Snoring Dentist

1.Oral Appliance Therapy
2. Continuous Positive Air pressure (CPAP)
3. Surgery


Clearly, the largest number of patients suffering from obstructive sleep apnea are in the mild to moderate categories and should be treated with oral appliances. Even severe cases respond favorably.  Despite the fact that treatment with the CPAP unit is successful, most patients cannot or choose not to wear the face mask with the attached air compressor. These patients are excellent candidates for oral appliances. The most recent data shows that using an oral device is superior to not using a CPAP or only using a CPAP a couple hours a night.  These patients prefer a non-surgical, non-invasive plastic intra-oral appliance that is only worn at night to help solve their problem.

Today there are basically two types of oral appliances:

  1. Mandibular Repositioner
  2. Tongue Retaining Device

It should be noted that since 1987 all medical devices, including oral appliances for the treatment of snoring and obstructive sleep apnea, are required to have marketing clearance from the FDA.

These oral devices are covered by most major medical insurance and PPO plans, Kaiser, Medicare and Tricare. We are also preferred providers for the above.

Types of Appliances

1. Dorsal Device

A commonly used mandibular advancement device. Click here to learn more.

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2. EMA

This two piece appliance is consists of two plastic parts which cover the upper and lower teeth and are joined together with elastics. The advantage of this appliance is that it is extremely comfortable

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3.  Herbst

This removable appliance is highly effective. The upper and lower acrylic components are held together by a plunger mechanism which holds the mandible forward in both the open and closed positions. The Herbst has the advantage of allowing the patient to open and close as well as providing some limited side to side jaw movement.
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CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)

The current gold standard utilized by the medical profession for the treatment of OSA is continuous positive airway pressure (CPAP). The patient wears a tightly fitting nose mask which is strapped to the head and connected by a hose to an air compressor pump. The air is forced into the airway through the nasal passages in order to open up the airway.

Complaints about the use of this air blower include pump noise, voice changes, skin irritations from the mask, nose and throat dryness, headaches from the strap around the head, tinnitus, difficulty getting to sleep, sinus infections, and difficulty breathing out against the air being forced through the nose.

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The patients who should use CPAP are the severe cases of obstructive sleep apnea as the device may indeed be a life saver. In cases of mild to moderate OSA, or in cases where patients refuse to wear the CPAP,  oral appliances may be the treatment of choice.

MOST COMMON SURGICAL TECHNIQUES

  1. Laser Assisted Uvulaplasty (LAUP)
     The purpose is to surgically remove the uvula when it is excessive and deemed to be causing the problem.
  2. Uvulopalatopharyngoplasty (UPPP) 
    This is the surgical removal of excess palatal tissue which is thought to be causing the problem.
  3. Maxillomandibular advancement
    This is the most invasive, yet the most successful in the properly selected case.

The disadvantage is that these surgeries can be quite painful during the healing period. Following the surgery, patients report voice changes and difficulty in swallowing their food.

Patients should be informed of all their options prior to any treatment whether surgical or non-surgical.

If you have more questions about snoring, call Center for Headache, TMJ, and Sleep Disorders in Denver, CO at (303) 758-4865, or visit CPAPgone.com