Sleep apnea is a condition where breathing repeatedly stops and starts during sleep. This interruption can lead to symptoms such as loud snoring, gasping or choking, and persistent daytime fatigue. While continuous positive airway pressure (CPAP) machines are a common treatment, mouth guards, also known as oral appliances, offer an alternative for certain types of sleep apnea.
Types and Function of Mouth Guards
Two primary types of mouth guards are used for sleep apnea: Mandibular Advancement Devices (MADs) and Tongue Retaining Devices (TRDs). Both are designed to maintain an open airway during sleep, addressing the physical obstructions that characterize obstructive sleep apnea. These devices are typically custom-fitted by a dental professional to ensure comfort and effectiveness.
Mandibular Advancement Devices are the most common type and work by gently pushing the lower jaw forward. This forward positioning helps to move the tongue and soft tissues in the back of the throat away from the airway, preventing them from collapsing and blocking breathing. Most MADs consist of two parts that fit over the upper and lower teeth, often connected by a mechanism that allows for controlled jaw advancement.
Tongue Retaining Devices function by holding the tongue in a forward position. These devices use a suction bulb or similar mechanism to keep the tongue from falling back into the throat, which can obstruct the airway. While less common than MADs, TRDs can be an option for individuals unsuitable for jaw-repositioning devices, such as those with certain dental conditions.
Measuring Their Effectiveness
Mouth guards are effective for individuals with mild to moderate obstructive sleep apnea. Their success varies, influenced by the severity of sleep apnea, consistent patient use, and device fit. Mandibular Advancement Devices reduce the Apnea-Hypopnea Index (AHI), a measure of breathing interruptions, and improve symptoms like snoring and daytime sleepiness. Research indicates MADs can reduce AHI by approximately 42%, and for some, MAD therapy can lead to a complete resolution of sleep apnea symptoms.
While CPAP therapy is considered more effective for reducing breathing pauses and improving blood oxygen levels in severe cases, oral appliances offer an alternative. Mouth guards provide comparable improvements in subjective measures like daytime sleepiness and overall quality of life. For those who struggle to tolerate CPAP, oral appliances are a comfortable option. Their higher adherence rates, compared to CPAP, can lead to better overall health outcomes for some patients.
Who Benefits and What to Expect
Mouth guards are suitable for individuals with mild to moderate obstructive sleep apnea, or those who cannot tolerate CPAP therapy. However, these devices are not recommended for central or severe obstructive sleep apnea. A thorough diagnosis, often involving a sleep study, is necessary before considering a mouth guard.
Obtaining a custom-fitted device begins with a prescription from a doctor following a sleep apnea diagnosis. A qualified dentist takes impressions to create a personalized appliance. After fabrication, the device is fitted and adjusted for comfort and effectiveness, with subsequent adjustments often needed.
Side effects may include jaw discomfort, teeth pain, dry mouth, increased salivation, or gum irritation. These effects are often temporary during initial adjustment. Over extended periods, some individuals might notice minor changes in their teeth position or bite. Regular follow-up appointments are important to monitor effectiveness and address any ongoing issues.