By Jeffrey Bassman, DDS, PC
In a previous issue of Healthy Cells Magazine, 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: firstname.lastname@example.org or website: www.jbassmantmj.com.