Oral appliances provide an effective treatment for disruptive snoring and many forms of obstructive sleep apnea. Oral appliances enjoy success rates of better than 90 percent for the treatment of snoring. They have also proven very effective for the elimination or substantial reduction in OSA symptoms in mild to moderate cases, and typically reduce the severity of symptoms in even severe OSA conditions.
For these reasons, oral appliances are now considered as a viable primary treatment option for mild to moderate OSA, and an alternative treatment for all OSA patients who are unwilling or unable to tolerate CPAP therapy. In certain cases, oral appliances may also be used in conjunction with CPAP, which allows for lower air pressures and a higher rate of treatment compliance.
Oral appliances are worn during sleep, and resemble a sports mouthguard or orthodontic retainer. They are made from comfortable thermoplastic materials that can be custom-fit to the user’s mouth. There are currently more than 100 types of oral appliances approved for the treatment of snoring and OSA. The majority of these devices fall into two general categories. Mandibular repositioning devices, which may also be called mandibular advancement deceives or MADs, reposition the lower jaw forward and down slightly to help keep the airway open during sleep. These are the most widely used types of oral appliances. Another type of oral appliance is used to hold the tongue in place during sleep to prevent it from blocking the airway.
The oral appliances provided by Dr. Lalji are quite different from generic, over-the-counter appliances, which have been shown to be generally ineffective for the treatment of sleep apnea, and which may cause bite problems and other complications. All appliances provided by Dr. Lalji are selected and custom-fitted based on the patient’s individual case, and are prescribed for OSA treatment only after diagnosis by a board-certified sleep medicine physician.
When properly fitted, an oral appliance is quite comfortable to wear, and easy to care for. This is why many patients who find they are unable to live with CPAP therapy find relief from oral appliances. In addition, because they are compact and non-invasive, oral appliances are ideal for travel, as they are small enough to fit in a carry-on bag or purse, and don’t require electricity to operate.
When patients are first fitted with an oral appliance, they may experience increased salivation or dry mouth, and temporary bite changes. These side effects are usually minor in nature, but because the appliance is influencing jaw position, it’s important to have the support of a dental sleep medicine professional such as Dr. Lalji, who is well versed not only in sleep medicine, but also TMD therapies.
One relatively new type of oral appliance is designed to alter the patients facial structure to create positive changes in the airway. The DNA appliance is employed as an orthodontic tool for the straightening of teeth and reshaping of the mid-facial bones. It has also been shown to improve the airway by expanding the spacial area of the jaws, and not only to alleviate OSA symptoms when in use, but also effect permanent changes that may reduce or eliminate the OSA condition over time.