Advancements in medicine have increased life expectancy. Nevertheless, several new challenges remain in improving quality of life.
With aging come physiological, psychological, and physical changes—one of them being tooth loss. Although this is now less frequent than in the past, it remains a significant concern.
Sleep in older adults has specific characteristics. Many develop the habit of taking naps during the day, which can lead to more superficial sleep at night. Their morning chronotype also becomes more pronounced, they go to bed early and, therefore, wake up very early. To help modify these habits, it is important to implement good sleep hygiene practices, and, in some cases, prescribe temporary medication to help them achieve restorative sleep.
Obstructive sleep apnea (OSA) tends to worsen with age.Pharyngeal muscles become looser and less responsive to the action of dilator muscle groups during sleep. Additionally, the adverse effects of certain medications—commonly used at that age—can compromise sleep quality.
Edentulism alters facial anatomy, reduces vertical dimension, increases joint rotational movement, promotes tongue hypertrophy, and reduces retropharyngeal space. Combined with aging, these factors increase the risk of developing sleep apnea.
Today’s study evaluated the use of complete dentures and their impact on sleep apnea. A total of 77 patients underwent a polysomnography and completed several questionnaires, both with and without dentures. Results showed an improvement in oxygen saturation when patients slept without their dentures. There was also a decrease in the apnea-hypopnea index, with the most significant improvements observed in patients with moderate to severe sleep apnea. It is important to note that sleep apnea should be treated using validated methods. While removing the dentures during sleep may enhance polysomnographic parameters, this measure alone is usually not sufficient for effective long-term management of the disorder.
Other studies have also reported positive results; however, some have yielded conflicting findings.
Removing dentures before going to bed also promotes better oral hygiene. Saliva plays an important role in clearing food residue and controlling bacteria. Therefore, this habit reduces the risk of inflammation, tissue injury, changes in gum texture, and bone resorption.
The treatment for sleep apnea in partially edentulous patients (e.g., missing upper teeth but retaining lower teeth or a lower denture), may include oral appliances. The bimaxillary device, composed of two independent plates, has shown excellent results.
For completely edentulous patients, CPAP remains the most recommended therapy. Mild cases of apnea may also benefit from the use of a tongue-retaining device.
By Dr. Walter Silva Júnior
Sleep dentist certified by the American Board of Dental Sleep Medicine (ABDSM).
Ph.D. in Sleep Medicine at the Hospital for Rehabilitation of Craniofacial Anomalies/University of São Paulo – Bauru, São Paulo.
Website: http://www.institutowaltersilva.com.br/
Instagram: @walter_silva_odontologiadosono
REFERENCE: Effects of nocturnal wearing of dentures on the quality of sleep and oral-health-related quality in edentate elders with untreated sleep apnea: a randomized cross-over trial
Elham Emami, Gilles Lavigne, Fernanda R. Almeida et al.
SLEEPJ, 2021, Vol. 44, No. 10
The Biologix Sleep Test®
Diagnosing obstructive sleep apnea is both simple and essential.
The Biologix Sleep Test® is a remote polysomnography that monitors oxygen saturation, heart rate, actigraphy, and snoring using a smartphone microphone.
Designed for at-home use, this test offers a simple yet effective method for healthcare practitioners to diagnose and monitor sleep apnea.
At bedtime, the patient only needs to place the sensor on their finger and start the test in the Biologix app. Upon waking up the next morning, after finishing the test, the result will be available at the exam portal in a matter of seconds.
