Despite the fact that continuous positive airway therapy (CPAP) is the most highly recommended treatment regimen for patients suffering from obstructive sleep apnea, not every patient has the ability to remain compliant to CPAP therapy. A plausible alternative for CPAP therapy for the treatment of sleep apnea is the use of oral appliances; this will however depend on the severity of a patient’s sleep apnea. Apart from being effective in the treatment of moderate sleep apnea, oral appliance therapy is also a great treatment option for snoring.
Here is a brief but detailed simplified guide that will help gain a clearer understanding of this life-changing and innovative treatment regimen.
What is an oral appliance and how does it work in treating sleep apnea and alleviating snoring?
These are dental appliances that come in handy in relieving moderate or mild obstructive sleep apnea; these devices also help eliminate snoring. They are worn when asleep and typically fit like an orthodontic retainer or a sport mouth guard. Oral appliances essentially work by supporting a patient’s jaw to help ensure the upper airway remains open.
There are currently 2 main categories of oral appliances used in the treatment of snoring and obstructive sleep apnea;
Mandibular advancement devices
Also known as MAD, this type of oral appliance looks very similar to an orthodontic retainer. Such devices fit into the mouth by snapping over the lower and the upper dental arches. They have mental hinges that connect the two pieces; the piece that’s fits over the lower teeth and another piece that fits over the upper teeth.
Mandibular advancements oral appliances work by pushing the tongue and the lower jaw slightly forward; this helps in preventing tissues such as the pharynx and throat muscles from collapsing hence the airway stays open. Most models are adjustable meaning the dentist can fine-tune the position of the jaw to ensure optimum effectiveness.
Tongue retaining mouthpieces
These are similar in construction to the mandibular advancement devices. The only difference is that tongue retaining mouth pieces have a very small compartment that fits perfectly around the tongue using suction. These type of oral appliance is very effective in treating patients who cannot adequately have their jaws re-positioned forward during sleep.
Procedure for acquiring an oral appliance device
If a sleep specialist ascertains that oral appliance therapy is the most suitable treatment option for you then your doctor will write you a prescription for a custom-made device that fits seamlessly. Additionally, you will also be referred to a knowledgeable and experienced dentist who will provide you with oral appliance therapy.
Oral appliances are typically customized using physical or digital impressions of patient’s teeth. The digital or physical models are sent to a dentist where the oral appliance is custom made. The great news is that the FDA has approved over 100 oral appliances so you have a wide variety to pick from. More great news is that most medical insurance plans currently cover oral appliance therapy.
Patients that qualify for oral appliances include;
- Patients suffering from moderate obstructive sleep apnea (this treatment regimen is not recommended for patients with severe sleep apnea)
- People experiencing primary snoring even in the absence of sleep apnea
- Patients who find CPAP uncomfortable or have tried and failed at it
- Some sleep specialists use it in combination with CPAP therapy to help lower the hypopnea index so more tolerable air pressure settings.
Are follow-up visits necessary?
Absolutely, you will need to visit your dentist routinely to ensure the oral appliance is perfectly fitted. Most dentist typically schedule annual assessments to ensure long-term success of this treatment regimen.
Is there any home care required to look after an oral appliance?
To ensure your oral appliance functions optimally you need to brush and floss your teeth before putting on the oral appliance every night. This is to ensure plaque does not build up on the appliance.
Advantages of using oral appliance in the treatment of obstructive sleep apnea and snoring
- Oral appliance therapy is not only effective but also non-invasive and free from detrimental side effects.
- Oral appliance therapy is comfortable, easy to stay compliant with and convenient for travel.
- Oral appliances are more tolerable and comfortable to wear as compared to CPAP masks that most patient find uncomfortable and intolerable.
- Since there is less equipment to become entangled when a patient is asleep, you are allowed to sleep peacefully even if you are an active mover during sleep.
- The oral appliance will help you feel like a new person and you will find that most of your symptoms will disappear and your energy levels and level of alertness will dramatically improve.
- If you remain diligent and committed to this treatment regimen then you will start sleeping more peacefully and for longer not forgetting those frustrating snores that inconvenience your bed partner will also be a thing of the past.
CONS of oral appliances
- Some patient experience soreness, tension and jaw pain especially in the beginning
- Dry mouth and excessive salivation is a common side effect
- If used for extended periods of time, there is a risk of possible damage or even permanent change to the jaw position
- Although rare, there have been reports of loosening of dental restorations (bridges, crown e.t.c)
A custom-fit oral appliance can significantly improve your quality of sleep, alleviate snoring, revitalize your health and boost alertness.