Oral Appliance Therapy (OAT) is a proven, comfortable and non-invasive sleep apnea solution approved by the American Academy of Sleep Medicine. OAT can provide a viable alternative for many OSA sufferers who are unable to tolerate CPAP therapy OAT involves the use of custom-fitted oral appliances, which are designed to open the airway and allow you to get a solid, satisfying night's sleep. This in turn affects all the body systems from the adrenals to the heart.
Most patients find OAT to be much more comfortable convenient OSA therapy than a CPAP machine and mask. It is easy to use and is not at all cumbersome while sleeping. It is also excellent for those who travel, as it is extremely small and portable. Compliance and consistency with the appliance wear are very high.
An oral appliance resembles a dental retainer or sports mouthguard, and is worn during sleep. These devices are designed to move the lower jaw forward, and to lift the base of the tongue forward and away from the back) wall of the throat. This helps stop oral snoring by reducing the vibration of the soft palate and uvula. The appliance does not improve restricted nasal breathing, which is caused by a deviated nasal septum or other nasal blockage. However, significant reduction in chronic nasal congestion is usually a benefit of OAT.
The majority of patients are able to fall asleep easily while wearing an oral appliance, and after an initial adjustment period of just a few weeks, find they do not want to sleep without the appliance. Because the airway is now open, the body responds quickly and experiences deeper, more refreshing sleep. If a patient forgets the appliance, or chooses not to wear it, they quickly return to previous patterns of poor sleep. A patient's bed partner can see the difference in restlessness and snoring without the appliance, and often encourages the patient to continue using the appliance.
Oral appliances are made of a thermoplastic, they will eventually wear down and must be repaired or replaced every four to eight years. They may also require minor repairs from wear-and-tear. Patients who grind or clench their teeth excessively may have to repair their appliance more often, and/or replace it sooner.
Most appliance is guaranteed for one year for normal use, wear and tear. After that, you will be charged only the lab fees for repair or replacement. Repair or replacements due to loss, abuse, dropping the device or damage by pets are always charged. Extended three year appliance replacement protection is available for a nominal fee.
Over time, OAT may result in minor chances to a person's bite, but it rarely leads to complications such as TMJ problems. In fact, OAT will mitigate such conditions by eliminating one of the major causes of the problem: the lack of an open airway. Depending on the status of the bone and position of the teeth, the appliance can change a patient's mouth structure. Sometimes these changes can aggravate TMJ symptoms, but only temporarily. Muscle soreness occurs in some patients, but much less than typical TMJ pain even with a TMJ splint. This soreness disappears in just a few minutes. Minor bite change or jaw movement, and excessive mouth dryness or salivation, sometimes occurs in the first few weeks of use.
OAT devices work best for mild to moderate sleep apnea cases, and have a history of success that can range as high as 90 percent. While they can usually provide at least some benefit to almost everyone, there can be issues with specific body types. They may not fully alleviate symptoms for patients with an extremely large neck or abdomen, or in extremely thin patients with a steep angle to the lower jaw.
Most patients experience a noticeable change in how they feel when they wake up and how they are able to function throughout the day. However, you can measure your progress with at home sleep study or in clinic PSG. Your specific situation should be evaluated by a practitioner to determine an OAT device, CPAP therapy, or a combination is best for you.
Oral Appliances, like CPAP, are usually covered by medical insurance when prescribed for the treatment of OSA. The patient must also have a DME or Durable Medical Equipment rider on the policy. Some policies cover more than others; we can help you check with your insurance company to determine your specific coverage.
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MARIA SOKOLINA D.D.S.
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