Do you need oral appliance therapy? Periodontics is the discipline of studying and treating the teeth and their surrounding structure, including the tissue, gums, bone and jaw.
While periodontics is commonly associated with treatment for periodontal disease and missing teeth, another common focus of oral appliance therapy is the treatment of sleep apnea.
What is Oral Appliance Therapy?
Often, patients with symptoms of mild to moderate sleep apnea, such as snoring, can benefit from the use of an oral appliance to provide supportive placement to the teeth, tongue and tissues. When appliances are used in this manner, it is called “oral appliance therapy.” Under certain circumstances, the use of oral appliance therapy can also be covered by medical insurance for the treatment of sleep apnea.
What Is Sleep Apnea?
Sleep apnea is a sleep disorder characterized by pauses between breaths during sleep. Individuals who suffer from sleep apnea can stop breathing multiple times during sleep, for either short or longer periods.
There are two basic types of sleep apnea:
- obstructive sleep apnea
- central sleep apnea.
In the case of obstructive sleep apnea, snoring can be one symptom of this sleep disorder.
In either type, symptoms of sleep apnea can range from mild to severe. In mild or moderate cases of obstructive type sleep apnea, use of oral appliance therapy can replace the need for use of a CPAP machine, which some people and their partners find hard to get used to.
What Is An Oral Appliance?
There are many different types of oral appliances for treatment of sleep apnea and other conditions. In the case of mild to moderate obstructive type sleep apnea, the most commonly prescribed oral appliance is a removable hinged device worn over the teeth (both upper and lower)to keep the airways open.
This appliance, called an EMA appliance, is custom-fitted by your dentist for your specific airway issues. First, an impression is taken of your teeth, and then the appliance is made, fitted and adjusted as needed.
You may need to wear the EMA appliance at night or during the day or during both day and night, depending on the severity of airway obstruction.
For most eligible patients, the appliance is easier to acclimate to and much simpler to use than treatments like a CPAP device. As a side benefit, the appliance is silent and will not disturb a sleeping partner.
How Does Oral Appliance Therapy Work?
The prescribing, fitting and ongoing use of an oral appliance therapy device is a team-based method. Typically prescribed by the sleep apnea specialist, the design and monitoring of oral appliance therapy can involve the specialist, a dentist, the appliance lab and a periodontal specialist.
Together, this group of medical specialists will ensure the oral appliance is custom fitted to keep your airways open at all times and especially during sleep. It is important to remember that use of an oral appliance is not a cure for sleep apnea, but it can keep the condition from worsening and help you avoid having to use a CPAP machine or other more invasive treatments.
How Does the Oral Appliance Keep Airways Open?
The oral appliance looks a lot like a double decker aligner or retainer. It is made from a clear flexible material. There are two aligners – one for your upper teeth and one for your lower teeth.
In between the two aligners there is a hinge. This hinge has different settings based on your specific mouth and jaw alignment, and what is required to keep your airways open and clear during sleep. The hinge can be adjusted as needed by repositioning the hinge.
When the hinge is in the optimal position, it works together with both aligners to reposition impactful tissues like the tongue, the soft palate, the uvula and the lower jaw itself, making sure these structures do not block your airway at any time.
The appliance also helps to strengthen the muscles in your tongue and stabilize your jaw over time, which can be of additional benefit in keeping your airways clear and unobstructed.
What Risks or Side Effects Can Occur With Oral Appliance Therapy?
To date, the risks or side effects of using an oral appliance to treat sleep apnea are mild to non-existent. There can be an initial adjustment period in the first couple of weeks as you get used to wearing your new appliance.
You may also experience some initial temporary discomfort as your medical team works to ensure your appliance gives you the optimal fit and comfort at night.
How to Get Started With Oral Appliance Therapy?
If you have already been diagnosed with mild to moderate obstructive type sleep apnea and/or snoring, you can proceed to talk to your doctor or dental specialist about therapy with an oral appliance. If you suspect you are snoring at night or you may have sleep apnea, the first step is to obtain a conclusive diagnosis.
Typically, this is done by visiting a sleep specialist and undergoing a sleep study. The sleep study can lead to a firm diagnosis, which can then open up options for treatment, including oral appliance therapy.
Other Applications of Oral Appliance Therapy
In addition to treatment of certain types of sleep apnea, oral appliance therapy can also be an effective treatment for temporomandibular joint disorder, or TMJ, for night time tooth and jaw clenching and grinding and for permanent joint repositioning.
Each of these oral appliance treatments is known to be safe and effective, and each can be fully customized to your individual oral health issues and treatment needs.
Drs. Marissa Cruz, Dr. Mana Nejadi and Dr. Rimple Sandhu are the co-founders and medical directors for King of Prussia Periodontist, a group dental specialist practice providing periodontal and dental implant services to King of Prussia, PA, and the surrounding areas.
All three surgical specialists are recognized as teachers and leaders in the field of dental medicine, periodontics and dental implants, supported by a team of compassionate and highly trained staff who provide a welcoming environment for patients of all ages.