Our practice specializes in the diagnosis and treatment of orofacial pain, headaches, TMJ, TMD, and sleep breathing disorders. We also offer oral appliance therapy, which is covered by medical insurance and Medicare. At Centrl Connecticut Orofacial Sleep Medicine, we recognize that orofacial pain and sleep are reciprocally associated in a bidirectional manner. This interaction should be taken into account by dentists and should be incorporated into their clinical practice.
Diagnosis
During this course you will learn how to recognize patients with sleep disorders that require medical attention. You will be able to determine what is appropriate for the dentist to treat, and what should be referred to a physician with special training in the management of these disorders.
Often, the anatomic features that contribute to sleep-disordered breathing can be identified during an oral examination. Therefore, dentists trained in dental sleep medicine are able to identify these patients, and refer them for further diagnostic testing and evaluation with board certified sleep physicians.
After graduating from dental school Dr. Gabriel completed a 2-year Orofacial Pain Residency Program where she managed over 1300 patients with TMDs, bruxism and sleep related disorders. She also has been trained in the use of various advanced diagnostic instruments such as Polysomnograms (PSG), MediByte HST, pharyngometry and Cone Beam CT. She continues to manage a variety of complex obstructive sleep apnea, snoring and TMD patients through her own practice, as well as in conjunction with her physician partners.
Treatment
Our team of dedicated sleep dentists works closely with our medical partners to provide a comprehensive treatment approach to patients with TMD, orofacial pain, and sleep disordered breathing. We offer comprehensive care utilizing the latest advancements in technology including polysomnography (PSG), MATRx, and CPAP/bi-level therapy.
Dental sleep medicine is a rapidly evolving field that provides significant opportunities for dental professionals. Panelists will share their experiences working in diverse settings, including general dentistry, hospital-based, DSM-only and multidisciplinary practices to explore the pros and cons of various pathways to practice growth. This session will also examine the current state of awareness of dental sleep disorders in North America. Specifically, the bidirectional associations between oro-facial pain and sleep will be discussed, along with their clinical implications for dental practitioners.
Oral Appliance Therapy
Oral appliances are small, custom-fitted mouthpieces that can improve snoring and decrease symptoms of obstructive sleep apnea. The devices look a bit like a sports mouth guard or orthodontic retainer and support the lower jaw in a forward position to keep the airway open. Unlike CPAP machines, oral appliances are comfortable, quiet, and require no external hardware or electricity.
Oral appliance therapy is most effective for obstructive sleep apnea and mild to moderate snoring. It is not effective for central sleep apnea, which occurs when the brain doesn’t signal the body to breathe.
Oral appliance treatment should be delivered by a dentist with specific training in dental sleep medicine, who is qualified to make appropriate therapeutic decisions based on available data from PSGs or home sleep apnea tests conducted by a physician. Qualified dentists have technical skill, acquired knowledge, and judgment regarding the outcomes and risks of oral appliance therapy. This judgment should be based on the evidence of effectiveness and the patient’s needs and preferences.
Sleep Testing
Sleep disorders, particularly obstructive sleep apnea (OSA), are important public health problems and have important diagnostic and management links to dental problems, such as orofacial pain and TMJ dysfunction. These mutually related conditions have stimulated the development of an interdisciplinary approach to their diagnosis and treatment.
During an overnight sleep study, patients arrive in the evening and are placed into a private room where they spend the night connected to wires that monitor important body functions such as heart rate, brain activity, oxygen levels, eye movement and snoring. Upon departure early the next morning, patients are free to resume their daily activities.
A Multiple Sleep Latency Test (MSLT) is a diagnostic tool that measures the time it takes for patients to fall asleep and determines how quickly they wake up in order to identify snoring or fragmented sleep. A Maintenance of Wakefulness Test (MWT) can also be used to evaluate a patient’s ability to stay awake during the day, and can provide a valuable indicator of OSA severity.