Oral Appliances

Snoring and Obstructive Sleep Apnea

Snoring is the sound of partially obstructed breathing during sleep.  While snoring can be harmless, it can also be a sign of a more serious medical condition known as obstructive sleep apnea (OSA).  When obstructive sleep apnea occurs, the tongue and soft palate collapse onto the back of the throat and completely block the airway, which restricts the flow of oxygen.  The condition known as Upper Airway Resistance Syndrome (UARS), is midway between primary snoring and true obstructive sleep apnea.  People with UARS suffer many of the symptoms of OSA but require special testing techniques.

Standards of Care

Oral appliance therapy is indicated for:

Patients with primary snoring or mild OSA who do not respond to, or are not appropriate candidates for treatment with behavioral measures such as weight loss or sleep position change.

Patients with mild to moderate OSA who prefer oral appliances to CPAP, or who do not respond to CPAP, are not appropriate candidates for CPAP, or fail treatment attempts with CPAP or treatment with behavioral measures such as weight loss or sleep position change.

Patients with severe OSA, who are intolerant or refuse treatment with nasal CPAP.  Oral Appliances are also indicated for patients who refuse treatment, or are not candidates for tonsillectomy and adenoidectomy, or craniofacial surgery.

Types of Oral Appliances

Nearly all appliances fall into one of two categories.  Oral appliances can be classified by mode of action or design variation.

Tongue Retaining Appliances

Tongue retaining appliances function by holding the tongue in a forward position by means of a suction bulb.  When the tongue is in a forward position, it serves to keep the back of the tongue from collapsing during sleep and obstructing the airway in the throat.

Mandibular Repositioning Appliances 

Mandibular Repositioning Appliances function to reposition and maintain the lower jaw (mandible) in a protruded position during sleep. This serves to open the airway by indirectly pulling the tongue forward, stimulating the activity of the muscles in the tongue and soft palate, and making them more rigid.  It also holds the lower jaw and other structures in a stable position to prevent excessive mouth opening.

Advantages of Oral Appliance Therapy

Oral appliances are comfortable and easy to wear

Oral appliances are small and convenient, making them easy to carry when traveling

Treatment with oral appliances is reversible and non-invasive

Information provided courtesy of the American Academy of Dental Sleep Medicine

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