Dental Device vs CPAP

Has anyone tried a dental device and ended up with cpap anyway? What happened?

A friend of mine is using his "Snore-Guard" dental device, 3M Painter's Tape, panty hose, and his Aura (Aeiomed) Headrest mask...hooked up to an AFLEX machine.

Don't laugh....he's a highly respected mechanical engineer who knows how to make things work. People come to him when equipment or processes in chemical plants malfunction.

He gets good results.....AHI of 1.0 or less.....and he found that the Snore-Gurd dental device wouldn't help his problem by itself. He finds that the value of his Snore-Guard is to keep his jaw aligned.....so that the tape and panty hose can do the job of sealing against mouth leaks.

Gerald

Whether a dental device works or not is dependant on WHY you are having apneas. If it is because your tongue is slipping back into your throat and blocking it, a mouthpiece can stop that. If it is because the structures at the back of your throat are collapsing, it won't do much, if anything. Most people seem to have the structural collapse and that's why dental pieces only work a small percentage of the time (less than 30%, I believe). Like weight loss, dental devices and surgery seem more likely to help those with mild/moderate apnea.

You'll find more information about mouth guards (actually, custom made mandibular advancement devices) at http://www.talkaboutsleep.com/message-b ... m.php?f=10 ; that's talkaboutsleep's dental sleep medicine forum.

There have been some members here who ended up preferring a dental solution - obviously that made them rather less interested in talking about cpaps - snork1 was one of the people who did much better with a madibular advancement device.

O.

I had used the Klearway mandibular advancement appliance for almost ten years. It was effective, as demonstrated by repeated sleep studies. Due to a variety of personal factors (not to mention my age, which I won't mention), over that ten years there were some undersired effects on my oral architecture. We (I had an oral-maxillofacial surgeon with considerable expertise in sleep apnea managing the device, as well as a "medical" sleep specialist) decided to introduce CPAP once weekly, and then twice weekly, to give my dentition a periodic "rest" from the appliance. This worked very well, and would have been continued, had I not dropped and broken the appliance. Since I already had CPAP available, and working effectively, there was no reason to rush back to the appliance, and in fact, no persuading reason to return to the appliance at all.

Bottom line is that oral appliances can and do effectively treat sleep apnea for some persons, such as myself. But the person must be a suitable candidate for this therapy, the sleep doctor/dentist MUST be experienced, there MUST be adequate follow-up and periodic polysomnograms, and your own regular dentist must be a partner in your care. Under these circumstances, use of an oral appliance can be a very effective and attractive alternative to CPAP

Oral appliances have the advantage over CPAP of being very small, very portable, very convenient for travel, very easy to maintain, and place no restrictions on sleeping position. They served me well for many years. Velbor

Now that you mention it, Velbor (the MAD, I mean, not your age, which, as you mentioned, you didn't metion...) I remember you did mention the device, in the past - my bad for forgetting.

O.

Thanks, everyone; very helpful information.

I'm new to this, so sorry if this question has been asked and answered before: how does one find a dentist experienced with sleep apnea, without calling every dentist in the state? My sleep doctor is a hard-line allopath, suspicious of anything other than CPAP and drugs, drugs, drugs. I use CPAP faithfully, but decline the drugs. Studying sleep disorders is relatively new in this state, so things are pretty primitive. I hate CPAP. Having to try to sleep with a vice clamped to my head means I wake constantly and often can't then go back to sleep. I'm ready to try a dental appliance, since it can't be any worse than this.

Without any endorsement from me, you might want to look at the site:
http://www.ihatecpap.com/index.html
by Dr. Ira Shapira, who frequently posts on the "TalkAboutSleep" discussion forum linked above by ozij.
Some helpful basic information can be found there.
On his site you will also find a "Find a Doctor" look-up for "Sleep Apnea Dentists",
but these appear to be more "advertisements" than statements of credentials.

Arguably a bit more useful is the site of the American Academy of Dental Sleep Medicine:
http://www.aadsm.org/
which has a "Find a Dentist" section.
Those dentists with an ABDSM after their name have at least gone to the trouble and expense of becoming certified.

One additional possible path is to contact the "Department of Oral & Maxillofacial Surgery" of a nearby teaching hospital; such departments may provide dental-oriented therapy for sleep apnea (without getting hung up on "surgery").

Good luck. Velbor