An oral appliance is a front-line treatment for snoring and mild to moderate obstructive sleep apnea. They are also a highly utilized non-surgical treatment option for TM Joint disorders.
Oral Appliance Therapy – Sleep Apnea
Appliance therapy for sleep-related breathing disorders involves the selection, fitting and use of a specially designed oral appliance that maintains an open, unobstructed airway in the throat when worn during sleep. A dental specialist will work as a team with your physician to provide diagnosis, treatment and ongoing care. A joint consultation will be required to determine the most effective treatment approach. The initial evaluation phase of oral appliance therapy includes examination, evaluation to determine the most appropriate oral appliance, fitting, maximizing adaptation of the appliance, and the function.
On-going care is an essential step in the treatment of snoring and Obstructive Sleep Apnea with Oral Appliance Therapy. They are used to assess the treatment of your sleep disorder, the condition of your appliance, your physical response to your appliance, and to ensure that it is comfortable and effective.
How An Oral Appliance Works:
- Repositioning the lower jaw, tongue, soft palate and uvula
- Stabilizing the lower jaw and tongue
- Increasing the muscle tone of the tongue
Advantages of Oral Appliance Therapy is their effectiveness in conjunction with how comfortable and easy they are to wear. Most people find that it only takes a couple of weeks to become acclimated to wearing the appliance. At the same time, these treatments are reversibile and non-invasive, and offer little risk with high probability of success.
Oral Appliance Therapy – Occlusal & TM Joint Appliances
The most common treatment for temporomandibular disorders is a denal or occlusal splint. Occlusal splints are removable appliances made of hard acrylic that fit between the maxillary and mandibular teeth. An occlusal splint is indicated to reduce parafunctional activity, deprogram muscles by disengaging an occlusion, and/or increase vertical dimension.
After your initial consultation, the dentist will make an impression of your teeth.After the splint is made, the dentist will fit and readjust it. You will be expected to wear it at the recommended times (all day, only at night, both), and to come in for follow-up appointments to check on your bite and have the splint readjusted, if necessary. Your dentist will advise you how to care for the splint.
These appliances may relieve pressure on joint structures, reposition the mandible in order to achieve a normal maxillomandibular relationship and neuromuscular balance, and alter condylar position to affect disc position. They can also protect teeth from attrition and adverse traumatic loading and be used to produce a placebo effect.
Stabilization splints are the most widely used treatments for TMJ disorders. Studies of their effectiveness in providing pain relief, however, have been inconclusive. If a dental stabilization splint is recommended, it should be used only for a short time and should not cause permanent changes in the bite. If a splint causes or increases pain, stop using it immediately and contact your dentist.
Oral Appliance Effectiveness
A 2010 study evaluating intraoral orthopedic appliances for temporomandibular disorders found hard stabilization appliances, when fitted with precision, have good evidence of modest efficacy in the treatment of TM Joint Disorder pain compared to non-occluding appliances and no treatment.
Other types of appliances, including soft stabilization appliances, anterior positioning appliances, and anterior bite appliances, have some RCT evidence of efficacy in reducing TM Joint Disorder pain. However, the potential for adverse events with these appliances is higher and suggests the need for close monitoring in their use.
If you have been fitted with a proper dental appliance and your pain has not subsided within 3 months it is recommended that you speak to your dentist to determine if this treatment is effective, or other options are available.