Sleep Apnea and Dental Mouthpieces
Oral Appliances Designed by Dentists for Symptom Relief
Sleep apnea symptoms may be prevented with a dental mouthpiece. The oral appliance fits into the mouth and prevents the back of the tongue from collapsing.
It may seem strange, but your dentist can provide you with sleep apnea treatment. Oral appliances designed to treat sleep apnea are approved for apnea treatment by the U.S. Food and Drug Administration, and are available through many dental offices. While not usually the first line of sleep apnea treatment, a dental mouthpiece is an option if surgical cures and CPAP machines prove ineffective.
How Sleep Apnea Mouthpieces Work
All sleep apnea mouthpieces work on the same principle: they prevent the soft tissue at the back of the mouth from collapsing, causing sleep apnea. An oral appliance also prevents the tongue from blocking the airway passages. Wearing a sleep apnea oral appliance feels very much like wearing a sports mouthpiece.
Types of Oral Appliance
Sixteen different dental mouthpieces are approved by the FDA for sleep apnea treatment. These sixteen treatment options can be broadly divided into two types of dental appliance: Tongue retainers and mandibular repositioning appliances.
Mandibular repositioning appliances are the most common type of sleep apnea mouthpiece treatment. A mandibular repositioning oral appliance works by altering the position of the lower jaw, or mandible. The dental mouthpiece pushes the lower jaw forward. This also repositions the tongue, which is attached to the lower jaw. By repositioning the lower jaw and tongue, the oral appliance keeps airways open and prevents sleep apnea symptoms.
Tongue retainers are less common dental mouthpieces, but tend to be more effective than other sleep apnea oral appliances. A tongue retainer uses a suction cup that attaches to the front of the tongue, pulling the tongue forward to prevent the back of the tongue from collapsing. Of course, having your tongue pulled forward by a suction cup might take some getting used to!
Oral Appliance Candidates
There's no reason why you can't begin sleep apnea treatment with a dental mouthpiece, but most people begin treatment either with a CPAP machine or surgical options. Should these treatments fail, the best candidates for sleep apnea mouthpieces are those with mild to moderate obstructive sleep apnea.
Physical features influence how well a person responds to an oral appliance. People with jaw lines that are parallel to the floor, with healthy teeth and small chins are good candidates for sleep apnea mouthpieces.
Choosing a Dental Mouthpiece
Which dental mouthpiece you use for sleep apnea treatment depends on your sleep physician, your dentist, and your personal preferences. For the best fit your sleep physician and dentist should work together closely: be wary if one ignores the other.
While only sixteen oral appliances are FDA approved, there are over forty models on the market. Some of these dental mouthpieces have not undergone extensive testing, and some have been designed by individual dentists who prefer to use their own product. While some of these untested mouthpieces work well, you may feel more comfortable with an FDA approved mouthpiece.
Ultimately, it's your mouth this little piece of plastic and silicone is sitting in every night, so your personal preferences should be taken into account. The more comfortable an oral appliance is, the more likely you are to keep using it.
Paying for Dental Appliances
Depending on your medical insurance you may have to pay for a sleep apnea mouthpiece out of pocket. Many insurance companies refuse to cover oral appliances, claiming that their use as a sleep apnea treatment is experimental. Apparently FDA approval isn't enough to sway some insurance companies . . . .
Side Effects of Dental Sleep Apnea Treatment
Like any other medical treatment, sleep apnea oral appliances can produce side effects. As you start wearing a dental appliance you may experience any of the following complications:
- dry mouth
- excess saliva production
- jaw pain
- tooth pain.
Most of these complications can be resolved by adjusting the mouthpiece or switching to a different oral appliance. You also need to clean your sleep apnea mouthpiece on a daily basis.
Long-term oral appliance side effects are of greater concern. Up to fifty percent of sleep apnea mouthpiece users develop changes in tooth position or even the position of their jaws. If you believe your teeth or jaw are changing positions due to an oral appliance report such changes to your doctor immediately.
Disclaimer: The information contained within this article is for informational purposes only, and is not intended to be a substitute in any way for care and treatment by a qualified health professional.
Resources
Quiet Sleep. (updated 7 December 2007). Overview of Oral Appliance Therapy.
Demko, B. (nd). Frequently Asked Questions (about sleep apnea oral appliances).
