Apnea: diagnostics and treatment. Dental sleep medicine
Apnea: diagnostics and treatment. Dental sleep medicine
Course overview
A dentist of any specialty must understand the diagnosis and treatment of obstructive sleep apnea.
We have prepared a comprehensive training on dental sleep medicine and apnea. During the course you will learn:
the role of the dentist in the diagnosis and treatment of apnea and respiratory dysfunction;
the relationship between the condition of the respiratory tract and occlusion pathology;
methods of treating apnea;
apnea treatment protocols in the neuromuscular concept.
Each course topic is required to be studied. This will allow you to comprehensively understand and be able to treat this pathology in all age groups of patients from a dental point of view.
Course lessons
Lesson 1. Breath. Norm and pathology
Dispelling the myths
The main functions of the airways
Normal breathing: main characteristics
Breath at rest and under load
Physico-chemical process of breathing
Protective barriers of the airways
The effect of stress on the occurrence of the pathology of the airways
The effect of the state of other systems on the functioning of the airways
Measuring CO₂.
Lesson 2. A Functional Approach to Sleep and Breathing: Tongue-Tie, Tongue-Tone, and Tongue-Space
The modern clinical definition of ankyloglossia
The impact of restricted tongue-mobility (tongue-tie), oral dysfunction (tongue-tone), and maxillofacial underdevelopment (tongue-space) on:
mouth breathing, clenching, and grinding
sleep issues, fatigue, depression, and anxiety
neck tension, pain, postural dysfunction, and fascial restrictions.
Ankyloglossia and its effect on the development of narrowed dental arches and dental crowding
The contribution of the tongue in the development of the maxilla
The spectrum of obstructive sleep disordered breathing
Upper airway resistance syndrome (UARS)
Obstructive sleep apnea syndrome
The differential diagnosis of sleep-related breathing disorders and sleep bruxism in pediatric and adult populations
The clinical signs of mouth breathing, tongue-tie, limited tongue-space, sleep-disordered breathing, and myofunctional disorders among patients in your practice
Orofacial myofunctional therapy
The 5 dimensions of tongue-tie diagnosis
Kotlow's free-tongue measurement
Assessment of anterior and posterior tongue mobility: the tongue range of motion ratio
The role and limitations of tongue-tie surgery in the broader context of myofunctional (tongue-tone) and maxillofacial (tongue-space) issues
CBCT protocols for airway and tongue-space analysis
Functional treatment approach to sleep, breathing, tongue-tie, and maxillofacial development
Clinical cases.
Lesson 3. Sleep apnea. What are the dentist's roles and responsibilities?
Dental sleep medicine: a concept
Groups of sleep disordered breathing (SDB):
Obstructive sleep apnea syndrome (OSAS)
Central sleep apnea syndrome (CSAS)
Sleep-related alveolar hyperventilation.
Complications of obstructive sleep apnea
OSA diagnostics: polysomnography, polygraphy, apnea/hypapnea index
BAVENO classification
Identification of patients with apnea at a dental appointment: questionnaire
Principles of apnea treatment:
Behavioral therapy
Surgical treatment
Oral appliances.
The role of the dentist in the treatment of apnea
Intraoral devices for the treatment of apnea: monoblock and duoblock, titrable and non titrable
Categories of patients with apnea at a dental appointment
Criteria for dental evaluation of a patient with apnea
Mandibular advancement device (MAD): indications, advantages and working mechanism
CPAP vs MAD: which is more effective?
Side effects of MAD: long-term and short-term
OSAS and Bruxism: possible scenarios of interrelation
Neuroplasticity and methods of brain stimulation
Myofunctional therapy for obstructive sleep apnea
Clinical stage of MAD manufacturing and oral examination.
Lesson 4. Scissor-bite. The relationship of the airways tract and malocclusion
Characteristic of airways and nasal bones expansion
Infra-occluded first permanent molars and resorbed deciduous molars
Scissor-bite of permanent molars and premolars
Overcorrection
Rational timing of treatment.
Lesson 5. Airway First. Comprehensive Approach to Pediatric Orthodontics
Literature review on craniofacial growth modification
Craniofacial growth modification and sleep disordered breathing in children
Multidisciplinary approach to craniofacial growth modification
Palatal expansion protocols for management of obstructive sleep apnoea (OSA)
Orthodontic treatment for management of obstructive sleep apnoea (OSA)
Clinical application of Continuous Positive Airway Pressure (CPAP) in children.
Lesson 6. Airway-Driven Pediatric Orthodontics. Diagnosis and Treatment Planning Protocols
Diagnosis. The 6 red flags exam finding for pediatric sleep-disordered breathing (SDB)
Daytime and night time symptoms of sleep-disordered breathing (SDB)
Orthodontic interventions for managing pediatric sleep-disordered breathing
Tongue-tie and its relation to sleep-disordered breathing (SDB)
The tongue range of motion ratio (TRMR)
Analysis of clinical cases.
Lesson 7. Management of Sleep-Disordered Breathing. Myofunctional and Airway-Driven Approaches
The spectrum of sleep-disordered breathing (SDB)
Protocols and analysis of polysomnography (PSG)
Maxillary deficiency: narrow vs. wide maxillary
Orofacial myology and tongue position
Oropharyngeal exercises for the management of obstructive sleep apnea(OSA) in children
Treatment of pediatric obstructive sleep apnoea with oral appliances.
Lesson 8. Myofunctional Orthodontics. Management of Pediatric Sleep-Disordered Breathing
Epidemiology and treatment of obstructive sleep apnoea (OSA)
Bimax advancement for OSA management
Craniofacial growth modification of the nasomaxillary complex and the mandible
Treatment protocols of Dr. Derek Mahony
Application of Advanced Lightwire Functional (ALF) appliance for arch development
Application of myobrace for arch development
Analysis of clinical cases
Q&A session.
Lesson 9. Diagnosis and treatment of airways dysfunctions and sleep problems. Role of the dentist
Role of the dentist in supervising the diagnosis and treatment of airways dysfunctions
Reasons for failure in the diagnosis and treatment of airways dysfunctions
Diagnosis and treatment of sleep problems
Dentistry post-covid.
Lesson 10. Modern approaches to sleep apnea syndrome treatment
Modern medicine. How is a dentist different from a general practitioner?
Symptomatic treatment
Prevention of diseases of the airways
Devices for the treatment of sleep apnea syndrome
Methods of treatment of night apnea syndrome
Opinions of various doctors in the treatment of night apnea syndrome
Evidence-based medicine.
Lesson 11. Bruxism and Obstructive Sleep Apnea Syndrome
Obstructive Sleep Apnea Syndrome: definition
Etiology of respiratory disorders: craniofacial anatomical factors
Physiopathology of obstruction
Mechanism of an obstructive apnea episode
4 levels of polysomnographic examination
Characteristics of mixed apnea.
Lesson 12. Sleep dentistry. Sleep apnea treatment in neuromuscular concept
Sleep apnea: definition
Causes of insufficient airway volume
The relationship of the airways and posture
The role of malocclusion pathology in the sleep apnea development
Sleep apnea diagnosis: STOP BANG questionnaire, polysomnography
Review of surgical methods for the sleep apnea treatment in children and adults
Sleep bruxism: definition and causes
Expansion techniques of the maxillo-mandibular structures:
ALF appliance
MARPE appliance
DNA appliance.
The use of basic TENS bite for fabrication of sleep appliances
