It is important to choose a treatment that has been scientifically proven to be effective and comfortable and used by qualified experts in the field. This is very important as there are many unproven and ineffective remedies for snoring and sleep apnea. There are only two proven effective treatments for snoring and sleep apnea – dental sleep appliances and the CPAP machine.
Customised dental sleep appliances are now regarded by sleep physicians as the best available treatment for snoring and a primary treatment for sleep apnea.
The appliances are made from thin yet high strength acrylic, go over the tops of the teeth and are worn during sleep. Sleep appliances have been proven to be effective, safe and comfortable and have minimal side-effects. Surgery is now rarely utilised because the results have been poor with potentially significant side effects.
Based on over 15 years of published scientific studies, dental sleep appliances are now accepted by the American Academy of Sleep Medicine, the peak body in the field, as a key treatment for snoring as well as mild to moderate sleep apnea.
Fitting a customised dental sleep appliance
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At SleepWise Clinic we receive referrals for oral appliance therapy for snoring and sleep apnea from specialist sleep physicians, GP’s, ENT’s, dentists and other health professionals.
How effective is a dental sleep appliance?
There are now studies demonstrating that appliances are over 95% effective in overcoming snoring.
Study by Victoria University conducted at SleepWise Clinic shows 96% of patients overcome snoring
A recent study at SleepWise Clinic*, involving 116 consecutive patients who have completed treatment, demonstrated that 111 were satisfied with the improvement in their snoring following the use of a customised, adjustable dental sleep appliance. The majority of these patients had adapted well to their appliance and were feeling more refreshed on waking and less sleepy during the day.
*’Assessment of dental sleep appliance treatment’ August-October 2010
Assoc. Professor G Kennedy PhD BBSc Grad Dip Mntl Hlth Sci (Clin Hypn) Dip Clin Hypn MAPS Victoria University.
How does a dental sleep appliance work to eliminate snoring & sleep apnea?
The main way that appliances work is by preventing the tissues at the back of the throat and the base of the tongue from collapsing back into the airway. These appliances take the lower jaw forward, bringing the tongue with it, thereby clearing the airway at the back of the throat.
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Types of dental sleep appliances
The most effective, comfortable types of appliances are those made from impressions and models of the patient’s own teeth. These customised appliances ensure a perfect fit and minimal dimensions.
Warning- beware “over the counter”, non prescription, dental devices.
While custom-made dental sleep appliances are proven to be effective, safe and comfortable, “over the counter”, non prescription, dental devices, such as the Snore Ban, have now been banned from direct sale throughout the US. The US FDA has banned these devices because they are far less effective than custom-made adjustable sleep appliances and because of the potential for side effects such as teeth movement and jaw joint damage. These devices are non-adjustable with one size fits all. Studies demonstrate that such devices are far less effective than custom-made adjustable sleep appliances. Available mostly for sale over the Internet, not only do these devices have the potential to cause side-effects, they are difficult for people to wear -even in the short term.
There are also non-adjustable and adjustable appliances:
An adjustable appliance is far superior because it allows the dentist, and importantly the patient, to slowly bring the lower jaw forward to the ideal most comfortable position that opens the airway.
A non-adjustable appliance makes it a guess to achieve the ideal forward position of the jaw and results in sub optimal outcomes. While such appliances are still used by some dentists experts in the field are in general agreement that they should have no place in current best practice
New Generation Custom-Made Dental Sleep Appliances
The Dorsal
Apart from its very minimal design (only covering the tops of the teeth) the dorsal has a special design feature. It allows the jaws to open and close, so you can sip water and actually talk while it is in the mouth! Simple adjustments for bringing the jaw forward can easily be made by the patient -this is a key feature of a new generation appliance.
Watch the video of Dr Harry Ball demostrating the Dorsal appliance.
The Silensor
The silensor has the most wide spread use of any appliance in the USA. The components are metal free – made in Germany from high strength nylon. The latest version can be considered the most unobtrusive appliance available that still allows the patient to adjust the mandible forward.
The EMA Appliance
The EMA (Elastomeric Mandibular Advancement) is a small and unobtrusive sleep appliance. The upper and lower components are held together with straps of varying lengths and flexibility. These straps allow for excellent side to side movement, as well as dictating the amount of jaw advancement.
The Orthoapnea
The Orthoapnea appliance belongs to the group of appliances that have an anterior mechanism for bringing the jaw forward. A unique feature is the miniaturization of the mechanism which provides maximal comfort and allows the jaw to move freely when connected
The optimal dental sleep appliance
There are over eight different custom-made dental sleep appliances, all with different designs, that have good scientific studies proving effectiveness and comfort. There is no one appliance that is suitable for each and every person. The choice of an optimal appliance for an individual will depend on many factors including the number of teeth, the width of the dental arches of the palate and lower jaw, the degree of jaw protrusion, the size of the tongue, and the age of the patient. It is important that dentists have available a range of new generation appliances rather than rely on just one as many do.
The importance of an experienced and trained dentist
According to a recent survey conducted by the Australian Dental Association only four percent of dentists regularly provide dental sleep appliances for the management of snoring and sleep apnea. . Most dentists who make dental sleep appliances only do so infrequently and it is only a small part of their dental practice, most of which is based on general dentistry.
Some dentists are using only a single appliance instead of selecting from a range to suit the patient’s needs. Some dentists are using appliances which are not of the latest design. It is important to choose a dentist who is regularly fitting a number of appliances each week. An experienced and well trained dentist will have the skills to make any adjustments that may be required in order to achieve the best results possible
Important criteria in choosing a dentist for dental sleep appliance therapy
- The dentist utilises a range of state of the art appliances such as the dorsal, silensor, or somnodent (provide web links).
- The dentist is experienced and trained in the field
- The dentist has made a minimum of 50 appliances and is delivering at least 2 per week.
The dentists at SleepWise Clinic are the most experienced in Australia having treated over 5000 patients with dental sleep appliance therapy.
Dr Harry Ball, Dr Aniko Ball and Dr Rebecca Oliver utilise the latest range of new generation appliances that have been scientifically proven to be effective and comfortable.
They work exclusively in this field and do not practice general dentistry.
SleepWise Dental Lab
At SleepWise Clinic we have our own laboratory manufacturing dental sleep appliances – SleepWise Dental Lab. SleepWise Dental Lab is the only specialist dental laboratory in Australia manufacturing the full range of high quality sleep appliances.
The lab provides appliances not just for SleepWise Clinic but for other dentists throughout Australia who are working in the field. A huge advantage in having a laboratory at the clinic is that each and every appliance provided for a patient is well-fitting, comfortable and adjusted to the highest standards. Another advantage of an onsite laboratory is that any maintenance and repairs can be done on the spot. If dentists are using a regular laboratory, adjustments can take one week or more during which the patient is without the appliance.
Benefits of Dental Appliance Therapy:
- You and your partner can look forward to a quiet night of sleep.
- No more embarrassing snoring sounds while travelling, camping or in any group situation.
- Wake up refreshed.
- Improved quality of life through greater vitality and participation
- Improved work performance due to greater concentration and energy levels.
- Decreased risk of fatigue-related vehicle and work accidents.
- Decreased risk of heart disease, stroke and blood pressure problems.
An Extra Benefit
Many people clench and grind their teeth during sleep and are unaware that this is occurring. This is a common cause of damage to teeth and dental work. Dental sleep appliances have an added benefit of protecting teeth and dental work during sleep.
Unproven and ineffective treatments
There are other treatments offered on the internet and in stores which include nasal strips, sprays, pillows, rings and the buteyko breathing technique. These methods are unproven and generally regarded as ineffective with some being the subject of ACCC investigations. These treatments are not recommended by sleep physicians and experts in the field.
