how oral appliances work

Oral Appliances are placed in the mouth and are worn much like an orthodontic appliance or sports mouth protector. They are worn during sleep to prevent the collapse of the tongue and soft tissues in the back of the throat so that the airway stays open during sleep. The appliances promote adequate air intake and help to provide normal sleep in people who snore and have a medical condition known as sleep apnea. Oral appliances can be used alone or in conjunction with other means of therapy such as continuous positive air pressure (CPAP). Determination of proper therapy can only be made by joint consultation of your dentist and sleep physician.

Types of Oral Appliances

Currently, over 40 different types of oral appliance are available to specially trained dentists to treat sleep disordered breathing. At first glance, this number appears overwhelming but on close examination each of the appliances falls basically into one of two categories and the diverse variety is simply a variation of a few major themes. Oral appliances can be classified by mode of action or design variation.

Tongue Retaining Appliances

There are very few tongue retaining devices available, but they have been well studied and shown to be effective in many patients. Tongue retainers function by directly holding the tongue in a forward position  by means of a suction bulb that holds the tongue. When the tongue is in a forward position, the back of the tongue does not collapse during sleep and obstruct the airway in the throat.

An example of a tongue retaining appliance.  The tongue is held in the suction bulb that protrudes from between the teeth on this cast.

Mandibular Repositioning Appliances

Mandibular repositioning appliances are by far the most numerous type on the market. They all function to reposition and maintain the lower jaw (mandible)  in a protruded position during sleep. It is felt that this serves to open the airway by indirectly pulling the tongue forward since the tongue is attached to the lower jaw, by stimulating activity of the muscles in the tongue and making it more rigid, and by holding the lower jaw and other structures in a stable position to prevent opening of the mouth.

An example of a mandibular repositioning appliance. Thin shells are placed over the upper and lower teeth and a device is incorporated that will pull the lower jaw forward as necessary to open the airway.

sleep news