Sleep apnea affects and can endanger a significant portion of Americans of most any age – none more so than overweight-to-obese adults. Employing a sleep apnea mouthpiece has significantly reduced varying degrees of patients’ occurrences, but these oral appliances are not without both their benefits and their drawbacks and risks.
Sufferers of untreated obstructive sleep apnea can experience interrupted breathing hundreds of times a night due usually to collapsed soft tissue in the back of the throat, depriving the brain and rest of the body of oxygen. The disorder does not discriminate, even affecting children, but the highest risk factors are tied to overweight men over the age of 40 with neck sizes 16-17 inches or greater and large tongues, jaw bones, and/or tonsils. Other significant risk factors are associated with a family history of the disorder, gastroesophageal reflux (GERD), and nasal obstruction due to a deviated septum, sinus problems, or allergies.
Under a trained dental professional or orthodontist’s recommendation, the American Academy of Sleep Medicine primarily supports two varieties of sleep apnea mouthpieces for the treatment of mild-to-moderate obstructive sleep apnea. Mandibular Advancement Devices (MAD), the most widely recommended appliance, closely resembles a sports mouth guard and keeps the airway clear by forcing the lower jaw forward and slightly down. A pacifier-like Tongue Retaining Device (TRD) keeps the airway as open as possible be holding the tongue in position.
While long-term benefits often follow short-term progress using a TRD, a sleep apnea mouthpiece may still need periodic adjustment or replacement and should be evaluated early on after its fitting to ensure its effectiveness.
That being said, there are overall considerations that should be thoroughly discussed with a dental professional or orthodontist prior to using either:
- As long as patients sleep on either their backs or stomachs habitually, both devices frequently reduce mild-to-moderate obstructive sleep apnea significantly and may improve breathing somewhat for severe sleep apnea patients. However, they tend not to be as effective when used by side-sleepers.
- As breathing interruptions diminish, patients experience vastly improved sleep when the devices are effective.
- Patients comply at a much higher rate than they do with CPAP treatments.
- Compared to standard surgical uvulopalatopharyngoplasty (UPPP), dental devices control sleep apnea over a much longer period with fewer complications.
- CPAP therapy has a higher overall effectiveness, and at a lesser cost.
- Sleep apnea mouthpieces can generate several mild side effects, including dry lips, increased salivation, nighttime pain, and tooth discomfort.
- Over a longer term, many patients cease complying with sleep apnea mouthpiece usage due to frustration with side effects, though some may be more inclined to stick with devices made of softer materials.
- Sleep apnea mouthpieces may sometimes reposition the teeth or jaws with long-term use unchecked by regular adjustment appointments; appliance treatments have worsened sleep apnea in a small percentage of patients.
Hope remains if a sleep apnea mouthpiece does not significantly improve both breathing and sleep. Rapid maxillary expansion involves temporarily applying a screw device to the upper teeth, which can alleviate nasal pressure with regular tightening and prove sleep apnea especially in patients with narrow upper jaws. Sleep apnea mouthpieces may not prove as effective in patients with a severe case of the disorder.
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