Most patients determine if they have OSA by contacting their physician. Often referred to a sleep center, it is common for those diagnosed with OSA to initiate their treatment with CPAP (Continuous Positive Airway Pressure). CPAP has a 100% chance of success even with very severe cases. CPAP therapy involves patients wearing facemasks during sleep. This mask attaches to a machine that pumps air down the airway, serving to keep it open and allowing for proper breathing. This also puts an end to snoring.
However, a large percentage of CPAP patients do not like wearing their masks and do not have severe apnea, thus making them the perfect candidates for oral appliance therapy. According to the American Academy of Sleep Medicine (AASM), a physicians’ organization, the initial treatment modality for mild to moderate OSA can be an oral appliance. These appliances reposition the lower jaw in a forward direction, thus holding the base of the tongue away from the pharynx. This allows for continuous air flow during sleep and cessation or reduction in snoring.
While an oral appliance is comfortable and easily tolerated, a properly adjusted CPAP remains the standard of care for all levels of OSA. When worn, a CPAP completely eliminates OSA. However, as compliance is often low with a CPAP, the AASM now recognizes that an oral appliance is often more effective due to higher compliance rates. Due to simplicity, most people prefer putting in a mouthpiece to sleep as opposed to putting on a facemask attached to a pump.
Oral Appliance Therapy (OAT)
“Although not as efficacious as CPAP, oral appliances are indicated for use in patients with mild to moderate OSA who prefer OA’s to CPAP, or who do not respond to CPAP, are not appropriate candidates for CPAP, or who fail treatment attempts with CPAP or treatment with behavioral measures such as weight loss or sleep position change.”
SLEEP, vol. 29, No. 2, 2006, page 242
Whereas OAT shows tremendous success for mild-moderate OSA, severe cases require CPAP. As stated earlier, the most severe cases sometimes require a combination of CPAP with OAT, known as a hybrid appliance.
Only dentist with proper training in dental sleep medicine can craft these oral appliances. Dr. Gerlach has received extensive training and has considerable experience treating OSA with oral appliances. He works closely with various medical groups in the Plano/Dallas areas in the interest of optimizing his patients’ treatment. These appliances take skill and knowledge to properly create and adjust to each patient’s unique mouth.
If you would like to find out more about whether you could be suffering from OSA, or if you currently struggle with a CPAP and would like to try an oral appliance, call Gerlach & Willard Dental Associates today.