Do you wake up suddenly at night, gasping for breath? Or do you have trouble falling asleep because your partner snores? Perhaps you feel like you're stopping breathing for a moment in between? This is what we medically call Obstructive Sleep Apnea (OSA) , or obstructive sleep apnea. If left untreated, this condition can lead to serious health problems. So today we're going to talk about a treatment for this, especially a solution that many people don't talk about.
Simply put, what are these Oral Appliances?
These are actually special devices that are custom-made for your mouth by a dentist. They're similar to the mouthguards used by boxers, but they work very differently. When you wear them in your mouth at night while you sleep, they help keep your airway open.
Now, what happens to someone with Sleep Apnea is that during sleep, the muscles at the back of the throat relax and the airway narrows or closes completely. Then, air doesn't get in, and a signal goes to the brain to wake you up a little to breathe. This cycle continues throughout the night. Because of this, you don't sleep well, and your body organs don't get the amount of oxygen they need. So what these oral appliances do is keep your mouth, jaw, and tongue in a specific position, keeping your airway open.
There are two main types of these devices.
These devices used to treat sleep apnea can be mainly divided into two categories.
1. Mandibular Advancement Devices (MADs)
This is the most commonly used type. It is also called mandibular advancement splints, mandibular repositioning appliances, etc. Simply put, this device pulls your lower jaw (mandible) forward a little. When the lower jaw moves forward, the tongue that is attached to it also moves forward. This increases the space for air to pass through the back of the throat.
These MADs usually come in two parts: one for the upper set of teeth and one for the lower set of teeth. These two parts are connected by screws, hinges, or rubber bands. This allows you to adjust how far the lower jaw needs to be moved forward.
2. Tongue-Stabilizing Devices (TSDs)
These are also called tongue-retaining devices. They are not as popular as MADs, but for some people they are a good solution. They use suction, which is a process that pulls your tongue forward and holds it in place. The device has a bulb-like tongue-retaining part that keeps your tongue in place during sleep.
TSDs can be a good alternative for those who cannot have a MAD device, for example, because their teeth are not strong enough.
| Type of device | How it works | Who is best suited for this? |
|---|---|---|
| Mandibular Advancement Devices (MADs) | Pulling the lower jaw forward opens the airway. | It is most commonly recommended for many Sleep Apnea patients. |
| Tongue-Stabilizing Devices (TSDs) | The tongue is pulled forward and held in place by suction. | Suitable for those with low tooth strength or who cannot use MADs. |
Most importantly, these appliances are most effective when custom-made by a dentist to fit your mouth. While there are "boil and bite" types available at pharmacies or online, research has shown that custom-made appliances produce the best results.
Who is this treatment best suited for?
Oral appliance therapy is best suited for people with mild to moderate obstructive sleep apnea . It is especially a good option for those who have difficulty using the CPAP (Continuous Positive Airway Pressure) machine, which is considered the best treatment for sleep apnea.
A CPAP machine is a device that delivers pressurized air to your airways through a tube and mask to keep them open. While CPAP is very effective, some people find it difficult to sleep with a mask on every night. Over time, they stop using it. Although an oral appliance is not as effective as CPAP, it can help many people control their symptoms.
Some people use both a CPAP machine and an oral appliance. For example, they use a CPAP at home and an oral appliance that is easy to take with them when traveling.
Are there people who shouldn't use this?
Yes, these devices are not suitable for everyone. Especially for those who:
- People with Central Sleep Apnea: This is a condition where breathing stops due to a problem with brain signals. This cannot be treated with oral appliances.
- Young children: Children's breathing problems require different treatments than adults. Consider these only if recommended by your child's doctor.
- People with severe OSA: It can be dangerous for someone with severe sleep apnea to try to control their sleep using this device alone. Therefore, you should definitely talk to your doctor about whether this is right for you.
How do you make a device like this?
To fix this, you need to follow a certain process.
1. First, you need to have a sleep study to confirm whether you have Obstructive Sleep Apnea.
2. If your doctor decides that an oral appliance is a good option for you, he or she will refer you to a dentist .
3. The dentist will take an impression or 3D scan of your teeth.
4. Based on those measurements, a manufacturer will create a device specifically for you.
5. After the appliance is made, you will need to see your dentist again. They will check to make sure it fits your mouth properly and is not stuck so that it doesn't come off at night.
6. Also, instructions will be given on how to clean and care for this.
Your doctor may also recommend another sleep study to see how well the device is working after it is inserted.
What are the side effects and benefits?
Like any treatment, this one has minor side effects and benefits.
| Side Effects | |
|---|---|
| Short-term - in the first few weeks | |
| Excessive saliva production | At first, there may be extra saliva because there is something strange in the mouth. |
| Jaw, tooth, and temporomandibular joint (TMJ) pain | You may feel a little pain at first because the lower jaw is in a new position. |
| Dry mouth and gum discomfort | These usually subside within a few days. |
| Long-term - rare | |
| Changes in the position of the teeth (bite) | Over time, the way your teeth fit together may change. |
| Teeth shaking or moving | This is why regular dental checkups are important. |
Benefits of this
- It can reduce OSA symptoms, especially daytime sleepiness and difficulty concentrating .
- Helps to achieve deep, uninterrupted sleep.
- Snoring can be reduced or stopped completely .
- A great alternative for those who cannot use a CPAP machine.
- It is very easy to take with you when traveling.
Take-Home Message
- Oral appliances are a good treatment for obstructive sleep apnea, especially for mild to moderate patients and those who find CPAP machines uncomfortable.
- The most successful of these devices are those that are custom-made by a dentist to fit your mouth.
- It may take some time to get used to this in the first few weeks. Although there may be minor discomfort, they usually go away after a few days.
- Before starting this treatment, be sure to talk to your doctor to make sure it is appropriate for your condition.
- It is very important to have your teeth and mouth checked regularly by a dentist throughout the duration of using the device.
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