Treatment Options and Technologies
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Oral Appliances
 Overview
of Oral Appliance Therapy
Oral appliances that treat snoring and obstructive
sleep apnea are small plastic devices, worn in the mouth, similar
to orthodontic retainers or sports mouthguards. They are worn
during sleep to prevent the collapse of the tongue and soft tissues
in the back of the throat so that the airway stays open during
sleep. The appliances promote adequate air intake and help to
provide normal sleep in people who snore and have a medical condition
known as sleep apnea.
Oral appliance therapy involves the selection,
design, fitting, and use of a specially designed oral appliance
that, when worn during sleep, maintains an opened, unobstructed
airway in the throat.
Currently, there are more than 40 different types
of oral appliances available. Oral appliances may be used alone
or in combination with other means of treating OSA, including
general health and weight management, surgery, or nasal continuous
positive air pressure (CPAP). (Learn
about CPAP failure and alternatives)
Oral appliances work in several ways:
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By repositioning the lower jaw, tongue, soft
palate, and uvula
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By stabilizing the lower jaw and tongue
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By increasing the muscle tone of the tongue
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Other Treatment Options:
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CPAP
There are several ways to treat snoring
and sleep apnea. The most common is with a device called
a CPAP machine. CPAP stands for continuous positive air
pressure. It is usually applied through a tube to a mask
that covers the nose. The air pressure that is generated
splints the structures in the back of the throat,
holding the airway open during sleep.
Learn about
CPAP failure
and alternatives
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Surgery
Treatment can also be accomplished with surgery to the
soft palate, uvula (that thing that hangs down from the
roof of your mouth), and tongue to eliminate the tissue
that collapses during sleep. More complex surgery can reposition
the anatomic structure of your mouth and facial bones, but
this is done only in extreme cases.
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Dentists with training in oral appliance therapy
who are familiar with the various types and designs of appliances
can determine which one is best-suited for your specific dental
and medical conditions. The dentist will work with your physician
as part of the medical team in your diagnosis, treatment, and
ongoing care. Oral appliance therapy can take from several weeks
to several months to complete. Even after the initial phase of
treatment is complete, Dr. Pecenka or Dr. Herald will continue
to follow you to be sure that treatment remains successful and
to evaluate the response of your teeth and jaws.
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Which Appliance Is
Best For You?
Dr. Pecenka and Dr. Herald use many diagnostic
tools to determine which appliance best addresses the patient's
particular problem. Radiographs (X-rays) help the doctors visualize
the hard and soft tissues that make up the airway and form a basis
for determining the proper reposturing of the lower jaw and tongue.
Photos of a few of the many available
types of dental appliances.
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The Pharyngometer allows the doctors to ascertain
in real time the severity and location of the airway constriction.
Reposturing the lower jaw during the accoustic survey allows the
doctors the ability to analyze how to initially build the sleep
appliance.
The doctors may also use pulse oximetry to determine
if additional contours that can be added to the appliance are
of significant benefit in opening and maintaining the airway.
The sleep appliance provided to the patient is
a unique, customized medical-dental device constructed to optimize
the patient's breathing at night during sleep.
Technology
 Our
office is equipped with state-of-the-art equipment necessary to
diagnose and treat snoring and sleep apnea.
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The Watch-PAT sleep monitor
by Itamar is the most advanced, convenient, and clinically
studied device of its kind. It is used to determine the effectiveness
of our therapy and to monitor the need for appliance calibration.
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Portable pulse oximetry is used to confirm
oxygen levels throughout the night and changes in heart rate
during sleep.
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Critical care monitors are used in our office
to ascertain changes in pulse and oximetry while awake AND
in our office.
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Pharyngometry, which is a 3-dimensional airway
examination, is a simple, noninvasive diagnostic tool that
allows the doctors to visualize areas of constriction in the
airway. This device is extremely important during treatment
planning and in selecting the type of appliance to be constructed.
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The above information is courtesy of http://www.quietsleep.com
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