In the following section we have provided answers to questions that patients frequently ask.

Are dental sleep appliances effective?
The American Academy of Sleep Medicine and the Australian Sleep Association now consider dental sleep appliances a first line treatment for snoring and mild to moderate sleep apnoea.  They are also ideal for patients with severe sleep apnea who cannot use CPAP or as an alternative when travelling and there is no access to power.

Dental sleep appliances have been scientifically proven to be very effective with studies demonstrating over 95% of people are satisfied with the level of improvement with their snoring.  A study at SleepWise Clinic in 2010 by Associate Professor Gerard Kennedy from Victoria University demonstrated that over 95% of patients in the study were satisfied with the improvement in their snoring. Most were waking more refreshed and less tired during the day.

What is the best treatment for snoring?
Most sleep physicians consider dental sleep appliances as the most effective treatment for snoring – with the least side-effects. Studies demonstrate that dental sleep appliances are far more effective than surgical treatments. Surgery is only around 55% effective with significant potential side-effects, including severe post-operative pain and regurgitation of food through the nose.

Choice magazine reviewed most of the “over the counter treatments” for snoring. This review was conducted by a team, which included sleep physicians, and concluded that these treatments were unproven and mostly ineffective. The treatments included sprays, medications and pillows. Breathing re-training such as buteyko is another treatment lacking in any standard scientific evidence of effectiveness in the treatment of snoring and sleep apnoea.

While weight loss and avoiding, caffeine, nicotine and alcohol prior to sleep can be very helpful, dental sleep appliances remain the gold standard for immediate elimination of snoring.

Are all dental sleep appliances as good as each other?
Not at all. There are currently over 50 different dental sleep appliances throughout the world. Many of these appliances have not had studies to prove effectiveness, are not adjustable and are “one size fits all”. Such appliances have been demonstrated to be far less effective and comfortable compared to the custom-made, adjustable appliances. While these appliances can be less expensive the fit is often a problem and most people find them difficult to wear. These types of appliances have been banned in the US by the federal FDA however at this point are still available in Australia.

SleepWise clinic utilises five different types of appliances. Each appliance used is custom-made and easily adjusted by the patient. These appliances are government approved having scientific studies demonstrating effectiveness and comfort. It is important to note that there is no one appliance which is ideal for each and every situation. The choice of the ideal appliance for each person depends on factors such as the size, position and number of teeth as well as the size and position of the jaws.

Are Dental Sleep Appliances comfortable to wear?
Although the mouth can be a sensitive area the vast majority of people adapt within a night or two and find the appliance surprisingly comfortable. This is because the appliances we make are tailor-made and very thin. Once the snoring stops and they are feeling more refreshed and have adapted to the appliance, most people would much rather wear the appliance during sleep than not wear it.

Is treatment covered by private health insurance?
Treatment with dental sleep appliances do attract private health insurance rebates. Contact SleepWise Clinic for a full list of the item numbers used for treatment and then you can check with your own fund as to the amount rebatable.

What is included in the treatment fee for a dental sleep appliance?

• A clinical visit in which the health of the teeth and mouth are assessed.
• Any radiographs (X-rays) which may be required.
• An assessment for the possible presence of sleep apnea.
• High level of support including any adjustment visits should they be required.
• A follow up assessment visit approximately six weeks after fitting the appliance.
• A guarantee that covers any faults, repairs, or maintenance with the appliance.

How long does a dental sleep appliance last?
If you don’t clench or grind your teeth a dental sleep appliance can last for many years – four or five and often many more years. Often all that is required after four or five years is a simple reline procedure to restore it back to near new. Even if you do clench and grind your teeth the appliance can still last for years and has the added benefit of protecting your teeth and dental work. If the appliance needs to be replaced several years down the track this is usually done at a reduction of 50% of the original cost.

What if I am missing teeth or have a bridge or denture?
There are new appliances which can be successfully used in many different situations – even if all the upper teeth are missing. You will need to have at least a total of four teeth to be able to utilise a dental sleep appliance. It is important to have a thorough assessment of the teeth, gums and jaw to ensure predictable, successful results with minimal long-term problems.

I don’t want to use the CPAP machine – is the dental sleep appliance an alternative?
While CPAP is regarded as gold standard treatment for severe sleep apnea, based on many scientific studies dental sleep appliances are now regarded by sleep specialists as a viable alternative to CPAP. There are many people who find it very difficult and are unable to use CPAP. It is then very important that these people have assistance to their breathing while asleep and the use of a dental sleep appliance then becomes essential.

The experience of CPAP users who have made the change is invariably that dental sleep appliances are much more comfortable than CPAP. Many other people with severe sleep apnoea might continue to use their CPAP and use a dental sleep appliance when travelling or times where there is no access to power. The possibility of changing to a dental sleep appliances can be determined at the initial consultation.

Do I have to wear the dental sleep appliance for life?
No. There may be other methods which you can do for your self that can help overcome the problem. This is very individual and is assessed and discussed in the first consultation. For many people weight loss, exercise or changing body position during sleep can go a long way to overcoming snoring and sleep apnoea. This can be difficult to achieve if you are sleepy and tired. The use of a dental appliance can result in a boost in energy levels through better quality sleep and hence the impetus to make lifestyle changes.

Are there any side-effects?
The vast majority of people have little or no side effects. A small percentage of people have minor side-effects such as excessive saliva, jaw tenderness, pressure on teeth and bite changes. Most side-effects are temporary and disappear after a day or two or with a simple adjustment.

How does the dental sleep appliance work?
Dental sleep appliances work by holding the lower jaw slightly forward during sleep thereby opening the airway at the back of the throat which is responsible for the snoring and obstruction. The tongue is attached to the lower jaw and with the jaw held forward the tongue is prevented from collapsing back.

Does SleepWise Clinic provide general dentistry?
No. The patient is referred back to their dentist for any general dental treatment that may be required. SleepWise Clinic works exclusively in the dental management of snoring and sleep apnea.