Treatments

Getting to the root cause before treatment begins

A comprehensive evaluation is essential before beginning any treatment. This may include clinical photographs, precise measurements, imaging (such as X-rays), and sleep studies to ensure an accurate diagnosis. Understanding the root cause is key to effective care. Whether you present with sleep-related breathing issues or chronic pain, our assessment process always considers both—recognising the strong connection between sleep disorders and craniofacial pain.

Treatments

Oral Appliance Therapy (OAT)

A thorough evaluation is needed prior to any treatment which may include photos, measurements, x-ray imaging and sleep studies. This is of most importance to achieve an accurate diagnosis, so we know what we are treating. Whether one presents for sleep breathing problems or chronic pain, our evaluation process will always look and evaluate both due to the highly overlapping nature between pain and sleep.

Continuous positive airway pressure (CPAP)

Continuous positive airway pressure (CPAP) machines work by blowing air at higher pressures to hold the airway open while you sleep. This is currently considered the gold standard for treatment, as with high enough pressure, it can over come almost all obstructive sleep apnoeas during the night. However, due to the high pressures needed, a number of patients find the units uncomfortable to live with and take with them on holidays. Latest research in the field are now focused on the term ‘precision medicine’, which means that obstructive sleep apnoea may have many underlying causes, and only by finding the reason behind the obstructive sleep apnoea, the treatment can be a lot more personalised, rather than a blanket approach to treating everyone with the same thing.

NightLase® therapy

Fotona’s NightLase treatment is a new approach in the management of snoring. It uses gentle heating which helps rejuvenate the collagen fibres of the soft palate. Like all of the treatments, there is no one approach that may suit everyone as there are many factors which need to be taken into consideration.

Breathing retraining

Although snoring/sleep apnoea make themselves visible during the night, dysfunctional breathing is said to effect us day and night, so in these situations, addressing the night time cause only may not help us during the day. Mouth breathing or hyperventilation for example causes our carbon dioxide levels to drop, a close analogy is leaving the lid off a bottle of soft drink over night, the carbon dioxide will escape and the drink will become flat. Carbon dioxide is extremely important to our functioning, for example the oxygen only leaves your blood and enters our tissues where the level of carbon dioxide is high enough. Have you noticed, while blowing up many balloons you may become dizzy. This is not because you have no oxygen, in fact, you have plenty of oxygen. The problem is the oxygen is not being offloaded to the cells, and rather it is just staying in the blood because you are breathing out too much carbon dioxide. Breathing retraining is a training method to help improve breathing with the intention of raising your carbon dioxide levels if they are low.

Tongue ties

Oral restrictions (such as tongue ties or lip ties) are one of those things which can go undetected if one doesn’t know what to look for. These restrictions can cause a number of issues at any age, and everyone can present differently as the body has an amazing ability to compensate for anything not right. In infants, tongue ties can lead to symptoms such as difficulty breastfeeding, reflux, colic and even links exist to sudden infant death syndrome. As a child, oral restrictions may be linked to mouth breathing, poor jaw development, obstructive sleep apnoea and difficulties with speech. As an adult, it may be linked again to obstructive sleep apnoea, may be a cause of tension/tightness in the neck and shoulders and of course if previously undetected, difficulties with speech. Of interest to note, someone may have a severe tongue tie and be able to stick their tongue out. The importance which is often over looked is the ability to elevate the tongue rather than stick it out. It is actually the tongue being held down which accounts for a lot of the symptoms listed above.

Myobrace – MyoMunchee – myofunctional exercises

Your teeth and jaws are positioned where they are due to an overall balance of forces. It only takes approximately 2 grams of force to move a tooth, assuming the force is there for a long time. Lips can exert around 200g and the tongue can exert around 500g. If these muscles, amongst other muscles, are not functioning correctly, they prevent the jaws from developing correctly, and the teeth end up in an incorrect position. Myobrace along with myofunctional activities are exercises for your facial muscles to strengthen them and also retrain them to function correctly. For example, if we see a tongue sitting in the roof of the mouth at all times (except while speaking and eating), that constant pressure on the palate will stimulate growth. If the tongue therefore sits low, the palate has no stimulation so growth will be less than ideal. Another example can be seen with swallowing. During a normal swallow, none of your facial muscles should move. If we need the lower lip or cheek to create a seal during a swallow, this continual activation of these muscles throughout the day will restrict the outward growth of the jaws, preventing ideal development.

Watch the video from Dr Barry Raphael from the USA talking about Myobrace and the importance of addressing function.

Craniofacial growth and development

Proper development of the skull and jaws is critical to proper development of many other systems. The cranium is made of 28 bones which all fit together like a big jigsaw puzzle. If one bone is distorted, it can lead to distortions of the other bones. The teeth are sitting in 5 bones, so if 5 bones are distorted, you can only imagine the effects on the rest of the cranium. The other thing to look at is our airways. Breathing is the most crucial thing we do. Jaws which are set back or narrow will reduce the airway, predisposing the person to breathing disorders. We love to see infants from as young as a few days old as the sooner we can recognise and address any potential dysfunctions, the earlier we can try intercept setting the pathway for a healthy development.

Watch the video from orthodontist Dr Derek Mahony in Sydney talking about craniofacial growth and development.