Sleep apnea is a common sleep disorder where breathing repeatedly stops and starts during sleep. Obstructive sleep apnea (OSA) is the most prevalent type, occurring when the upper airway becomes blocked. This article explores oral appliances, often referred to as mouthguards, as a potential treatment option for individuals with sleep apnea.
How Oral Appliances Work
Oral appliances address sleep apnea by maintaining an open airway during sleep. These devices are designed to reposition the lower jaw or tongue, preventing soft tissues in the throat from collapsing. When the jaw or tongue is held forward, it creates more space in the back of the throat, allowing for unobstructed airflow.
This action helps reduce pauses in breathing characteristic of sleep apnea. The primary goal is to prevent the physical blockage that occurs when muscles relax during sleep, which can lead to reduced oxygen levels.
Different Types of Oral Appliances
Two main categories of oral appliances are used for sleep apnea: Mandibular Advancement Devices (MADs) and Tongue Retaining Devices (TRDs). MADs are the most frequently prescribed type, resembling a sports mouthguard. These devices typically consist of two pieces that fit over the upper and lower teeth, connected by hinges or screws. They work by gently pushing the lower jaw forward, which in turn moves the tongue and soft palate away from the back of the throat, thus opening the airway.
TRDs function differently. These appliances use a suction bulb to hold the tongue in a forward position, preventing it from falling back and obstructing the airway. While MADs are more common, TRDs can be an option for individuals who may not be suitable for MADs, such as those with insufficient teeth to anchor a MAD. Both types should be custom-fitted and professionally prescribed to ensure effectiveness and safety, as over-the-counter options lack precision or efficacy.
Effectiveness and Patient Candidacy
Oral appliances are effective for many individuals with mild to moderate Obstructive Sleep Apnea (OSA). These devices can significantly reduce snoring and improve sleep study parameters, such as the apnea-hypopnea index (AHI). While beneficial, they may be less effective for severe OSA compared to other treatments like continuous positive airway pressure (CPAP).
Oral appliance therapy is an option for those with mild to moderate OSA, or for those with more severe OSA who cannot tolerate CPAP therapy or prefer an alternative. Candidacy depends on factors like condition severity, patient anatomy, and treatment adherence. A sleep specialist or dentist can evaluate these criteria to determine if an oral appliance is appropriate.
Practical Considerations for Use
Using an oral appliance involves certain practical considerations for daily management and long-term care. Some common side effects may arise, including temporary jaw discomfort, changes in bite alignment, and increased salivation. These effects are often mild and tend to diminish as individuals adjust to wearing the device.
Proper maintenance and cleaning are important to ensure the appliance’s longevity and hygiene. Users should clean their oral appliance daily with a soft toothbrush and mild soap or a denture cleaner, rinsing it thoroughly before storage. Regular follow-up appointments with a dental professional or sleep specialist are also necessary. These visits allow for adjustments, monitoring effectiveness, and addressing side effects.