Sleep disorders and snoring are prevalent, are detrimental to quality of life with serious health consequences and are often undiagnosed and untreated. Although CPAP is still considered the Gold Standard of treatment for obstructive sleep apnea (OSA), not everyone can tolerate or are able to comply with that therapy. For those people we may be able to offer an alternative treatment with an oral appliance. Working closely with your sleep doctor, medical providers and medical insurance we can offer a comprehensive treatment with oral appliance therapy.
If you have been referred to our office for treatment or are coming in for a pre-treatment assessment:
Your visit to our office will include a thorough history and head, neck and throat evaluation to assess your situation. This information is correlated with testing to establish an accurate diagnosis and determine the appropriate treatment options. We will coordinate your care with your sleep physician and dentist to help resolve the snoring or apnea condition.
The treatment option we offer is oral appliance therapy (OAT). Based on your specific circumstances, oral appliance therapy can be a very effective solution for treating snoring and sleep apnea.
What is Obstructive Sleep Apnea (OSA)?
Obstructive Sleep Apnea (OSA) is a chronic sleep disorder in which you have pauses in breathing or shallow breaths while you sleep. This sleep disruption can contribute to or cause health problems that can affect the quantity or quality of life.
Symptoms & Risks of Obstructive Sleep Apnea
Different people have different symptoms of sleep apnea, some mild and others more severe. Common sleep apnea symptoms include:
- Associated diseases such as diabetes, heart problems, high blood pressure, obesity and stroke
- Daytime sleepiness or fatigue
- Difficulties with memory and concentration
- Disturbed sleep
- Impaired emotional functioning
- Loud, disrupted snoring
- Morning and daytime headaches
- Pauses in breathing
- Sleepiness while driving
- Unusual moodiness or irritability
Oral Appliance Therapy (OAT)
An oral appliance is a small acrylic device that fits over the upper and lower teeth or tongue (similar to an orthodontic retainer or mouth guard). This device holds the jaw in place or slightly advances the lower jaw or tongue, moving the base of the tongue forward and opening the airway. This improves breathing and reduces snoring and apnea. The appliance is fabricated and customized for each patient by a dentist with advanced training in the treatment of snoring and sleep apnea. The appliances are typically comfortable and well tolerated by the patients. They are relatively easy to place and remove, easy to clean and are convenient for travel.
Indications for Oral Appliance Therapy (OAT)
The American Academy of Sleep Medicine has stated that an oral appliance is indicated as a first treatment of choice for patients with primary snoring, mild obstructive sleep apnea (OSA) or patients with moderate obstructive sleep apnea (OSA) who prefer the appliance to CPAP, and as a second treatment option for patients with severe sleep apnea who cannot tolerate CPAP.
Therefore, oral appliance therapy is indicated for:
- Primary/heavy snoring
- Mild or moderate sleep apnea and certain cases of severe OSA • Poor tolerance of nasal CPAP
- Failure of surgery
- Use during travel
- In combination with nasal CPAP
Possible Side Effects of Oral Appliance Therapy
There are a number of temporary side effects that may be noticeable during the first few weeks or may require minor adjustment of the appliance by the dentist. These include:
- Tension in the jaw
- Sore teeth or gums
- Excessive salivation or a dry mouth
- Temporary change in the bite when appliance is removed in the morning
- Noises in the jaw joint (TMJ)
The potential side effects that can be more problematic include:
- Jaw muscle or joint pain
- Permanent changes in the bite
- Slight movement of teeth
- Loosening of dental restorations (crowns, bridges, etc.)
Like all treatments, success is not guaranteed but we will make our best effort to maximize the potential benefit and minimize the potential side effects.
Long-term care and benefits
Since sleep apnea is a long-term chronic condition, the treatment is an ongoing process that requires a commitment by both the patient and the provider. Treatment with an oral appliance is more than a “fit it and quit it” approach to care. In order to provide comprehensive care and achieve optimum results and minimize and manage possible side effects, it is important to recognize that long term benefit requires long term care. I look forward to working with you to provide the care that you need to attain the health that you expect. I am committed to your care.