Use of mouth piece instead of CPAP

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Use of mouth piece instead of CPAP

Postby Kali » Wed Jun 22, 2005 11:26 pm

Has anyone experimented with the use of plastic mouth pieces to combat sleep apnea?
My father has sleep apnea and uses a mouth piece and is content with it.

I travel alot and the use of a CPAP machine is not possible.

THe following site has the mouth pieces for sale <<commercial link removed>>

any suggestions on what to look for when buying these items?

The price is very reasonable compare to what my father has paid by going through his physician (about $1,000).

Placing my jaw forward helps me breathe better, so I am thinking this is a good start to help the situation.

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Postby Mike » Thu Jun 23, 2005 6:10 am

Kali,

I attended a lecture on sleep apnea in DC and Dr. David Rappoport had this to say about dental devices;

Dental devices, that pull the jaw forward, again, logical, seems like a great idea, should have worked better than it did, does work in enough patients that we are still doing it, but doesn't work quite predictably enough to be a mainstay treatment, certainly not of severe disease.


So, it is possible that it will help, but you would still need a sleep study with the device to determine if it is working. Just because the snoring is reduced doesn't mean that all of the apnea's and hypopnea's have been stopped.

Additionally, there are thousands of "cures" for snoring. Most of them are old wive's tales that vary from ridiculous to dangerous to both. Few of them are effective. The one thing that you can be guaranteed is that they will take your money.


Hope this helps!


Regards,
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Postby rested gal » Thu Jun 23, 2005 4:39 pm

Kali, in the "Links" section of this message board, you can find a list of discussions on other message boards regarding dental appliances and other procedures:

Just click below to go directly to that list of topics:

LINKS to surgery, turbinates, Pillar, TAP experiences

Hope that helps.
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Use of mouth piece instead of CPAP

Postby James » Mon Jul 04, 2005 6:35 pm

Kali,

I recently (May) attanded a talk in Dublin by a dentist who is qualified in fitting such devices. Firstly you should contact your sleep specialist for a referral to a suitably qualified dentist. Not all dentists have expertise in this field. At present there are c.40+ different devices ranging from MADs (Mandibular Advancement Devices) to TRDs (Tongue Restraining Devices) to combinations to oral CPAP interfaces.

MADs are suitable in the main for those with fairly good teeth (at least 10 good rear teeth), TRDs are for those with little or no natural teeth. Both devices are really only good for mild apnea and/or snoring. The idea in liasing between specialist and dentist is that the dentist will know in advance the severity of the apnea and consequently how far forward he will have to bring the lower jaw. Often they may want another sleep test to see how the device is working. It is also important to keep in contact with them after the fitting in case any small adjustments are required.

Some specialists may suggest buying a 'boil and bite' type MAD in the first instance to see if you will tolerate such an item in your mouth, before committing yourself to the 'real' thing.

Anyway, thats the nuts and bolts of the thing. A larger number of sufferers using CPAP have started using MADs for week ends away and the like with good success rates.

Only today I saw the new ResMed S8 CPAP machine. It's tiny, also the new Good Night (Puritan Bennett/Tyco) with humidifier is if anything smaller and lighter again. Without the humidifier its footprint is no bigger than the jewel case of a CD and approx 3/4 inches in height. Overall less than half the size of my current ResMed S7. Obviously the CPAP companies are listening to people who want to travel light.

Daniel
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Oral Appliances for snoring and sleep apnea

Postby rbddds » Wed Jul 06, 2005 10:50 am

I have recently stumbled across this forum and have read with interest many of the posts and replies, especially the ones about oral appliances, since I am a dentist and I have devoted my entire practice to the treatment of snoring, uars, and sleep apnea utilizing state of the art dental orthotics. Daniel made some good points about the oral appliances. Perhaps I can add to that:
1. Not all oral appliances are the same.
2. Not all dentists are the same; please seek out one who has knowledge in this area and has treated many patients.
3. At present, it is impossible to predict who an oral appliance will work on and who it won't.
4. At present, it is impossible to predict how far one will have to move the lower jaw forward to get an acceptable result.
5. It is true that the oral appliances work best on patients who suffer from snoring, upper airway resistance syndrome, and mild sleep apnea. In fact, it is my professional opinion that they should be the first line of therapy for these patients. However, they can also work for severe OSA patients. I have recently completed successful titration for two such patients. One went from a pre treatment AHI of 122 to a post treatment AHI (w/ MAD only) of 5. Another went from pre AHI 95 to post AHI 1.

I hope this helps.

Dr. D
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TMJ?

Postby Steve » Wed Jul 06, 2005 11:43 am

My concern with a dental appliance that draws the jaw forward for 8 hours per night is that it would cause TMJ. My dentist said the same even before I got a chance to mention my concerns. She said the patients she had with dental devices for treatment of sleep apnea all had their jaws go out of alignment in about a month. #-o

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Postby dusangpyong » Fri Aug 05, 2005 5:25 am

Does anyone know the name of the dental appliance(s) that helps both sleep apnea and TMJ Disorder at the same time? I do know that there is something available, just not the name or if it is something that is still being tested or if it is just a modification of a dental appliance that is already available.
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Re: TMJ?

Postby Daniel » Fri Aug 05, 2005 4:32 pm

Steve wrote:My concern with a dental appliance that draws the jaw forward for 8 hours per night is that it would cause TMJ. My dentist said the same even before I got a chance to mention my concerns. She said the patients she had with dental devices for treatment of sleep apnea all had their jaws go out of alignment in about a month. #-o

Steve


Hi Steve,

I can only suggest that your dentist is not familiar/qualified to fit such devices. Best practice is to liase with your sleep doc, who should know suitably qualified dentists. Your sleep doc has an important input in the choice and fitting of a dental device. It is also extremely important that the progress, or lack of, be closely monitored after deciding to use such a device.

Daniel
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