Sleep Apnea

Massachusetts Dental Society

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Don't Lose Sleep Over Sleep Apnea

OSA/Sleep Apnea Symptoms
In a study conducted at Stanford University in California, one out of three chronic, severe snorers was found to have a harmful degree of sleep apnea. Snoring, although harmless, may be a sign of obstructive sleep apnea (OSA). Daytime symptoms of OSA may include excessive drowsiness, irritability, difficulty in thinking clearly, and falling asleep. OSA is a serious medical condition and may have a serious impact on the cardiovascular system. It may also contribute to elevated blood pressure. Diagnosis and treatment of such a disorder should involve a joint effort between a physician (preferably a pulmonologist, otolaryngologist (ENT), or sleep specialist) and a dentist with specialized advanced training in this area.

When symptoms are severe, treatment options may include: surgery to the nose, throat, or tongue. Nonsurgical therapies might include air compression devices, and nose masks to force the airway open and aid breathing during sleep. Oral appliance therapy, can also be an effective way of treating snoring and OSA for many patients. Following an examination and prescription by your OSA physician, an MDS dentist can provide oral appliance therapy employed on its own, or in combination with other methods of treatment.

Oral Appliance Therapy
An oral appliance is a small plastic device, similar to an orthodontic retainer or an athletic mouthguard. It is worn in the mouth during sleep to prevent the soft throat tissues from collapsing and obstructing the airway. Dentists with training in oral appliance therapy, in consultation with their patient’s physician, can design, construct, and fit these special appliances to meet their patient's individual situations and conditions.

In recent clinical studies, physicians and dentists have found that, in a majority of patients, a well-made, well-fitted oral appliance will effectively reduce or eliminate snoring, and significantly help symptoms of mild and moderate OSA. Oral appliances work by bringing the lower jaw forward by holding the tongue forward and then by lifting a drooping soft palate. A combination appliance may perform two or more of these functions at the same time.

Oral appliance therapy offers many advantages. Oral appliances are relatively small and easy to wear. They weigh only a few ounces and are easy to travel with. Most people become completely comfortable wearing the appliance within a few weeks. Oral appliances are relatively inexpensive, the total cost of therapy being considerably less than the cost of alternative treatments. Treatment with an oral appliance is reversible and non-invasive. 

If you snore heavily and are interested in trying oral appliance therapy, it is important that you are first thoroughly examined by your physician or a sleep specialist. The examination may involve staying overnight at a sleep study center. This is important because you may have sleep apnea without realizing it.

On your first visit, the dentist will thoroughly examine your teeth and mouth, with the aid of x-rays and dental molds. You may then be fitted with an appliance, which you will take home and try out for a week. Over the next few weeks, if necessary, you may try out other types of oral appliances. Finally, your dentist will design and fit your custom-made appliance.

After two or three months of regular use during sleeping hours, your dentist will refer you back to your physician or sleep specialist to determine how effectively the appliance is controlling your snoring and OSA. You will continue to visit the dentist at regular intervals, and he or she will work with you to modify and maintain your oral appliance so that it remains effective.