SLEEP & CPAP CENTER
If you struggle with snoring or obstructive sleep apnea, wearing a custom dental device may be your best option for peaceful sleep. Oral appliances that treat snoring and apneas are small custom dental devices worn in the mouth similar to custom sports guards or orthodontic retainers.
These devices are professionally fitted by dentists educated in sleep disorders and dental sleep medicine. This CPAP alternative is a non-surgical treatment for obstructive sleep apnea for patients with mild to severe sleep apnea.
In most cases, an oral appliance device becomes as effective as a CPAP and eliminates the need to rely on a CPAP nightly. Sometimes, however, patients with severe sleep apnea combined with other medical conditions qualify for the oral appliance but may need to supplement their therapy with a CPAP at a low pressure.
Oral sleep appliances or mandibular repositioning devices (MRD’s) work by repositioning and stabilizing the jaw in a forward position and/or upward position. This mechanism can prevent muscles and tissues from collapsing back into the airway which causes airway obstruction resulting in snoring and apnea.
Most patients find oral appliances far more comfortable and less cumbersome than CPAP therapy, a common treatment option for obstructive sleep apnea. When successful, oral appliances vastly improve the quality of life and improve relationships. Positive results include:
Most insurers and Medicare do cover an oral appliance. Documentation, paperwork and coverage of an oral appliance device can vary by the insurer. The minimum documentation required may be a copy of a recent sleep study showing you have sleep apnea, sleepiness questionnaire, clinical notes from the sleep apnea screening appointment and a CPAP refusal or intolerance affidavit may be needed. Some insurers may ask for a copy of a physician’s written order for the oral appliance. Each insurer has its own guidelines for coverage. In addition, individual deductibles, copayment amounts or percentages need to be considered.
To start the process, contact a sleep center or a sleep dentist that offers this alternative treatment. A recent sleep study evidencing sleep apnea will be required. This test would be conducted in the sleep lab or at home via a home sleep test before fabricating a sleep apnea oral appliance. A sleep dentist will then conduct a consultation to determine if you are a candidate for an oral appliance. Some patients may require some dental work before an oral appliance can be fabricated. If the results indicate that you may benefit from a sleep apnea appliance, dental impressions and a registration of your bite are made to fabricate the oral appliance tailored to you.
All treatments for sleep apnea have the potential for side effects. CPAP therapy, the most commonly prescribed treatment for sleep apnea is no exception. Some common side effects of CPAP include dry mouth, dry eyes, skin irritations, nasal dryness and sinus infections. Here are the more common side effects that you may experience when wearing a dental sleep apnea device.
In approximately 70-85% of cases, oral appliances will effectively reduce or eliminate apnea events. Snoring is eliminated or considerably reduced in approximately 90 % of cases. Factors such as the dentist’s experience providing the service, limitations of the device chosen, the severity of apnea, natural jaw movements, and the weight of the individual can all impact success levels. Compared to CPAP therapy, oral devices overall stack up quite high in ‘effectiveness.’ CPAP therapy may be more effective when used. Still, oral devices are tolerated considerably and worn for more hours than CPAP therapy. In other words, they might be similar in the overall effectiveness for treating obstructive sleep apnea.
Successful treatment for snoring and apnea can have a large positive impact on the quality of your life. And your relationships! For those that suffer with noticeable symptoms, successful oral appliance therapy (OAT) can result in:
Yes, patients that wear a nightguard currently or have been told they grind their teeth are often excellent candidates for oral sleep appliances. If successful, oral appliances can treat the apnea and manage the bruxing (teeth grinding) while eliminating the patient wearing a CPAP (Continuous Positive Airway Pressure Device) simultaneously with a nightguard. Wearing both at the same time can add more difficulty to CPAP usage.
Yes, patients with a history of TMJ or jaw pain symptoms often transition nicely into regular usage of an oral appliance. However, it is recommended that TMJ problems be managed before starting oral sleep appliance therapy. In some cases, patients with current mild “TMJ” symptoms often feel improvement after wearing an oral sleep appliance.
Once your appliance is fabricated the sleep dentist will begin the process of adjusting the device to its most effective and comfortable setting. A sleep study at home or in a lab will be necessary to confirm the efficacy of your oral device. This will ensure that your device is functioning at an optimal level for your specific sleep apnea. For those patients that adapt well to an oral device, your dental sleep medicine specialist may order an in lab titration study to expedite the finding of the optimal position of the oral appliance.
If the sleep appliance is determined to be beneficial, you will be seen at least annually for evaluation and to verify the fit and effectiveness of your oral appliance.
You should also see your sleep specialist as recommended. With time, changes may occur in soft tissue, dental conditions and other body structures that may make it necessary to be refitted or to evaluate other alternative treatments.
If you are ready to treat your sleep apnea or say goodbye to your CPAP machine, call the sleep lab at (909) 987-3535 or contact our recommended board certified dental sleep medicine specialist at (909) 941-2811 to begin your dental consultation today.