Oral Appliance Therapy

Obstructive Sleep Apnea has been a malady since the 1800s. Factors such as hypertension, stroke, daytime sleepiness, snoring, A-FIB, night sweats, and sexual dysfunction have been known to be correlated to OSA. It is well documented by the Academy of Sleep Medicine and the Academy of Dental Sleep Medicine that, with proper treatment, these pathologic symptoms can be improved by using an oral appliance.

Oral Appliance Therapy is the first line of treatment recommended by the Academy of Sleep Medicine and The Academy of Dental Sleep Medicine for patients who have mild to moderate obstructive sleep apnea diagnosis.

Oral appliance therapy allows the lower jaw to be positioned forward to prevent the tongue from collapsing into the airway. CPAP machines are the gold standard of care and virtually move the tongue forward by having increased air pressure. To accomplish this, it is necessary to wear a facial or nasal mask to force oxygen into the airway. 65% of patients after a three-month period discontinue wearing their CPAP machines for a multitude of reasons.

For patients who are unable to tolerate CPAP machines and have been properly diagnosed via a sleep study by a pulmonologist or sleep physician, oral appliance therapy is an excellent alternative and has a higher compliance rate of wear than a CPAP. The appliances are easy to wear, comfortable, quiet, and easy to transport. As a general dentist, Dr. Skowronski works in conjunction with the pulmonologist or sleep physician to accurately fit a custom-made appliance for the patient and be certain the patient’s snoring and apnea is resolved all the while making sure the patient has proper oxygen saturation levels while sleeping.

Benefits of Oral Appliance Therapy

While CPAP can be effective, it doesn’t work for most people. The treatment is uncomfortable, cumbersome, and generally a nuisance. That’s why many people seek oral appliance therapy. Oral appliance therapy is better for many people because it is:

  • Effective
  • Comfortable
  • Easy to use
  • Discreet
  • Convenient
  • Easy to travel with

Oral appliance therapy is about as effective as CPAP for most people. This makes it a great choice for many people who find it more comfortable and easy to use. It’s also discreet. Instead of a mask, hose, and pump, all you have is a custom fit sleep appliance. It’s incredibly low maintenance and very easy to clean. Nor do you have to replace numerous parts on a regular basis. This makes it very convenient, and it’s so easy to travel with.

Obstructive Sleep Apnea Treatment Process

Your sleep apnea treatment is broken down into several appointments.

Initial Appointment

  • Review the patient’s sleep study and diagnosis from their referring physician.
  • Complete a comprehensive oral and TMJ exam and explain to a patient what oral appliance sleep therapy is.
  • Utilize a pharyngometer to assess a patient’s airway and determine if and which specific oral appliance will be effective.
  • The patient will complete an Epworth sleep assessment.

Records Appointment:

  • Tomograms are completed in the office on the CBCT Machine. Tomograms are specific sectional cut x-rays of the head of the upper and lower jaws. Specifically, an anterior-posterior radiograph is taken to view nasal closure, such as turbinates or a deviated septum.
  • 3D digital scans are completed of upper and lower teeth. These scans are sent to the lab directly for the fabrication of a custom-made nighttime appliance.
  • Photos are taken of the patient to view any postural issues or facial discrepancies.

Insert Appointment:

  • Insert nighttime appliance and review proper wear.
  • AM Bite Restorer to be fabricated to ensure the patient’s bite will not change due to nighttime appliance wear.
  • Advise the patient to monitor snoring at night and contact the office to provide an update after 48 hours of wear.

6 Week Follow-Up Appointments:

  • The patient will be seen in the office every 6 weeks for a period of 4-5 months.
  • At the 5-month mark, the patient will be provided a “Watch-Pat device” that the patient will take home and wear overnight. This device allows Dr. Skowronski to confirm the success of the oral appliance. The Watch-Pat provides readings that include: heart rate, oxygen saturation levels, apnea events, and even sleep positions. This report will be reviewed by Dr. Skowronski, and a copy will be provided to the patient’s referring physician.

Are You Ready to Be Free of Sleep Apnea?

If you are tired of being tired all the time, and you are sick of your CPAP, oral appliance therapy can help. Please call (586) 977-8413 today for an appointment at Skowronski Family Dentistry.