Most people don’t think of their dentist as part of the picture when it comes to sleep apnoea, but oral appliances for sleep apnoea are a recognised treatment option, and dentists play a specific role in providing them. This doesn’t replace the work of your GP or a sleep physician, it sits alongside it, and understanding how the two connect is worth knowing if you or your doctor have raised this as an option.
The Short Version
- Oral appliances work by gently repositioning the lower jaw to help keep the airway open during sleep.
- They’re generally considered for mild to moderate obstructive sleep apnoea, and sometimes for snoring alone.
- Diagnosis happens through a sleep study, arranged by your GP or a sleep specialist, not by your dentist.
- A dentist’s role is fitting and adjusting the custom appliance once a diagnosis and referral are in place.
- Suitability depends on individual circumstances, and outcomes vary between individuals.
What Sleep Apnoea Is, Briefly
Obstructive sleep apnoea happens when the airway becomes partly or fully blocked during sleep, causing repeated brief waking moments throughout the night, often without the person realising it’s happening. Common signs include loud snoring, waking up gasping, and persistent daytime tiredness, though these signs alone don’t confirm a diagnosis. If sleep apnoea is suspected, the next step is a proper assessment, generally starting with your GP.
How Oral Appliances Work
Oral appliances, often called mandibular advancement splints, work by gently holding the lower jaw and tongue slightly forward during sleep. This helps keep the airway from collapsing or narrowing, which is what causes the breathing pauses associated with obstructive sleep apnoea. The appliance is worn only at night and looks somewhat similar to a sports mouthguard or orthodontic retainer.
A few things worth knowing about how these devices function:
- They don’t treat the underlying cause of sleep apnoea, they help manage the airway obstruction while worn.
- Effectiveness varies between individuals, and response to treatment is generally reviewed after a period of use.
- They’re typically recommended for mild to moderate cases, with more severe cases often needing a different or combined approach.
Custom-Fitted Oral Appliances vs Over-the-Counter Options
Custom-fitted oral appliances are made specifically for your teeth and jaw, based on impressions or scans taken by your dentist. This is different from generic “boil and bite” devices sold online or in pharmacies, which aren’t tailored to your individual anatomy and are generally considered less reliable as a treatment option.
A properly fitted appliance allows for adjustment over time, which matters since the degree of jaw advancement needed can vary and may need fine-tuning based on how you respond. This kind of titration generally isn’t possible with an off-the-shelf device.
Working With Your Sleep Physician
It’s worth being clear about where a dentist’s role starts and stops here. Diagnosing sleep apnoea requires a sleep study, which is arranged through your GP or a sleep specialist, not through a dental appointment. Working with your sleep physician means your dentist provides the oral appliance as part of a coordinated plan, generally after a diagnosis has been made and an oral appliance has been identified as a suitable option for your specific case.
If you already have a diagnosis and your sleep physician has suggested an oral appliance may be worth exploring, a check-up is often a sensible starting point, since your dentist will also want to confirm your teeth and gums are suitable for wearing an appliance.
Is an Oral Appliance an Alternative to CPAP?
For some patients with mild to moderate obstructive sleep apnoea, an oral appliance may be considered as an alternative to CPAP, particularly where CPAP hasn’t been well tolerated. This isn’t a universal substitute, and whether it’s appropriate depends on the severity of your condition and your sleep physician’s assessment.
A few factors that generally influence this decision:
- The severity of obstructive sleep apnoea, based on your sleep study results.
- Whether CPAP has been tried and how well it was tolerated.
- The condition of your teeth and gums, since the appliance relies on them for support.
- Your own preference between the two approaches, discussed with your treating specialist.
According to Healthdirect, your doctor can refer you to a sleep specialist for a diagnosis and treatment of obstructive sleep apnoea, and it’s important to treat OSA because it can increase the risk of other health problems. The Better Health Channel also notes that sleep apnoea is relatively common, affecting an estimated 5% of Australians, with higher rates in men over 30.
Frequently Asked Questions
Can My Dentist Diagnose Sleep Apnoea?
No, a formal diagnosis requires a sleep study, generally arranged through your GP or a sleep specialist. Your dentist’s role is providing and fitting the oral appliance once a diagnosis and suitability for this treatment have been confirmed, and this pathway can vary depending on your individual circumstances.
How Long Does It Take to Get Used to Wearing an Oral Appliance?
This varies between individuals, and some people adjust within a couple of weeks while others take longer. Your dentist can advise on what to expect and make adjustments if the fit isn’t comfortable.
Will an Oral Appliance Stop My Snoring Completely?
It may reduce or resolve snoring for some people, but results vary considerably between individuals. Your sleep physician and dentist can discuss realistic expectations based on your specific case.
Can I Use an Oral Appliance If I Have Missing Teeth or Wear Dentures?
This depends on individual circumstances, since the appliance generally relies on having enough natural teeth for support. Your dentist in Camberwell can assess whether this treatment is suitable for your situation.
Do I Need to See My Sleep Physician Again After Getting an Oral Appliance?
Yes, follow-up with your sleep physician is generally recommended to check how well oral appliances for sleep apnoea are working for you, sometimes including a follow-up sleep study. This coordination between your dentist and sleep physician is a normal part of ongoing care, though the exact follow-up schedule depends on individual circumstances.
Ask Care Dental Camberwell About Oral Appliance Therapy
If your GP or sleep physician has raised an oral appliance as an option, the team at Care Dental Camberwell can talk through what’s involved and assess whether your teeth are suitable. You can book online or contact Care Dental Camberwell to arrange a consultation.