Dental Tribune United Kingdom Edition

May 16-22, 201114 United Kingdom EditionFeature S noring and bruxism are common problems frequent- ly experienced during the night by most people in the UK, yet they not only result in prob- lems for the individual, they can also cause those who share a bed or a house with them to have their sleep disrupted frequently. Snoring is mainly caused by the partial closure of the airway during sleep. As the neck muscles relax, the soft tissue in the upper throat vibrates creating the harsh sound known as snoring. Those who are overweight are more vulnerable to snoring, as are those who are older as the throat muscles become weaker with age. In some people, drinking alcohol can cause further relaxation in the neck and throat, resulting in snor- ing, and in others it is merely a re- sult of the shape of their airways. However, no matter the reason, snoring is more harmful than it otherwise appears. Hypertension, cardiovascular disease, diabetes and high cholesterol are all more common in snorers, but it is the sleeping issues that can be most detrimental. Many snorers suffer daytime sleepiness as a result of Obstruc- tive Sleep Apnoea (OSA), in ex- treme situations this sleep dep- rivation can result in the sufferer inadvertently falling asleep with little warning, which can of course be incredibly dangerous. OSA oc- curs when breathing briefly ceases during sleep. These interruptions occur when the airway narrows so much that it closes, reducing the oxygen level in the blood. Adrena- lin is then released into the body, sometimes partially wakening the snorer without their knowledge. In severe cases of OSA, Continu- ous Positive Air Pressure (CPAP) is used to pump filtered humidified air into the nose to prevent the up- per airway from collapsing. Where snoring is concerned, patients should be screened in order to eliminate the possibility that they could be suffering with OSA. The most effective solution for simple snoring is a mandibular advancement splint (MAS). Worn during sleep, these are designed to hold the lower jaw slightly for- ward to reduce the chance of the airway narrowing. Although snoring is a main cause of sleep disruption for most people, bruxism is more damag- ing to the individual. Whereas snoring is the result of muscle re- laxation, bruxism is the result of muscle tension. Bruxism is a type of parafunc- tional hyper-activity that can cause a range of painful symptoms including poor sleep quality, mi- graines, tinnitus, neck ache, TMD and even depression. It can also lead to excess erosion of the teeth causing related dental problems, such as stress fractures, broken cusps and abfractions. A lack of motor control during sleep causes the nociceptive trigeminal inhibi- tion (NTI) reflex to be overridden, For many people at stressful times in their lives the effects of brux- ism can be exacerbated, what’s more, as this is most commonly a nocturnal issue, patients are usu- ally unaware of the cause of their problems and it often goes undiag- nosed and therefore, untreated. The effects of bruxism can be reduced with the implemen- tation of an occlusal splint. The most effective splints not only in- hibit nociception by keeping the canines and molars separated, but also trigger the NTI reflex, forcing the muscles to relax and physically preventing the damag- ing clenching action, as opposed to the most commonly used full arch soft splints, which can often be uncomfortable to wear and not always effective as they can still permit and in some cases actually increase clenching. DT A good night’s sleep Matt Everatt discusses some solutions to snoring and bruxism About the author Matt Everatt Tech- nical Director S4S For more informa- tion on S4S products call: 0114 250 0176 or email: info@s4s- dental.com www.s4sdental.com