Littleton, CO dentist Dr. Guy Grabiak and team celebrate case study award for long-term healthy results with their patient.
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Yes, There Are Effective Alternatives to CPAP

Mar 22, 2024 | Sleep Apnea / Airway

Sometimes a snore is just a snore. Sometimes it’s a sign of obstructive sleep apnea (OSA), a potentially serious sleep disorder that affects millions. Perhaps you. Perhaps a loved one.

And it isn’t pretty.

This is the sound of the upper airway being blocked during sleep. Breathing temporarily stops. The body’s stress response kicks in to wake you up and get you breathing again. These pauses in breath – known as apneic events – can last from a few seconds to over a minute and may occur hundreds of times per night.

Yes, hundreds.

The chronic deprivation of oxygen and fragmented sleep associated with OSA do more than just make you wake up tired and feel sleepy through the day. They have far-reaching consequences on overall health and well-being. From increasing the risk of high blood pressure, heart disease, stroke, and type 2 diabetes to exacerbating mental health issues like depression and anxiety, the wide-ranging impacts of untreated sleep apnea underscore the importance of recognizing and treating this disorder.

If You Have Obstructive Sleep Apnea, CPAP Isn’t Your Only Treatment Option

For a long time, CPAP was the only real option for treating sleep apnea, and while it’s been a literal lifesaver for many, many people who need it can’t tolerate it. The mask can feel uncomfortable or claustrophobic. Having to tote medical equipment while traveling can seem inconvenient – as can the need to always have access to a power source or needing a backup battery in the event of extended outages.

There can also be negative dental consequences to long-term CPAP use. The force of air can create gaps between teeth, for instance. Or affect the bite. Even possibly contribute to dental implant failure.

Fortunately, CPAP is no longer the only option. Oral appliances, for instance, can be used to hold the jaws and tongue forward, keeping them from falling back as you relax into sleep, blocking the airway. Special appliances can even help redevelop and enlarge an underdeveloped airway, effectively treating one of the root causes of OSA.

And some of the newer options involve no appliance at all. One of these is myofunctional therapy.

Can You Really Treat Sleep Apnea with Myofunctional Therapy?

person showing tongueThink of myofunctional therapy – a/k/a “myo” – as physical therapy for the muscles of the mouth and face. It involves exercises to retrain these muscles, which can improve a person’s bite, breathing, and facial posture. The training targets the soft tissues of the face, neck, and mouth so that optimal tongue position and oral rest posture become habitual.

As you develop healthier orofacial habits, your therapist helps you become more aware of your mouth and face muscles. They’ll give you exercises to complete at home that focus on ideal swallowing, breathing, and resting patterns. Practicing these positions and movements will increase your muscle strength and coordination.

And, yes, it may even reduce symptoms of sleep apnea, according to recent research.

The most recent review of the scientific evidence was published last summer in The Laryngoscope. Through a search of the medical literature, the research team identified 7 randomized controlled trials that met their criteria, involving 310 patients in total – mostly adults.

Compared to those who received sham myofunctional therapy or no therapy at all, those who underwent “myo” showed statistically significant improvements in three key areas:

  • AHI, a measure of how many apneic events a person experiences each hour (an AHI over 5 indicates apnea).
  • Subjective sleepiness, as measured by the Epworth Sleepiness Scale, a common questionnaire used for apnea screening (you can take the test for yourself right now, if you like).
  • Minimum oxygen saturation, a measure of how much oxygen the blood is carrying.

Only one of the 7 studies analyzed focused on children, and in that case, the researchers noted that compliance was poor, and there were no improvements in AHI, minimum oxygen saturation, or snoring frequency.

But this is at odds with an earlier review, which found that myo improved AHI in children even better than it did in adults. Where AHI dropped by about 50% in adults, it dropped 62% in children. Adults also showed improvement in the other measures listed above, as well as snoring.

Finding the Right Sleep Apnea Solution for You

Of course, myo on its own may not be sufficient for everyone with sleep apnea. Often, it’s done in conjunction with oral appliance therapy and other treatments. Ultimately, the right course of treatment depends on the individual’s needs, including the severity of their OSA and its causes, as well as their preferences and tolerances.

For some people, CPAP is fine. For others, myo might be enough. Or oral appliance therapy. Or some combination of therapies.

Next time, we’ll look at another of these alternatives that’s been a real game-changer in the treatment of OSA: Vivos.

lizmar thurber

Noelle Jones

Office Manager

With a robust career spanning over 20 years in the dental sector, Noelle Jones has developed a profound expertise that blends technical proficiency with visionary leadership. Starting her journey as a dental assistant, Noelle has continually expanded her skill set and knowledge base. She pursued higher education at Georgia Perimeter College, where she completed programs in dental lab technology, chairside assisting, and business management. In 2024, Noelle found her perfect match in the professional world at Denver Dentistry, a practice that embraces the principles of biological dentistry. This role not only marks a significant step in her career but also profoundly shifts her perspective on the impact dental health has on the rest of the body. Beyond her professional endeavors, Noelle is an avid adventurer who loves exploring the natural beauty of Colorado. She is on a quest to hike all the "14ers" in the state. When not scaling peaks, she enjoys traveling and cherishing moments with her husband and their three beloved dogs. Noelle's dedication to dental excellence and her commitment to a holistic approach in her field make her a pivotal member of the Denver Dentistry team.

The foundation of providing safe and personalized holistic care begins by getting to know you and your goals for your oral health and overall health, both short term and long term. Dr. Grabiak will then learn about your family’s dental and medical history, along with your dental and medical history. Afterwards, we begin your exam by taking a sample of your saliva (Sillha), checking for seven different biomarkers. That same day, we will send you home with a report showing how you scored in those different biomarker categories.

The head and neck examination is often overlooked by busy clinicians but it is as crucial as an element of the oral cancer examination. Dr. Grabiak begins his exam outside of the mouth by starting with a soft tissue check of the neck and the jaw. A thorough head and neck examination is essential for detecting early skin cancers, any overdeveloped jaw muscles that may be contributing towards bruxism, and enlarged lymph nodes that may indicate an active virus or infection.

After the extraoral exam, Dr. Grabiak begins his extensive intraoral exam. During Dr. Grabiak’s exam he is evaluating the teeth, uvula, mucosal tissues, tongue, floor of the mouth, hard and soft palate, and the oropharynx. Part of this exam includes taking high-definition photos of the mouth, all at different angles so you can see exactly what he is seeing. Our hygienist will then come in and complete a comprehensive periodontal assessment. In some cases, Dr. Grabiak and your hygienist may recommend additional testing to get to the root cause of the evidence of symptoms they are seeing in your mouth. This entire process takes roughly an hour. In some cases, depending on what Dr. Grabiak and your hygienist had found during their exam we will invite you back for a follow-up appointment called review of findings.

In preparation for the review of findings, Dr. Grabiak and your hygienist will take the time to evaluate all of the data that was collected from your examination and testing to determine your specific needs. At your review of findings appointment Dr. Grabiak will sit down with you one on one to review the data that was collected from your appointment, along with any recommendations. This allows you the time to ask Dr. Grabiak any questions that you may have about your treatment recommendations and expectations from treatment.

Jeromy Mulkey

Jeromy Mulkey

Operations Manager

Jeromy earned his Bachelor of Science in Finance from New Mexico State University in Las Cruces, New Mexico. His journey in the dental field began when he moved to Colorado in 2015 from Hannibal, New York, a small town outside of Syracuse. Starting as a patient coordinator in corporate dental, Jeromy quickly advanced to office manager and eventually managed multiple offices for a DSO, including specialty practices over the next 4 years. In 2019, his transition to holistic dentistry at Denver Dentistry began. This transition brought new challenges and a renewed passion for learning about the latest sciences and technologies integrated into their practice. Since starting at Denver Dentistry, Jeromy has enjoyed learning about safe mercury removal (SMART Protocol), airway management, ozone, salivary testing, biocompatibility testing for materials, heavy metals testing, and the systemic and oral health connection. Jeromy currently resides in Littleton, enjoying the proximity to the mountains. Outside of work, he cherishes time spent with his wife and daughter and enjoys activities such as snowboarding, bouldering, paintball, soccer, basketball, camping, and hiking. Jeromy's dedication to delivering exceptional customer service and contributing to the team's mission of bringing more healthy smiles to satisfied patients is at the core of his professional ethos.
Chelsea White

Jazmin Contreras

Dental Hygiene Assistant

A native of Guatemala and raised in Carbondale, Colorado, Jazmin Contreras embarked on her medical journey with a degree in Kinesiology from Colorado Mesa University, where she graduated at the top of her class in 2020. Her early professional life included a significant role in a chiropractic office, where she gained an appreciation for the interconnectedness of whole-body health. This experience laid the groundwork for her holistic view of healthcare. Fluent in both English and Spanish, Jazmin leveraged her linguistic skills as a medical interpreter, greatly enhancing her communication capabilities and deepening her understanding of patient needs and concerns. This role proved essential in her development as a healthcare provider, enabling her to effectively bridge cultural and linguistic barriers in medical settings. Jazmin's career trajectory took a definitive turn when she joined Denver Dentistry. Under the guidance of Dr. Grabiak, she was introduced to an innovative holistic approach to dental care that aligned with her own values and aspirations. It was here that Jazmin found her calling, thriving in an environment that embraced both traditional and alternative medical philosophies. Known for her robust critical thinking and problem-solving skills, Jazmin is passionate about educating her patients on the nuances of holistic dentistry. She is dedicated to demystifying dental care, ensuring her patients not only receive top-notch treatment but also understand the broader implications of oral health on overall well-being. When not at the clinic, Jazmin and her husband indulge in the great outdoors, pursuing activities such as hiking, camping, and kayaking. These adventures not only satisfy their love for nature but also provide Jazmin with a refreshed perspective and renewed energy, which she brings back to her patients and her practice.
lizmar thurber

Lizmar Thurber

Expanded Duties Dental Assistant

Lizmar Thurber is a highly experienced Expanded Duties Dental Assistant, distinguished by her extensive background in both traditional and holistic dental practices. Her educational journey began at the University of Florida, College of Dentistry’s Division of Continuing Education, where she specialized in Expanded Duties of Dental Auxiliary Personnel, Radiological Health, and Safety in 2002. She further enhanced her credentials by earning a Bachelor of Science in Biology with an emphasis in Pre-Medicine from Grand Canyon University in Phoenix, Arizona, in 2015. In her role, Lizmar leverages a robust skill set tailored to holistic dental care. She has a profound understanding of holistic health practices and is skilled in using biocompatible materials for dental procedures, such as fillings and crowns, to reduce toxicity. Her empathetic demeanor and excellent interpersonal skills are pivotal in alleviating patient fears, thereby creating a comforting and reassuring environment. Known for her bilingual proficiency in English and Spanish, Lizmar effectively communicates with a diverse patient base, providing clear explanations of holistic dental treatments and procedures. Lizmar's exceptional communication abilities and her capacity to adapt to various treatment modalities are essential in navigating the unique aspects of holistic dental care. Her versatility and adaptability make her an invaluable asset to any dental team, enhancing patient care with a comprehensive, patient-centered approach. Beyond her professional endeavors, Lizmar cherishes the time spent with her family. Together with her husband, and their sons, she actively participates in various sports activities. They frequently travel for the Colorado Prospects baseball club and engage in other sports like basketball and soccer. Additionally, Lizmar serves her community as a worship pastor, where she shares her passion for music and guides others in their spiritual journey with Christ.

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