Treating Sleep Apnea Tailoring the Oral Appliance To the Patient
Dentists who have working experience with many oral appliances have observed that some not only work differently than others but differently on different patients, who, of course, vary in both their anatomy and temperament.
Published studies suggest two types of oral appliances effectively treat snoring and obstructive sleep apnea (OSA) tongue retaining devices (TRD) and anterior mandibular retaining devices (MRD).
The TRD is made of a soft flexible vinyl type bulb holding the tongue (by its front half portion) forward between the front teeth as one may stick their tongue out at somebody. This impacts more of the upper back of the throat.
The MRD is usually made of a more rigid material usually fitting on the teeth of both jaws either pulling or pushing the lower jaw forward and the tip of the tongue forward. This impacts more of the lower back of the throat.
Both TRD and MRD vary in their design, which includes the material from which they are made, how they are held in place, what type of force is required to accomplish this.
Positioning potential in how easily the jaws can and do move.
How easily the jaw position can be modified in three dimensions (back and forth, side to side and up and down)?
Does the patient or dentist do the work to help determine and actually change the jaw position.
If it must be anchored firmly to the teeth, how is it anchored and how well does it remain anchored well. If it loosens can it be re-tightened, and can this place stress on the teeth?
How fragile is it and how easily can it be repaired, if it cracks or breaks, or be modified, if dental work that alters the shape of the teeth is required? How costly is this?
How easily is it kept clean and does the material degrade over time?
Does the design impede or favor the position of the tongue within the mouth, provide enough room for allowing modification to improve this?
Matching the design characteristics of a particular appliance to the anatomy, functional movement and temperament of each patient is best determined through careful examination and analysis of them including a trial run of testing appliances through “trial procedures”.
Trial procedures will be discussed in a future edition of Your Health Magazine.
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