By Jeffrey Bassman, DDS, PC
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| Jeffrey Bassman, DDS, PC |
In the last issue of Healthy Cells Magazine (January 2013), I discussed
snoring and sleep apnea and the pros and cons of wearing a CPAP machine
or one of its varieties. Again, I want to emphasize that the CPAP is the
best option for snoring/sleep apnea sufferers.
For those patients who have had a sleep study and have been diagnosed
with snoring and/or sleep apnea and have been prescribed a CPAP machine,
many cannot tolerate the machine and don’t wear it. A large percentage
of wearers stop doing so within three weeks of getting one. This is
alarming since the symptoms of sleep apnea can be devastating, even
leading to death.
An oral mouthpiece (appliance) offers a viable option to the CPAP, with
several advantages. I want to emphasize that the CPAP works best, but if
the patient is not going to wear it, there is hope with an oral
appliance.
As mentioned in the last article, a definition of sleep apnea is
necessary in order to understand why wearing a CPAP machine or an oral
mouthpiece should be utilized to prevent many destructive health
ailments. Sleep apnea is a chronic medical condition where the affected
person repeatedly stops breathing during sleep, often “gasping for a
breath.” These episodes last 10 seconds or more and cause oxygen levels
in the blood to drop. It can be caused by obstruction of the upper
airway, resulting in obstructive sleep apnea, or by a failure of the
brain to initiate a breath, called central sleep apnea.
An oral appliance is intended to be worn during sleep and is designed to
move and maintain the lower jaw (mandible) in a forward position. When
the mandible is brought forward, the airway is opened up more, and air
flow is increased. These FDA-approved devices essentially treat
Obstructive Sleep Apnea by preventing airway obstruction and allowing
the patient to breathe easily and continuously. Worn in the mouth like
an orthodontic appliance during sleep, oral appliances keep the soft
tissue from collapsing and interrupting normal breathing patterns.
There are hundreds of oral appliances: some that can be ordered online
or bought at pharmacies; and others that are custom made by a dentist
(hopefully one who specializes in dental sleep medicine). A word of
caution: an oral mouthpiece for snoring/sleep apnea not constructed or
worn properly can be ineffective and even create symptoms of TMJ/TMD
(temporomandibular joint dysfunction.) A discussion of TMJ will be
addressed in a later article.
There are many advantages of an oral appliance over a CPAP machine, if the patient insists on not wearing the machine.
- No masks or straps to deal with
- No noise from a machine
- Easy cleaning, unlike the air flow tubes, nasal pillows and mask
- Normally avoid dry mouth, nose and throat
- Sleep position is not dictated by machine masks and tubes
- Normally very comfortable
- Rare to have claustrophobia from an oral appliance
- Avoid travel hassles, especially air travel
- Tend to tolerate better, for longer
I am not saying that everyone is a candidate for or can even tolerate an
oral appliance, but the alternative to not wearing either a CPAP or a
mouthpiece is playing with fire as far as one’s health.
In the next article, I will discuss different types of oral appliances,
circumstances that may limit someone from wearing one, the appliances
that I use for my patients, and the steps taken to constructing a
custom, comfortable and well fitting one.
Dr. Jeffrey Bassman has been practicing dentistry in the Quad Cities
since 1977, and TMJ and dental sleep medicine since 1985. He limits his
practice to only these two specialties. For more information or a free
consultation, please contact Dr. Bassman at 563-391-1525, by email:
jbassmantmj@earthlink.net or website: www.jbassmantmj.com