May 2019 DSM Insider 32 - Page 20

SAMUEL CRESS, DDS O MYOFUNCTIONAL APPLIANCE THERAPY & THE TREATMENT OF OBSTRUCTIVE SLEEP APNEA ral Appliance Therapy (OAT) and Mandibular Advancement Devices (MAD) are used for the treatment of Obstructive Sleep Apnea (OSA) with successful results. Usually, appliance therapy involves holding the jaw and tongue in an anterior position resulting in an open airway thus reducing the number of apneic and hypopnic events. Maintaining this forward position for an average of 7 hours per night, 365 days a year may inflict trauma to the TMJ, stretching musculature, and resulting in malocclusion. The tongue is a sizeable contributor to OSA. What do we know about the human tongue’s role in the oral cavity? The tongue provides a crucial role in chewing and swallowing food. It also enables speech and vocalization in humans. How does it do that? The tongue is totally trainable. In fact, that’s how we learn to speak. The process involves a complex coordination of moving air from our lungs in synchronization with the larynx, palate, jaw, tongue, and lips to form vowels and consonants that express sounds that are a translation of thoughts originating in the neural network of the brain. What if a new approach is taken to “train” the tongue to stay in a specific position during sleep while at the same time maintaining airway patency? The science of “tongue training” is known as Myofunctional therapy. Myofunctional therapy is an area of dentistry that focuses on normalizing the space in the oral cavity by ‘re- educating’ or ‘re-patterning’ the oral and facial muscles, primarily the tongue. If we are able to hold the jaw in a natural and comfortable position and train the tongue to stay forward we have achieved the same result for the treatment of OSA without some potential side- effects such as TMD and malocclusion. the mandible in an anterior position, the Meridian PM integrates Myofunctional therapy into the treatment for OSA. The Meridian PM holds the jaw in its natural and comfortable position while training the tongue to stay forward in its proper position. The Meridian PM provides an excellent, effective treatment option for OSA that translates to improved overall quality of health. SAMUEL CRESS, DDS Meridian PM The Meridian PM represents a revolutionary development in OAT. Unlike traditional oral appliances that maintain an open airway by holding Samuel E. Cress, D.D.S., director of The Center for Craniofacial & Dental Sleep Medicine in Sugar Land, TX. He completed his Doctorate of Dental Surgery from the University of Texas Health Science Center, San Antonio, Dental Branch. Dr. Cress also completed his residency in Dental Sleep Medicine at Tufts University School of Dental Medicine in Boston and his residency in TMD through the American Academy of Craniofacial Pain.