Oral appliance therapy presents a less intrusive and cheaper alternative for many sleep-related breathing disorders. If necessary, oral appliance therapy can be combined with more conventionally used therapy to enhance the effectiveness of these treatments. Better yet, it allows people to continue their lives much more normally while providing long-term relief.
Oral appliances work in several ways:
- Repositioning the lower jaw, tongue, soft palate and uvula
- Stabilizing the lower jaw and tongue
- Increasing the muscle tone of the tongue
Dr. Forsmark is trained in oral appliance therapy and is familiar with the various designs of appliances. He can determine which one is best suited for your specific needs. Dr. Forsmark will work with your physician as part of the medical team in your diagnosis, treatment, and on-going care. Determination of effective treatment can only be made by joint consultation of your dentist and physician. The initial evaluation phase of oral appliance therapy can take from several weeks to several months to complete. This includes examination, evaluation to determine the most appropriate oral appliance, fitting, maximizing adaptation of the appliance and the function.
Treating sleep apnea
Oral appliances are extremely effective in managing obstructive sleep disorders because they position the lower jaw and tongue in a more forward position during sleep. As the tongue moves forward, the airway opens up, making breathing easier.
No one technique is effective for everyone; however, the American Academy of Sleep Medicine recommends oral appliances as a first line therapy for the treatment of mild to moderate sleep apnea and for those severe sleep apnea sufferers whose CPAP treatment has failed.
Acceptance rates of oral appliances versus CPAP
Anything new and different in the mouth takes getting used to, but in a recent study, 91 percent of sleep apnea patients who were treated with an oral appliance were still using their appliances comfortably at the end of one year. In comparison, CPAP compliance is less than 50 percent. Studies show that if patients are given a choice in treatment, the overwhelming majority will choose oral appliance therapy over CPAP.
Treatments for "simple" snoring and Upper Airway Resistance Syndrome (UARS)
Oral appliance therapy is an excellent way to treat both "simple" snoring and UARS. Remember that even "simple" snoring can disturb sleep quality of the snorer and the bed partner alike! Oral appliances treat "simple" snoring in much the same way as the more serious disorders. The jaw is held in a more forward position during sleep and the airway in the back of the throat opens up. As a result, the annoying vibration or snoring stops and peaceful sleep can resume.
There is considerable evidence that the intense vibration in the soft palate caused by snoring initiates an inflammatory response in that tissue. It is suspected that, over time, this chronic tissue inflammation induces swelling and causes "simple" snoring to deteriorate into more serious disorders. Oral appliance therapy reduces or eliminates the swelling by stopping the vibration.
Why not buy an over-the-counter-mouthpiece?
You have probably seen mouthpieces advertised on TV or for sale at your pharmacy. The principle is the same, but these OTC mouthpieces don’t work for most people because they are basically a one-size-fits-all solution. To be effective, you need an oral appliance that is custom fit for your mouth and that addresses your individual reason for snoring. OTC mouthpieces can also cause dental damage and/or TMJ, because they are not designed to work precisely with the alignment of your teeth and jaw. Over time, if you actually continue to wear them, they can cause you to hold your jaw in a strained position, creating long-term problems.
When you see Dr. Forsmark for your snoring, he will work closely with your doctor and sleep specialist, learning all of the details of your personal snoring habits, including the cause and severity. Impressions are taken, and your oral appliance is created not only to address why you snore, but to fit your teeth and mouth perfectly. This means more comfort, compliance, and a better working device. It also prevents damage to your teeth and jaw.
Is it really that important?
Unfortunately, yes. Long-term snoring can cause serious health problems from sleep deprivation lone, and OSA can be deadly. During an OSA event, your blood-oxygen level dips dangerously low. This is why you wake up or partially wake up. The many dangers of OSA include: Abnormal heart rhythm, Heart disease, High blood pressure, Heart attack, Stroke, Diabetes, Insomnia, Headaches, Sleep deprivation, Sexual dysfunction and Depression.
Sleep deprivation itself is not to be taken lightly. Long-term sleep deprivation has mental and physical side effects including: Daytime sleepiness, Falling asleep while driving, Low productivity, Irritability, Depression, Irrational thinking, Memory problems, Difficulty concentrating, Slow reaction time, Hallucinations and a Depressed immune system.