Snoring and Sleep Apnea Dental Appliances

If you or a loved one has sleep apnea and hates wearing a CPAP, this article could be a life saver! Apnea is an extremely complicated condition but the overall concept is easy to understand.

Everyone has heard people snore.  Not everyone who snores has apnea.  Snoring or no snoring, if one stops breathing and then gasps for air, odds are extremely high they have apnea.  During this time of not breathing, over and over during the night and night after night, all kinds of chemical, physical and emotional events are occurring at the same time.  Society has trained us to simply think this action is both funny and irritating but is much more serious than anyone ever thought.

Sleep Apnea is a killer. It causes heart attacks, strokes, increases diabetic problems and the list goes on and on.  The reason it is so destructive and dangerous is not difficult to understand.  Oxygen is the number one drug the body needs to survive and people with apnea do not get enough oxygen during the night.  When oxygen is cut off from a body part, that part can be injured and it can even die.
Acting as a double whammy, when Oxygen is cut off, Carbon Dioxide gas builds up.  CO2 irritates lung tissue and blood vessels which creates the need to bring in fresh oxygen.  This life threatening need to breathe causes the gasping that is typical in people with apnea.  In the sleep world, this gasping is called an event.  Every time a person has an event, it disturbs the sleep cycle with the end result of being tired and not feeling good during the day.

The CPAP is the gold standard for treatment of sleep apnea.  It literally forces oxygen into the lungs.  When people are able to tolerate the CPAP, they sleep better and feel like a new person the next morning, all because the body is getting the right amount of oxygen.
The problem is that only 50% plus or minus are able to tolerate the CPAP.  Yes, it is the machine that fits over either the nose or face during sleep.  People either love it or hate it.  

Oral Appliances for CPAP Intolerant
There are many types of Sleep Apnea with the most common being Obstructive Sleep Apnea.  When the tongue, tonsils, throat, etc. collapse in the throat, it obstructs breathing.

These anti snoring appliances hold the lower jaw forward and when the jaw comes forward, it brings the tongue with it which opens the back of the throat.  When the throat opens up, the patient is able to breathe normally giving them the proper amount of oxygen.
Most people, including those in the medical field, are unaware that the oral appliances are the first recommended treatment for mild to moderate apnea, reserving the CPAP for the more severe cases.

Drawbacks to Oral Appliances
While the devices are very comfortable and in some cases, even more effective than CPAP, the oral appliances have their drawback.  The major concern is the blur between medicine and dentistry.  While a dentist cannot diagnose sleep apnea, it is beyond the scope of medicine for an MD to make a dental device.  Dentists can’t submit medical insurance forms and physicians can’t submit dental forms.  The bottom line is insurance companies do great in paying for CPAP but not oral appliances.

While apnea oral appliances can have several jobs, i.e. prevent apnea, protect the teeth from nighttime grinding and in some cases help with TMD/TMJ head pain, they can also create joint and bite issues.  It is always best that the dentist making the sleep appliance be well trained in the art and science of TMD.
Dentists trained in sleep apnea know how to screen for apnea.  They know how to read a sleep study but what they can’t do is diagnose sleep apnea.  Only a specially trained sleep physician can legally diagnose the condition which requires an overnight, proper sleep study.

The dentist’s job is to first screen each patient for sleep apnea.  When there is someone with all the signs, it is our job to question and educate the patient.  If the patient admits they have sleep issues, we have to refer them to the before mentioned sleep doctor.  The sleep doctor sees them for a consultation and in most instances orders a sleep study to determine all issues that are occurring during sleep.  
The sleep study is sent back to the sleep MD who reads it and recommends treatment.  If, and only if, the MD recommends an oral device, can the device be legally made.  

If you have a CPAP, you have already had a sleep study and have been diagnosed.  If you are CPAP intolerant and simply refuse to wear it, you are in danger as stated above.  To be able to legally get an oral device, you must go back to the MD and get a prescription to be sent to your dentist.
Yes, it is a cumbersome ordeal but one worth living for!