Sleep apnea, a pause in breathing, is a common condition that affects millions of people. Symptoms in include snoring, gasping and sleepiness. According to a 2010 survey in "Sleep Medicine," this disorder affects 33 percent of the population. Several treatments exist including surgery, drugs, and counseling. Dental devices, also known as oral appliances, have become popular as well. These removable appliances increase airway space, stabilize the mandible, advance the tongue or soft palate, and change muscle activity. Such devices can be grouped into three categories. There are also custom-made appliances.
Mandibular Advancers
A 2009 experiment reported in "Pneumologia" shows that mandibular advancers decreased snoring and increased blood oxygen levels following one month of use. Compliance was high in this study, and the side effects were minimal. A 2010 investigation presented in "Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics" reveals that mandibular advancers are particularly effective in a specific subtype of apnea patients. These people, known as "positional patients" had fewer apneas during two nights of treatment.
The new mandibular advancers are adjustable allowing for dental prosthetics and missing teeth. A 2010 case study offered in the "American Journal of Orthodontics and Dentofacial Orthopedics" describes the use of a modified mandibular advancer in a patient with few teeth. The device decreased the number of apneas and increased the amount of sleep.
Tongue Retainers
A 2009 report published in the "Journal of Clinical Sleep Medicine" indicates that tongue retainers can be as effective as mandibular advancers at treating sleep apnea patients. Up to 71 percent of the subjects tested showed either complete or partial improvements. The device consistently decreased apnea, reduced snoring, and increased alertness. Yet a 1997 experiment offered in "Medizinische Klinik" shows that compliance rates for users of the tongue retainers are low. In fact, 75 percent of the patients in that study stopped using the device because of side effects or poor results.
Soft Palate Lifters
A 2000 report presented in "Sleep Medicine" tested the mandibular advancer, the tongue retainer, and a third type of device called the soft palate lifter. Results indicated that only the mandibular advancer was effective at decreasing the number of apneas. A trend for increased deep sleep was also noted in mandibular advancer group. Finally, users of the soft palate lifter were the least likely to continue treatment.
Combination Devices
A 2009 case report in "Sleep & Breathing" describes the treatment of a sleep apnea patient using a custom-made oral appliance. This device combined the mandibular advancing and tongue retaining properties noted above. Such an appliance was needed because the patient had no teeth. The combination device was effective and well tolerated.
References
- "Sleep Medicine"; Obstructive sleep apnea syndrome in the Sao Paulo Epidemiologic Sleep Study; S. Tufik et al.; May 2010
- "Pneumologia"; Use of mandibular advancing devices in the treatment of snoring and mild to moderate obstructive sleep apnoea syndrome; B. L. Adriana et al.; October 2009
- "Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics"; Treatment outcomes of mandibular advancement devices in positional and nonpositional OSA patients; J. W. Chung et al.; May 2010
- "American Journal of Orthodontics and Dentofacial Orthopedics"; Oral appliance treatment for obstructive sleep apnea in a partly edentulous patient; L. C. Giannasi et al.; April 2010
- "Journal of Clinical Sleep Medicine"; Tongue-retaining device: efficacy and side effects in obstructive sleep apnea syndrome; D. S. Lazard et al.; October 15, 2009
