If you or someone you know has been diagnosed with mild to moderate obstructive sleep apnea, then we may be part of the solution to help treat this disorder.
Oral appliance therapy (OAT) is indicated in patients with mild to moderate obstructive sleep apnea, and those with severe apnea who are unable to use nasal CPAP. Oral appliances maintain an open airway by repositioning the jaw forward. The appliances are worn in the mouth as you might wear an orthodontic retainer or sports mouth guard.
Oral appliances are also used in combination with surgery, weight loss, and traditional CPAP therapy to treat apnea.
Before any treatment options can be determined, a sleep study must first be performed to determine the severity of one’s symptoms as it can have a direct influence on the recommended therapy.
The most common form of therapy is continuous positive airway pressure (CPAP) devices, which blow a steady stream of pressurized air through a mask into the respiratory system. For moderate to severe sleep apnea patients, most sleep professionals will recommend CPAP therapy as a first-line treatment option.
For mild to moderate sleep apnea, a dental device can often be the recommended therapy. Dental devices may also be recommended to be worn in conjunction a CPAP device to help increase the efficacy of the CPAP.
Who qualifies for dental appliances?
• Patients with mild to moderate sleep apnea (not recommended for severe sleep apnea, except if OK’d by sleep physician)
• Patients with primary snoring (in absence of sleep apnea)
• Patients who have tried and failed at CPAP therapy
• In combination with CPAP device to help lower patient’s apnea/hypopnea index for more tolerable air pressure settings.
How do dental appliances work?
There are two major categories of dental devices:
1. Mandibular advancement devices (MADs)
2. Tongue Retaining Mouthpieces
MADs used to treat sleep apnea look very similar to sports mouth-guards or orthodontic retainers. They fit into the mouth by snapping over the upper and lower dental arches and have a connecting component that links the two pieces: one fits over the upper teeth, and the other fits over the lower teeth.
MADs work by moving the lower jaw and tongue slightly forward, which helps prevent throat muscles and tissues (such as the pharynx and tongue) from collapsing back into the airways allowing for normal breathing during sleep. Most MADs are adjustable, allowing for us to fine-tune the position of the jaw for maximum effectiveness.
Tongue retaining mouthpieces are similar in construction to the MAD, but have a small compartment that fits around the tongue using suction to keep it held forward, preventing it from collapsing back into the airway. These devices are mostly used in patients who cannot adequately have their jaw repositioned forward.
Making/fitting the device
We make a custom fitted oral device to suit your particular needs. Over-the-counter options are available, but not recommended. Over-the-counter devices may be appealing because of their reduced prices, but can actually complicate sleep apnea, and many are not effective in treating the apnea.
Pros of Dental devices
• Many patients find dental devices to be more comfortable and tolerable to wear as opposed to CPAP masks.
• Patients on CPAP often complain of dry, itchy noses from the air pressure drying out their sinuses. Oral devices do not have this problem.
• There is less equipment in which to become entangled with during sleep
• There is a lot less equipment, and therefore easier to travel.
Cons of Dental devices
• Potential jaw pain, soreness, or tension
• Sore teeth and/or gums
• Excessive salivation or even dry mouth
• Possible damage or permanent change to jaw position/bite
• Loosening of dental restorations (crowns, bridges, etc)
If you’re concerned you may have sleep apnea, you should contact your local sleep clinic to schedule a consultation with a sleep specialist or talk with your primary care physician about your sleep troubles. Be sure to ask them about all of the available treatment options including CPAP and dental devices and inquire which may be best suited for you.