Snoring & Sleep Apnea
Snoring is simply is a minimal disruption in respiratory air flow.
When this disruption occurs, air flow velocity increases which causes vibration of the soft palate and upper airway tissue. The result is sound issued from the vocal chords.
Sleep apnea, on the other hand, is a sleep disorder characterized by
abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur five to thirty times or more an hour. The effects of sleep apnea range from fatigue to weight gain.
Three forms of sleep apnea exist, they are:
- Obstructive (OSA)
- Central (CSA)
- Complex or mixed sleep apnea (a combination of OSA & CSA)
Several dental appliances exist which limit the effects of OSA. If you suffer from sleep apnea, Bangor Family Dentistry is able to fit you with a device that will open airways and help you have better sleep. The three types of devices we endorse and make available to our patients are:
- Thornton Adjustable Positioner (TAP®)
- Herbst: Herbst Telescopic and SAUD Appliance
- Tongue Retaining Device (TRD)
The Thornton Adjustable Positioner (TAP®) consists of two separate arches designed for mandibular advancement. The advancing mechanism allows for unlimited advancement of the lower jaw. The (TAP®) is the only device that allows adjustments to be made while the patient is sleeping. (TAP®) arches are custom fit to the patient's dental models.
To engage the advancing mechanism, a screw in the upper arch is turned to advance the mandible until the patient begins to feel slight discomfort in the temporomandibular joint or in the facial muscles. (Maximum mechanical protrusion is, on average, about 2.5mm beyond maximum protrusion.) The advancing screw is then turned back until patient is comfortable. With the jaw held forward the airway is more open and OSA is limited.
The Herbst Appliance has been proven to be effective on chronic snoring and mild to moderate obstructive sleep apnea sufferers. This appliance allows patients to move laterally and vertically without disengaging the appliance. Another advantage of the Herbst is if it is determined that the initial position does not provide the anticipated relief of the condition, the mandible can easily be moved forward by two adjustment options. The Herbst traditional hardware includes sets of 1, 2, and 3 mm advancing increment shims. The Herbst Telescopic version allows the clinician to advance in .1 mm increments by making one full turn of the protrusion collar up to 6-8 mm from the start position.
The Herbst appliance is fabricated from hard acrylic, thermoactive and soft materials and is tooth retained via friction grip or clasps. The SAUD version is made of heat-sensitive acrylic and is reinforced by a metal framework and is ideal for the patient who is a "heavy grinder" and might break other appliances. The SAUD adjustment mechanism is positioned on the sides of the device and consists of a piston that slides within a tube. The position of the jaw may be adjusted by using small rings that slide over the piston and when the tube is positioned over the piston it will advance the jaw. Small rubber bands are used to keep the jaw from falling open while wearing the device.
A Tongue Retaining Device (TRD) is a device that works by holding the tongue in a forward position by means of a suction bulb that holds the tongue. With the tongue held forward, the airway is more open reducing the effects of OSA. TRDs are also effective for patients who want to limit snoring.
A TRD is made of flexible polyvinyl material which adapts to the contours of the teeth and dental arches. TRDs do not depend on the teeth to hold it in place. A TRD is a good choice for patients who have peridontal disease or other maladies of the teeth, gums, or mouth.
If you suffer from sleep apnea, call 207-947-4767 or schedule an appointment so that we may provide a solution to help you sleep better.