Oral Appliance Therapy for Snoring and Sleep Apnea: an Alternative to CPAP
The underlying principal that makes oral appliance therapy effective is the same thing that guides emergency care givers who are offering mouth to mouth. During mouth to mouth, the patients’ head is positioned back with the jaw forward to ensure the airway is clear, allowing breath to reach the lungs. Oral appliances use this same method to position the jaw forward, keeping the airway open during sleep.
Similar in appearance to an athletic mouthguard or retainer, oral appliances are uniquely crafted to fit each patients’ smile. Our skilled lab creates a comfortable custom appliance, and Dr. Clark and his team work one on one to ensure the most comfortable fit and maximum effectiveness. Oral appliances are easy to wear, clean, and transport easily in a compact protective case. CPAP intolerant patients love the comfort and portability of oral appliances compared with bulky CPAP systems.
What Should I Expect with an Oral Appliance?
In most cases, sleep apnea sufferers adjust quickly to oral appliance therapy, especially compared with CPAP systems. In most cases, patients only notice some minor discomfort during their adjustment period, including:
- Tightness, grinding, clenching, or a clicking jaw, which may limit jawbone mobility briefly
- Soreness in the teeth or gums
- Drooling or dry mouth
- A feeling of a slightly misaligned bite, making chewing and speaking feel different for the first few hours after waking
In most cases, these symptoms are significantly reduced, if not completely alleviated, after a few nights of consistent oral appliance usage.
Recommendations from the AASM and the AADSM
There are two professional organizations that provide guidance, training, and standards of care for sleep apnea: The American Academy of Sleep Medicine (AASM), and the American Academy of Dental Sleep Medicine (AADSM). Dr. Marks’ goal is always to meet these standards, and whenever possible, exceed them so that we are able to offer the highest quality treatment options. The AASM and AADSM standards recommend patients seek sleep apnea treatment from their dentist in a number of situations, including:
- Patients who suffer from loud, nightly snoring may want to consider oral appliance therapy even if they are not diagnosed with sleep apnea. Work with a dentist to design and place a custom appliance to reduce or end instances of snoring.
- If a sleep doctor recommends oral appliance therapy, it is always best to visit a dentist who has training in dental sleep medicine to receive a quality, custom appliance. These personalized, titratable appliances are comfortable and effective, especially when compared with other non-custom appliances, improving patient compliance significantly.
- For those patients who are CPAP intolerant or who fail to stay in compliance using CPAP, sleep physicians should encourage patients to seek treatment from a dental specialist who can craft a custom oral appliance to relieve sleep apnea.
- If a sleep physician or other medical professional does have an oral appliance created, patients should schedule a follow-up appointment with a dental practitioner qualified to offer sleep apnea treatment. This allows the dentist to ensure the oral appliance is not having adverse effects on the teeth or bite alignment and that function remains unimpeded.
- Following the placement of an oral appliance, patients should continue with additional sleep testing and follow up appointments to ensure the efficacy of treatment. A sleep dentist is typically able to provide these follow up treatments.
- Ongoing treatment is essential to the successful treatment of sleep apnea with CPAP, oral appliances, or combined therapies. Regardless of the treatment options, patients should have a plan in place for follow-up care with their dentist and/or sleep doctor.