Can The Dentist Cure OSA? When Dental Devices Win Over CPAP Machines

Obstructive Sleep Apnea (OSA) is seen as chronic, so it’s a condition you will have to deal with for a long time – if not your lifetime. However, using a CPAP machine doesn’t have to be on the agenda. Some alternate treatment options work for a select few and can be recommended by your dentist as well as your doctor! Today, we’ll explore oral appliance therapy, its dental devices, and, of course, continuous positive airway pressure.

Knowing the different types of sleep apnea will be an important part of answering which treatment options are right for you, so here’s a quick recap…

Obstructive Sleep Apnea (OSA) occurs when your airways are blocked by collapsed soft tissue or another obstruction; like enlarged tonsils and adenoids, fatty neck muscles, etc. It is the most common type of sleep apnea, and the only one with effective treatments outside of CPAP therapy.

Central Sleep Apnea (CSA) and Mixed Sleep Apnea both happen due to brain signals failing, and the neurological stimulus needed to correct those sleep disorders doesn’t currently exist outside of CPAP therapy. Still, the dentist can absolutely identify sleep apnea side effects if they’re present at your next 6-month checkup.

Regardless of which form of sleep apnea you have, your dentist will be able to pick up on the telltale signs. For example, snoring is the #1 side effect of OSA, and it can affect your oral health. It can lead to bad breath, dry mouth, more bacteria buildup, and even tooth decay, which is exactly what the dentist is looking for. 

Furthermore, OSA is usually caused by comorbidities; including obesity, high blood pressure, and heart disease. So, if you have any comorbidities, plus anatomical risk factors like tongue position and size or an elongated soft palate, your dentist need only read your chart and start your cleaning to say you have (or may soon have) sleep apnea. And, ladies, 26% of pregnant women are diagnosed with sleep apnea in their third trimester.

Oral appliance therapy is a non-invasive, effective treatment option for OSA patients with the anatomical risk factors we mentioned earlier. According to experts at Harvard Medical School, oral appliance therapy works by using one of three main categories of dental devices:

• Mandibular Advancement Devices move your lower jaw into a comfortable, forward position while you sleep, keeping your upper airways free of obstructions.
• Mouth Guards are similar to mandibular advancement devices but really act like an orthodontic retainer, repositioning your jaw at a lesser degree.
• Tongue-Retaining Devices focus on the tongue and ignore the jaw. They are soft, plastic splints placed around your tongue to hold it forward all night long.

The American Academy of Dental Sleep Medicine advises a prescription for any oral appliance–just like you would with CPAP therapy–but there are pros to an oral appliance over a CPAP machine. All are portable without needing a travel CPAP device, they’re quieter, and are certainly easier to wear than a CPAP mask.

Of course, when you ask your dentist about oral appliance therapy, it may help to know a few recommended brands that produce dental appliances for sleep apnea.

There are three well-known providers who manufacture dental appliances for sleep apnea: SomnoMed, Oventus, and Signifier Medical Technologies. Let’s take a look at each of them, along with their top products…

SomnoMed has innovated the tongue-retaining devices originally invented by Dr. Richard Palmisano and now offer several versions of splints, known as SomnoDent Oral Devices. Avant, Herbst, and Brux are all well-known models within the series, varying from custom-fitted acrylics to comfort liners that cradle your teeth. Plus, Dentistry IQ reveals that SomnoDent Oral Devices have their own compliance recording technology for your OSA!

Who can use SomnoDent Oral Devices?

• Patients with mild OSA
• Patients who are mouth breathers
• Patients with smaller mouths
• Patients with a larger tongue
• Patients with a wide mouth when open

Another oral treatment of obstructive sleep apnea is Oventus’ O₂Vent Optima, which is a customized, 3D-printed, nylon oral device that stabilizes the patient’s upper airway. It’s also the only dental device on this list to treat moderate OSA.

One study in the European Respiratory Journal suggests that the efficacy rate of treating moderate OSA with a CPAP or a mandibular repositioning appliance (like O₂Vent Optima) is less than 2%. High praise indeed!

Who can use O₂Vent Optima?

• Patients with mild to moderate OSA
• Patients who suffer from primary snoring
• Patients with a larger tongue
• Patients with an elongated soft palate
• Patients with elongated lateral walls

Finally, eXcite OSA is the preferred daytime therapy solution for sleep apnea and the only dental device Aeroflow Sleep currently carries.

This revolutionary mouthpiece sends small vibrations or neuromuscular electrical stimulation (NMES) to the areas of the upper airway most likely causing your obstruction. All you have to do to use it is download the app, insert the device, and run a session for 20 minutes. It’s that easy!

Who can use eXcite OSA?

• Patients with mild OSA
• Patients who suffer from primary snoring
• Patients with poor tongue muscle function
• Patients who are not pregnant or may become pregnant
• Patients who do not have pacemakers, implanted electrodes, metal implants, prosthetics, braces, and/or a history of mouth ulcers

All three of the aforementioned dental devices are backed by the Food & Drug Administration (FDA,) so you know they work; however, the dentist will almost always recommend CPAP therapy first. That’s because CPAP therapy is still your best chance at combating OSA, especially if your diagnosis extends past mild OSA.

Continuous positive airway pressure (CPAP) is exactly what it sounds like. It’s pressurized air produced by a CPAP, APAP, or BiPAP machine that lowers your AHI. The full setup may sound scary at first, but there’s a reason CPAP therapy is the gold standard. When used as directed, a recent Dutch OSAs Guideline showed an estimated success rate of 80% for CPAP.

Bonus! CPAP therapy has benefits beyond treating sleep apnea too; including a healthier heart, lower risk of diabetes, reduced daytime sleepiness, and a better quality of life.

Before we wrap this up, it’s time to set the record straight on one thing; sleep apnea cannot be cured with either a dental device or CPAP machine, and certainly not at the behest of your dentist (or doctor.) What they can do is talk to you, offering their professional opinion as a licensed healthcare practitioner and guiding you toward the treatment option that suits your unique health needs.

If that treatment option turns out to be CPAP therapy, Aeroflow Sleep can help too! Your CPAP supplies may be covered up to 100% through insurance when you join our family of patients. We’re in-network with most private insurance companies and are also accredited by Medicare and Medicaid. All you need to do is fill out the Qualify Form linked below to find the peace of mind that we are on your side.

References

Dominguez, J. E., Street, L., & Louis, J. (2018, June). Management of obstructive sleep apnea in pregnancy. Obstetrics and gynecology clinics of North America. Retrieved September 29, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995135/

Corliss, J. (2021, April 28). Dental appliances for sleep apnea: Do they work? Harvard Health. Retrieved September 29, 2022, from https://www.health.harvard.edu/blog/dental-appliances-for-sleep-apnea-do-they-work-2021042822476

Oral appliance therapy - american academy of dental sleep medicine. (n.d.). Retrieved September 29, 2022, from https://www.aadsm.org/oral_appliance_therapy.php

Visscher, L., Brusse-Keizer, M. G. J., & Eijsvogel, M. M. M. (2014, September 1). The efficacy of CPAP and oral appliances in moderate obstructive sleep apnoea, used as CBO guideline states. European Respiratory Society. Retrieved September 29, 2022, from https://erj.ersjournals.com/content/44/Suppl_58/P2217