleep-disordered breathing. However, the Seattle Protocol also comes with a host of other positive benefits for our patients. 

Improved safety: The Seattle Protocol prioritizes patient safety by allowing us to take a systematic and collaborative approach to airway management. By following a standardized protocol, Dr. Jeff Eggert or Dr. Elizabeth Eggert can identify and address airway issues quickly and effectively, minimizing the risk of complications during dental procedures. It is also completely reversible so there are no long-term ill-effects.

Increased comfort: The Seattle Protocol takes a gradual and gentle approach to airway management to maximize patient comfort by introducing interventions slowly and adjusting them as needed. More importantly, when the Seattle Protocol is successful, our patients can finally enjoy a comfortable night’s sleep!

Better outcomes: By identifying and addressing airway issues before beginning any dental restorations, the Seattle Protocol ensures that our patients can maintain their new smiles for as long as possible, without any complications. This will not only help our patients recover more quickly but also ensure that they get the most out of their financial investment. 

Personalized care: The Seattle Protocol is designed to be flexible and adaptable to the individual needs of each patient. By tailoring interventions to each patient’s unique situation, we can provide the solution that’s right for you. 

At Eggert Family Dentistry, the Seattle Protocol assists us in treating our patients with airway patency issues or sleep-disordered breathing. The systematic steps allow us to both address the problem and identify the solution so our patients can receive the best possible care during dental procedures, and achieve the best possible outcomes afterward!

Real Results: Tom’s Story 

One of our patients, Tom, came to us with excessive wear, erosion, and many fractured teeth. Tom needed to reconstruct his mouth and we did that in phases, however, during the process we ran into a few complications: 

The force of Tom’s bite was so strong that he broke many temporary crowns. Dr. Elizabeth Eggert wanted to get down to the bottom of why Tom’s body would do this because even new crowns wouldn’t survive in such a harsh environment. 

Given Tom’s other symptoms, including difficulty breathing through his nose, dry mouth, and the use of a CPAP machine, Dr. Elizabeth Eggert recommended Tom complete the Seattle Protocol to help address his airway patency.

After completing five of the six steps of the Seattle Protocol, Dr. Elizabeth Eggert fabricated a sleep appliance for Tom to continue to improve his airway patency, reduce his bruxism and help him sleep better. After just a month of using his sleep appliance, Tom experienced less clenching, jaw pain, and an overall improvement in his sleep!

Think You Could Benefit from the Seattle Protocol? 

If you, too, are experiencing airway patency issues or sleep-disordered breathing, call our office today to schedule a consultation. At Eggert Family Dentistry, Dr. Jeff Eggert or Dr. Elizabeth Eggert will be able to collaborate with you on finding a solution to your unique situation. If you think you could benefit from the Seattle Protocol, contact us or call us at 651-482-8412 for a consultation today!

Teeth Grinding: Long Term Effects and Treatment Options

By: Dr. Elizabeth Eggert

We all have different ways and different places we hold stress in the body. Some of us have a tense neck or tight shoulders or a tender lower back, which can all be stress responses to the ups and downs of this complicated world we live in.

From a dental perspective, there’s one stress response we frequently notice in some patients’ mouths: bruxism.

Bruxism is just a fancy word with Greek origins that means grinding the teeth. (It’s also a pretty good Scrabble word to keep in your back pocket, if you’re into that kind of thing.)

People with bruxism may grind or clench their teeth during waking hours without really noticing it, or they may grind or clench their teeth while they sleep. Either way, many or most bruxers aren’t aware that they grind or clench unless someone else alerts them to the situation, such as a dental professional or a sleeping partner. In fact, some bruxers don’t inflict serious damage on their teeth, and discover their bruxism habit due to TMJ problems, chronic headaches, or by recognizing how tense their jaw muscles tend to be.

However, bruxism can have very negative consequences on dental and oral health. Over time, people with bruxism can wear their teeth down to flattened surfaces with an even, square appearance. They may even end up with chipped, loose or even fractured teeth. What’s more, grinding and clenching can damage dental restorations such as crowns or fillings and cause premature failure.

Treating Bruxism with a Dental Splint

There are a variety of ways to treat bruxism.

The simplest treatment protects your teeth instantly: An occlusal appliance. This is a custom dental splint designed to be worn while sleeping. It prevents your teeth from touching and it also absorbs bite force. These are different from mouth guards, which are designed to protect your teeth from high-speed foreign objects like baseballs, hockey pucks, or impact with the ground.

Dental splints get high scores in protecting your teeth, but depending on how they are designed, they don’t always discourage the urge to grind, so patients may still suffer from other effects of grinding such as headaches, TMJ issues, and poor jaw mobility.

Other Treatments for Bruxism

There are other potential treatments for bruxism that aim to stop or discourage the grinding behavior, which will help alleviate those non-dental consequences listed above.

These treatments include:

  • Treatment for airway issues that may be causing the grinding
  • Prescription medications
  • Botulinum neurotoxin type A, more commonly known by the brand name Botox
    Counter stimulation, such a small electrical impulse that’s activated by clenching
  • Treating the underlying stress or anxiety that may be causing the bruxism
  • Behavioral techniques such as biofeedback therapy

Here at Eggert Family Dentistry, Dr. Jeff and Dr. Elizabeth screen for evidence of bruxism during our exams. If your teeth indicate any damage from grinding, we’re here to partner with you in resolving the problem. Likewise, if you’re experiencing any symptoms that could indicate bruxism, such as jaw pain and stiffness, chronic headaches and more, be sure to let us know so we can help you overcome this destructive and uncomfortable activity.

Prolonged teeth grinding or clenching has the potential to damage your teeth irreversibly, so it’s worth taking every possible measure to overcome bruxism and to mitigate its erosive effect on your teeth. We look forward to helping you overcome bruxism and enjoy healthy teeth and reduced jaw and facial tension. Call us today at 651.482.8412 to schedule your next appointment.

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Dental Health and Airway Issues

By: Dr. Elizabeth Eggert

We’ve discussed the relationship between obstructed breathing and dental/oral health in other posts, such as The Link Between Airway and Dental Issues; The Effects of Airway Issues in Children; and What is the Seattle Protocol and How Does it Help Pinpoint Airway Obstructions?

Today, we’ll revisit the topic with particular focus on the tonsils and adenoids.

Airway issues, respiratory obstructions, and mouth-breathing can result in enlarged tonsils and adenoids, which can present their own set of health challenges.

What Are Tonsils and Adenoids?

Both tonsils and adenoids are lymphatic tissues, and are part of the body’s immune system.

You can sometimes see your tonsils: they are the two fleshy lumps visible at the back of the throat. They vary in size among different people. These glands occur in pairs, one on each side of the back of the throat at the junction of where the nasal passage meets the throat. Their job is to trap germs, including bacteria and viruses. They also produce antibodies which help destroy germs, preventing throat and lung infections. They usually reach full size by age 4.

Your adenoids are hidden from view. They hang from the upper part of the nasal cavity and can be examined by a medical professional aided with a mirror and light or a small flexible scope. Adenoids are made of similar tissue as tonsils, and they also trap bacteria and viruses and produce antibodies. The adenoids also reach full size by age 4, and tend to shrink after early childhood. In teenagers and adults, they can be nearly undetectable.

Both glands play an important role in infant and early childhood immunity, but become less critical as children grow and their bodies develop other successful tools to fight germs.

Mouth Breathing and Tonsils

Obstructed breathing and airways often cause people to breathe through the mouth instead of the nose. While this may seem like a minor issue, mouth breathing actually has a host of negative consequences on both dental and overall health.

In terms of the tonsils, mouth-breathing increases the turbulence of breath going directly into the throat. This dries out the tonsils, causing post-nasal mucus drip and exacerbating allergic reactions. It can cause chronic inflammation of the tonsils, which enlarges the glands and interferes further with breathing because of the obstruction they cause in the throat.

In other words, enlarged tonsils are both a symptom and a cause of airway obstruction. They both indicate and contribute to impaired breathing while sleeping, which can cause a host of unwelcome symptoms. From a dental perspective, these issues include cavities, teeth grinding, malocclusion, periodontal disease, TMJ problems and more. Other health issues that can result include headaches, snoring, obesity, ADHD, asthma, sleep apnea, and more.

Thorough Dental Exams at Eggert Family Dentistry

Here at Eggert Family Dentistry, Dr. Elizabeth and Dr. Jeff conduct thorough exams that include looking at your soft tissues like your tonsils. We recognize the critical role of respiration in your overall health and your dental health. If you think you or your child may have airway issues, or if you or your child has chronic issues with tonsils or adenoids, please share that information with Dr. Elizabeth and Dr. Jeff so we can help identify the problem and come up with a solution to support improved health, immunity and vitality for you or your child. Just contact us or schedule an appointment at 651.482.8412 today!

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