In the last 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.
In review, for many patients who have had a sleep study, 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. An oral mouthpiece is intended to be worn during sleep and is designed to move and maintain the lower jaw (mandible) in a forward position. By maintaining the mandible forward, this opens up the airway and allows much more oxygen to flow into and out of the lungs during sleep. I discussed the advantages of an oral appliance in the article in Healthy Cells Magazine.
Before considering a mouthpiece, it is imperative that you should have any and all dental work completed by your dentist- cleanings, filling, crowns, bridges, etc. Obviously, it is a lot easier and economical to make the mouthpiece to the restored dentition. There is no guarantee an existing mouthpiece can be properly modified effectively to fit new restorations and additional costs may be incurred.
There are many types of oral appliances for snoring and sleep apnea. There are some types of “non-custom” mouthpieces that you can purchase online or at local drug stores. I do not recommend such mouthpieces!! Since they are not custom designed and constructed, the fit can actually end up moving teeth, altering your bite and may
create permanent tmj/tmd problems.
There are hundreds of custom designed appliances made by dentists and dental labs that provide different degrees of relief and comfort. Some are fixed upper and lower mouthpieces that are luted together and lock the mandible in a forward position throughout the night. Others are separate upper and lower parts that position the mandible forward but with more freedom to move. These types, which are the most common, have plastic connectors attaching the upper and lower parts. There are even some mouthpieces that have a tube attached it to allow the CPAP machine hose to hook onto it. Others have a tongue extender that keeps the tongue from falling back which can block the airway.
Suffice it to say that sometimes the most successful mouthpiece for one person will be a failure for another. I have found that often the best mouthpiece is determined by the diagnosis and examination of the dentist or dental sleep specialist. Most importantly, the factors that greatly influence success are: the comfort and expertise of the practitioner, the familiarity and technical skills and support of the dental lab that constructs the mouthpiece for the dentist, post-op re-evaluations, and the cooperation and patience of the patient!
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| Jeffrey Bassman, DDS, PC |
Feel free to call our office for a free consultation and a demonstration of the mouthpieces. 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, email: jbassmantmj@earthlink.net or website: www.jbassmantmj.com