Which Oral Sleep Apnea Appliance Is Best?

I am a dentist specializing in dental sleep medicine. The answer is, whatever appliance is best for you. Over the years, efficacy testing has shown that anterior traction devices, i.e., trays joined in the middle, show consistently better efficacy than lateral thrust devices, i.e., appliances with lateral wings the bring the jaw forward. In many. but not all cases, holding the jaws closed will also increase efficacy. That being said, you have to pick the best device for each patient. Some people are claustrophobic and just can not tolerate having the trays joined together. In that case, a device with lateral wings which allows free opening and closing could be the solution if the reduced efficacy would suffice for that patient. Some people lateral brux ( move from side to side ) at night. In that case, the appliance must accommodate it. There are many other factors to be considered. The bottom line is that a sleep dentist should have many appliance choices to be considered. A "one trick pony" with only one choice may not get the job done, A.B. Luisi, Jr., D.M.D.. The Naples Center For Dental Sleep Medicine.

Good morning, I was informed that dental devices have a poor success rate if you have severe OSA (37), do you have a view on this at all, not seen a lot of evidence to support of disprove this. Thanks D

Thank you for your inquiry Chameleon67. Actually, I would respectfully disagree with that statement. The official position of the American Academy of Dental Sleep Medicine is that oral appliances can be used to treat mild, moderate, and severe obstructive sleep apnea. Initially, the F.D.A. approved oral appliances for only mild to moderate OSA. For medico-legal purposes, the manufacturers tend to stick to that statement. Testing has shown that, although CPAP does lower AHI better than oral appliances, the medical outcomes are the same. This is because patients tend to wear the oral appliances much longer every night than CPAP users do. I have used OAs many times to successfully treat severe OSA. There are failures. About five percent of the patients are called non responders because the oral appliances will simply not produce the desired result. But to have success, you must have a highly skilled sleep dentist using the very best appliances on the market. A.B. Luisi, Jr., D.M.D.. The Naples Center For Dental Sleep Medicine.