Oral Appliance Therapy

A dental device could be the simple answer for treating your snoring or sleep apnea.

Oral appliance therapy is the use of an appliance (somewhat like an orthodontic retainer) that fits in the patient’s mouth and pulls the lower jaw forward to open the airway during sleep. These appliances can vary in design, but all have the same purpose in the end--to assist in maintaining an open airway for the patient while they sleep.

How does an oral appliance (dental mouthpiece) work?

The principle behind which an oral appliance works is not new. During the 1930’s the first oral appliance to keep the lower jaw forward and assist in airway patency was used. In the 1970’s the surgical procedure to move the lower jaw forward was developed. In the 1980’s the Tongue Retaining Device was developed and is still used on selected cases. Only recently have the adjustable mandibular advancing oral appliances been developed and utilized. Although there are a number of mandibular advancing devices, they essentially are striving to do the same thing. That is:

1. Move the lower jaw, tongue, soft palate, and hyoid bone into a position to help create a more open airway.
2. Help to prevent airway closure during sleep by stabilizing the tongue, mandible, and hyoid bone.
3. The appliance gives the tongue muscles an artificial muscle tone. This increased muscle tone makes the tongue less likely to relax and cover the airway during sleep.

As oral appliance therapy has become a real entity for the treatment of snoring, sleep apnea, and upper airway resistance syndrome, more dentists will become trained in this treatment modality. A patient should expect the dentist to be well-educated in this form of treatment. As this therapy works hand-in-hand with the medical community, your treating dentist has to be aware of the medical ramifications of snoring, apnea, and upper airway resistance syndrome. The dentist must also be familiar with all of the types of therapy to treat snoring and sleep apnea. This includes surgery, c-pap, oral appliance therapy, and any combination of these treatments. Standard of care now dictates that some form of follow-up testing must be performed to verify a patient's treatment success or failure. This can range from an overnight oximetry to an overnight sleep study. Symptoms alone are not always an accurate gauge for treatment success.

Not only am I a clinician that is actively treating the simplest of snoring patients to the virtually untreatable severe sleep apnea patient, I am also a sleep apneic myself. I have worn the Thornton Adjustable Positioner for seven years now. This is only one of many oral appliances that doctors can and do use. I not only look at the treatment scenario as a doctor, but also a patient.