What Can a Dentist Do For Patients With Obstructive Sleep Apnea?
What can a dentist do for their patients that have Obstructive Sleep Apnea (OSA)? Turns out that a dentist educated in recognizing and treating sleep apnea can do a lot! To find out more ask if your dentist is providing screening and therapy for Obstructive Sleep Apnea. You don’t have to wait to have an expensive test with a sleep physician to evaluate is your airway closes off at night before doing some type of provisional therapy. Oral appliance therapy is not very expensive considering the benefits it can provide. Depending on the type of appliance prescribed, you cost may be about $300.00 to $1,000.00.
Snoring devices such as the Silent Nite sleep Appliance made by Glidewell labs gently holds the lower jaw forward (mandibular advancement device) to open the airway space and maintain that opening while you are sleeping. You don’t have to have a concern with snoring to benefit from this device! You can benefit from this treatment while you are waiting to get a definitive diagnosis from a sleep study. Our office works with Glidewell Dental Lab to custom make these appliances from very accurate impressions of your teeth. The appliance will last much longer than the three or four months it takes to get a medical diagnosis of sleep apnea. In July 2019, the Silent Nite appliance was cleared by the FDA for use to reduce snoring and for treatment of mild to moderate obstructive sleep apnea. This appliance is flexible, thin and custom-fabricated to be comfortable enough for you to wear all night.
If you are diagnosed with OSA and put on a CPAP, the Silent Nite appliance can be worn with the CPAP allowing the CPAP pressure to be less because the airway is more open. Less pressure is more tolerable for patients. The Silent Nite appliance will minimize symptoms in the interim between screening and definitive treatment whatever that is. Silent Nite appliances are not a new therapy. These appliances have been used over 20 years and over 400,000 of these have been delivered to patients. Other appliances more specific to the treatment of OSA can also be made by our office working in conjunction with a qualified lab.
It has been found that only about 25% of people who were instructed to use a CPAP every night are using the CPA, and only about 4 hours per night. Only a very small percentage use their CPAP every night.
Can your bite change when you wear an appliance for OSA?
Appliances that move the lower jaw forward also change the position of the jaw joint or TMJ. Tissues behind the joint can fill with extra fluid because of the space created. When the appliance is removed in the morning, it is a good idea to use a wafer called an AM aligner. We provide these from Glidewell labs along with your appliance. Just warm up the aligner in warm water, place it over your teeth and bite into the aligner. Better yet, use the AM aligner after a warm shower when all the muscles are warm and bite into the aligner to recapture your natural bite. Once your bite feels normal again rinse the aligner off with cool water and store it for the next day.
Is obstructive sleep apnea really worth treating?
Yes! These symptoms and more may be associated with even mild sleep disordered breathing:
- Excessive and possibly dangerous daytime sleepiness (think accidents!)
- Cardiovascular complications
- Trouble paying attention
- Difficulty in social situations
- Increased risk of heart attack, high blood pressure, obesity, stroke and diabetes
- Morning headaches
- High blood pressure
The DreamTAP is a custom fit appliance that provides advancement of the lower jaw (mandibular advancement device) to treat sleep disordered breathing the most severe being obstructive sleep apnea. The appliance is fabricated by Glidewell Laboratories using impressions of your teeth from your dentist. There is a single point midline contact area. The patient can move their jaw side to side to find the ideal position. The hardware is located in such a way that the tongue space is not invaded and the appliance is easier to adapt to. The hardware is a nickel-free and very biocompatible. It is stronger than surgical stainless steel! The simple hook in the front of the appliance helps patients keep their mouth closed while sleeping and eliminates the need for additional clasps and bands.
Most importantly, the TAP appliance has a 25-year history of success and 36 peer-reviewed studies. In every study, this appliance was found to be as successful as the use of a CPAP or continuous positive airway pressure device. And, this appliance is more likely to be worn by the patients that need it!
Our office has had great success with appliance therapy for snoring and sleep apnea. We offer dreamTAP, Silent Nite, and Herbst appliances along with many others. We would be happy to discuss this therapy with you. It just might be life changing!
Yours for better dental health,
Julie Gillis DDS, AAACD
Restoring Teeth/Restoring Smiles