Commonly known as obstructive sleep apnea (OSA), this condition causes regular disruptions of breathing during sleep because of an upper airway obstruction. These interruptions can cause cognitive problems, daytime tiredness, and major medical hazards like heart disease, stroke, and hypertension. Although the most successful treatment for OSA is continuous positive airway pressure (CPAP), many patients search for alternate therapies since it is difficult to follow CPAP use. For such patients, oral appliance therapy has become rather important as a substitute.
Oral devices are made to keep the throat’s wide, unobstructed airways free throughout sleep. For people with OSA, there are essentially two kinds of oral devices: tongue-retaining devices (TRDs) and mandibular advance devices (MADs). Children with OSA have access to another therapy called rapid maxillary expansion (RME).
Devices For Mandibular Advancement (MADs)
Oral appliances used most often for OSA are MADs. They work by pulling the lower jaw and tongue forward, therefore opening the neck, and fit over the upper and lower teeth. These devices come in many shapes, materials, and adjustability choices and resemble mouthguards.
Usually adjustable, customized MADs—which are chosen for their better fit and comfort—allow exact control over the degree of jaw advancement. Since it can affect the comfort level of the user and the efficacy of the treatment, this customizing is absolutely vital.
Studies have indicated that MADs can dramatically lower apnea counts and raise blood oxygen saturation levels. They improve general quality of life by also helping to lower daytime tiredness and snoring. Though adverse effects like dry mouth or more salivation could develop, they usually go away with time.
Devices for Tongue Retention (TRDs)
Less often seen than MADs are TRDs. They hold the tongue forward using a suction bulb to keep it from falling back and obstructing the airway. Usually one size fits all, TRDs can be customized with some exceptions.
Although TRDs are less investigated than MADs, studies indicate they do help lower daytime alertness and the frequency of breathing disruptions. Patients without teeth or those with jaw problems making MADs inappropriate may find them especially helpful. TRDs can, however, occasionally be painful and might lead to dry mouth or too strong salivation.
Quick maxillary expansion (RME)
Children with OSA can have RME, an orthodontic treatment. It uses a custom-made expander to broaden the upper jaw via outward pressure on the upper molars. By altering the anatomical form of the mouth and throat, this extension can assist in opening the airways. RME devices are worn all the time and seek to create a permanent anatomical alteration unlike MADs and TRDs.
Patients should have their mouth appliances expertly fitted and schedule frequent follow-up visits with their healthcare providers, notwithstanding the possible advantages. This skilled control guarantees the treatment stays efficient and helps control any negative effects. For many OSA sufferers—especially those with mild to moderate severity who are unable or unable to employ CPAP therapy—oral appliances offer a good treatment choice. For those with this sleep condition, dental appliance therapy can greatly enhance their quality of life and general health with correct selection, fit, and follow-up.