Mouth Devices If you have mild to moderate obstructive sleep apnea and can't tolerate or haven't been helped by CPAP, oral appliances may be an effective treatment option. These devices, which must be fitted by a Dentist or Orthodontist, and worn in the mouth at night include: ** Mandibular advancement device (MAD). The most widely used mouth device for sleep apnea, MADs look much like a mouth guard used in sports. The devices snap over the upper and lower dental arches and have metal hinges that make it possible for the lower jaw to be eased forward. Tongue retaining device. Used less commonly than MAD, this device is a splint that holds the tongue in place to keep the airway open. For people with mild to moderate sleep apnea, particularly those who sleep on their backs or stomachs, dental devices may improve sleep and reduce the frequency and loudness of snoring. Also, people are more likely to use their dental appliances regularly than CPAP. Dental devices have also been shown to control sleep apnea long term compared to uvulopalatopharyngoplasty (UPPP), the standard surgical procedure for apnea, in which the surgeon removes soft tissue from the back of the throat. If you are fitted with a dental device you should have a checkup early on to see if it is working and periodic checkups for possible adjustment or replacement. If you experience pain or changes in your bite, your dentist or orthodontist who fitted your device may be able to make modifications to correct the problem. The best treatment for obstructive sleep apnea depends on a number of factors, including the severity of your problem, the physical structure of your upper airway, other medical problems you may have, as well as your personal preference. You should work with your doctor or sleep specialist to select the best treatment option for you.
Selecting The Right Appliance For Each Individual Patient It is important that a dentist can choose from a range of snoring or sleep apnoea mouth guards or appliances in order to select the one most appropriate for the individual patient. The choice of appliance may depend on factors such as number and configuration of teeth, the relationship between the upper and lower teeth, the presence and degree of bruxism (clenching and grinding), the presence of jaw joint dysfunction and the amount of intra oral space.
Custom made oral appliances are now regarded by medical experts in the field as one of the two proven treatments for snoring and sleep apnoea. Patient comfort and compliance are the keys to successful outcomes with oral appliance therapy. It is important that the dentist uses appliances that are robust, fit well, are of minimal dimensions, and are associated with little side effects.
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