Georgetown Family Dentistry Lake Orion, Michigan MI
Dental Sleep Medicine


Snoring and Obstructive Sleep Apnea

• Dental Sleep Medicine...What is it?
• Oral Applications for Snoring Management
• The Effects of Snoring and Sleep Apnea
• Historical Perspective
• Treatment Protocol for Oral  Appliance Therapy
• Classification of Oral Devices
• The Vital Role of Dentists & Oral Examinations
• Sleep Apena Patient Testimonials

Snoring Prevention

Dental Sleep Medicine: Apnea literally means "unable to breath." If you have sleep apnea, your breath can become very shallow or you may even stop breathing while you are asleep. This state of not breathing can occur up to hundreds of times a night. Obstructive sleep apnea (OSA) also called obstructive sleep apnea syndrome, occurs when there is complete or partial blockage of the upper airway during sleep. During a sleep apnea episode, the diaphragm and chest muscles workharder trying to open the airway. Breathing usually resumes with a loud gasp, snort, or body jerk. These episodes can interfere with sound sleep. They can also reduce the flow of oxygen to vital organs and cause irregularities in heart rhythm.

Sleep apnea is more common among people with thick or large necks. The condition is also more common among people who have smaller airways in their noses, throats, or mouths. The small airway could be related to the actual size and shape of the airway, or to obstructions or other medical conditions that are causing obstructions. People with sinus problems or nasal congestion, who are more likely to experience sleep apnea. Your dentist may also fit you with a snoring prevention mouth device to be worn while sleeping to help prevention snoring and loss of oxygen.

The Vital Role of Dentists
Dentists, hygienists and staff are often the first health care providers to discover sleep disorders.

• Since a dental practice often treats entire families on a routine basis, the setting is a natural place to aid in identifying   patients at risk for having Sleep Apnea and snoring.
• Oral examination can disclose an airway obstruction, e.g. tonsils, a long soft palate and a large uvula.
• It is vital for the dentist with their knowledge of the oral cavity to advise their patients about sleep disorders and work with   their physicians.

• Dental questionnaire should include at least 2 sleep disorder questions:
      1. Do you Snore?
      2. Do you gasp for air while sleeping?

DENTAL SLEEP MEDICINE - Lake Orion, MI - Dr. Joseph Mastromatteo, D.D.S. P.C.

Dr. Mastromatteo DDS PC Dental Sleep Medicine-Sleep Apnea Treatment-Lake Orion, MI

Meet the Doctor - Dr. Joseph Mastromatteo
Dr. Mastromatteo was raised in Mt. Clemens, Michigan. He received his Bachelor of Science degree from Michigan State University and his Doctor of Dental Surgery degree from Georgetown University. After dental school he served in the Dental Corps of the United States Army. He then began a private practice in family and cosmetic dentistry in Lake Orion, MI.

He is a member of the American Dental Association and the Michigan Dental Association. Since 1999 Dr. Mastromatteo has expanded his practice to include Dental Sleep Medicine. Along with his family and cosmetic dentistry he works in conjunction with sleep specialists at the department of Clinical Neurophysiology at Beaumont Hospital treating patients who suffer from sleep disorders such as snoring and sleep apnea with dental appliances. He is a member of the American Academy of Dental Sleep Medicine and the American Academy of Sleep Medicine. Click here for
info on Dental Sleep Medicine.

Oral Appliances for the Management of Snoring and Obstructive Sleep Apnea

• Snoring and Obstructive Sleep Apnea – What are the effects? How it works.  How it affects others.
• Historical Perspective – Repositioning of the tongue and mandible to maintain a patent airway during sleep is not new.
• Oral Appliance Examination
• Classification of Oral Appliances for Obstructive Sleep Apnea
• Requirements of an Oral Appliance
• Informed Consent for Oral Appliance
• AADSM Treatment Protocol for Oral Appliance Therapy
• Patient Testimonials
• The Vital Role of Dentists in treating Snoring and Obstructive Sleep Apnea

Causes of Sleep Apnea

Historical Perspective
Repositioning of the tongue and mandible to maintain a patent airway during sleep is not new.
• 1930 - helmets and chinstraps were used to reposition the mandible forward.
• 1934 - Pierre Robin reports that first use of an oral appliance to reposition the mandible.
• 1979 - Mandible surgically advanced to open airway and other surgeries.
• 1982 - Cartwright and Samelson report on a tongue retaining device.
• 1984 -  Numerous authors publish data on oral appliance effectiveness.

How Oral Appliances work.
Mandibular Repositioning Appliances
Tongue Retaining Device (TRD)
How snoring device works

Moving the jaw and tongue forward with an oral appliance can open
the airway to reduce sleep apnea and snoring.

Requirements of an Oral Sleep Appliance

• Sleep Specialist - Physician referred
• Appliance cannot change position of teeth
• Appliance should be adjustable
• Appliance should be patient friendly
• Appliance should be repairable
• Appliance should be FDA approved
• Appliance requires a minimum of eight healthy teeth on each arch
• Appliance should be designed to connect to CPAP

Classification of Oral Appliances for Snoring and Obstructive Sleep Apnea

Mandibular Repositioning Appliance

Combined Oral Appliance

Tongue Retaining
Device (TRD)


Treatment Protocol for Oral  Appliance Therapy
  1. Medical diagnosis for Sleep Disordered Breathing (SDB) and refer to dentist if appropriate for oral appliance.
      Dentists are not medically qualified nor legally permitted to diagnose sleep disorders.

  2. Patient referred by physician with a sleep study and prescription for an oral appliance.
  3. Dental examination for type of oral appliance or treatment.
  4. Informed consent statement should be signed by the patient before appliance insertion.
  5. Dentist inserts appliance and titrates it to the optimum position.
  6. After adequate titration the dentist refers back to the physician for SDB assessment.
  7. Final resolution of the SDB is determined by the referring physician.
  8. If the medical assessment shows need for more titration then the patient is referred back to the dentist.
  9. In specific cases when the titration fails to achieve the desired results the referring physician may recommend
       an alternate form of therapy.
10. An annual dental assessment is recommended for the SDB since it gets worse over time.  The dental recall        examination evaluates complications, compliance, appliance deterioration and further titration.  Knowledge
       of various appliances is necessary as no one appliance works for all patients.
11. Dentists who treat SDB are encouraged to pursue additional education in this field.

Sleep Apnea Treatment Testimonials...

“I had been diagnosed with severe sleep apnea. I could not use a CPAP machine.
I had emphysema. I had cardiac arrhythmia and high blood pressure. Hospitalized twice, turned blue, have been in the ER many times. I was fitted with an oral sleep appliance.
He literally saved my life”

Royal Oak, MI

Lake Orion, MI Dentist - Dr. Joseph Mastromatteo, DDS, PC
Lake Orion Dental Care & Smile Restoration
Cosmetic & General Dentistry Lake Orion MI
Lake Orion Family Dentistry
Cosmetic Dentist in Lake Orion, MI
Dentist in Lake Orion, Oxford, Auburn Hills, Clarkston, Lapeer, Metamora, Rochester Hills, Troy, Birmingham, Royal Oak