Montgomery Dental Medicine FAQ’s

Cincinnati, OH Oral Appliance Therapy And FAQ’s

Oral Appliance Therapy

For more than 10 years, Oral Appliance Therapy has been a successful, noninvasive alternative to treating sleep apnea in our practice. Sleep Apnea has traditionally been limited to Continuous Positive Airway Pressure (CPAP).

However, many people are unable to sleep soundly with CPAP because they cannot tolerate the mask and the related pressure. Another alternative is surgery but only has less than a 50% success rate.

Now there is an alternative for mild to moderate sleep apnea. Oral Appliance Therapy (OAT) is a proven, comfortable, non-invasive sleep apnea solution approved by the American Academy of Sleep Medicine. To read their article, published in the Journal SLEEP, click here. You may also reference the Journal SLEEP's article on Sleep Loss by clicking here.

Frequently asked questions about appliances:

Do these devices work for every patient?
No. OAT devices work best for mild to moderate sleep apnea cases. While they can usually provide at least some benefit to almost everyone, there can be issues with specific body types. For instance, they may not be effective in reducing the apnea to normal for patients with an extremely large neck or abdomen, or in extremely thin patients with a steep angle to the lower jaw. Your specific situation should be evaluated by a practitioner to determine an OAT device, CPAP therapy, or a combination is best for you.

Do the devices allow comfort while sleeping?
Yes. After an initial adjustment period of just a few weeks, most patients 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.

How often do devices need to be replaced?
Because the appliances are made of a thermoplastic, they will eventually wear down and must be repaired or replaced every 4-8 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.

Are there any guarantees for these devices?
The appliance is guaranteed for 1 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 3 year appliance replacement protection is available for a nominal fee.

Can the devices create TMJ problems or change my bite?
Usually the appliance helps TMJ problems by eliminating one of the major causes of the problem: lack of open airway. However, 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.

How will I know if my device is working?
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.

Does insurance cover this device?
Most likely, just as CPAP is usually covered by insurance, so are Intraoral Appliances. Like CPAP, it is covered by medical insurance rather than dental insurance since sleep apnea is a medical problem. 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.

How does it work?
By advancing the mandible (lower jaw) forward, the base of the tongue is lifted forward from the posterior (back) wall of the pharynx (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.

Can the use of the device eliminate my sleep apnea over time?

Rarely. Most of the time, the cranial facial structure or the anatomies of the airway are the most significant issues in sleep apnea. OAT changes this structure but only while the patient is wearing the appliance; most people will need the appliance forever.

What are the advantages of wearing the device?
OAT is an extremely comfortable, easy to use device that opens the airway and allows you to get a solid, satisfying night's sleep. This in turn affects all the body systems: from the adrenals to the heart, our bodies need deep, consistent sleep to stay healthy.
OAT is much more comfortable 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.

While surgery is invasive and irreversible, OAT is neither of these. If there are any side effects, they are minor and temporary.

Are there any common side effects?
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.

Accepting new patients. For the best oral health service, call Montgomery Dental Medicine at 513-891-5860 to schedule an appointment. Because it’s not just about your teeth!

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