What are the usual medical options for treating Sleep Disordered Breathing?

Continuous Positive Air Pressure (CPAP) or invasive and irreversible surgery.

CPAP: of the 100% of apnea patients for whom it is prescribed (CPAP is considered the 'gold standard'), there is 46% compliance after the first 3 months. 37% of those still using the CPAP soon abandon it completely (RT, the Journal of Respiratory Therapy). 

Physical Side-Effects Include:

• lacerations to the bridge of the nose due to the mask 
• rawness of the throat due to constant airflow 
• bloating of the stomach
• deprivation of sleep, the very reason the mask is prescribed!

Social Side-Effects Include:

• Patient Embarassment 
• His bed partner's lack of acceptance of the device 

Surgery: ranging in invasiveness; kind estimates say surgery is 30%-50% effective. None of the aforementioned options have been found to be efficacious by the American Academy of Sleep Disorders (AASD).

• tonsillectomy/adenoidectomy 
• uvulopalatopharyngoplasty (UPPP) 
• tracheostomy 
• gastroplasty 
• nasal surgery
• radiofrequency palatoplasty
• tongue base suspension
• maxillomandibular advancement 

 

           Yes - But what are the dental options for Snoring or Sleep Apnea?

Sleep Disorders Dentistry

We use airway orthotics, (oral appliances). An oral appliance looks much like an athletic mouth guard, but not as thick. You don't need a loud, cumbersome machine forcing air into your lungs nor invasive surgery involved in the usual treatment of sleep disordered breathing.

Airway orthotics (AO) come in varied designs and many are FDA-approved. They are completely non-invasive, totally painless and must only be worn at night.

In order to fit the oral appliance correctly, we perform two tests: rhinometry and pharyngometry. Via the Eccovision, a suite of diagnostic equipment employing acoustic reflection technology, the two tools map the nasal and pharyngeal airways, respectively.

Diagnostic Equipment

In order to determine the severity of your problem, your dentist will "map" your nasal passages and your airway with a suite of diagnostic equipment called the Eccovision, a self-contained processor emitting sound waves through two tools - the rhinometer and the pharyngometer. It's like drawing a picture with sound.

It's quick and completely painless.

The rhinometer uses acoustic reflection to map the nasal passages, searching out any obstruction or enlargement.

As for the airway itself, the pharyngometer is used. This tool sends sound waves through the throat, noting its diameter, collapsibility, and problem spots.

Then, if a problem is discovered, we can fit you with the oral appliance, fitting it effectively with the Eccovision to position the airway correctly, allowing for maximum patency (airway muscle strength and openness).

If we find a problem, you are treated with an FDA-certified oral appliance. Its purpose? To make sure your airway stays in optimal breathing position while you sleep. The good news is that you only have to wear it at night.

Below are examples of three of twenty-five different styles of snoring/sleep apnea appliances.  We will discuss your options with you and together decide which type will best fit your needs.

TAP Appliance	SomnoMed	Full Breath