Obstructive Sleep Apnea:

FINDING RELIEF IN ORAL APPLIANCE THERAPY

Written by Andrew Sedler, COO

Written by Andrew Sedler, COO

Written by Andrew Sedler, COO

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Obstructive sleep apnea (OSA) results in serious medical complications that often affect the quality of life and may reduce a person's lifespan; therefore, sleep apnea should be taken seriously by the sufferer, and help should be sought out. Clinicians can screen sleep apnea patients and prescribe solutions that ultimately will improve the patients’ life. While positive airway pressure or PAP is an excellent solution to OSA sufferers, many patients are unable to tolerate this method of treatment. Oral appliance therapy (OAT) offers an alternate solution.

Effects of Obstructive Sleep Apnea

OSA affects approximately 22 million Americans.

The prevalence of OSA increases with age. The most affected group is middle-aged men who are obese. One of the most prominent signs of sleep apnea suffers is loud snoring during sleep. This identifier can create restlessness and directly affect the amount of sleep for the sleep apnea sufferer and their partner as well.  Oftentimes, sleep apnea sufferers wake up tired and can experience exhaustion throughout the day.

Sleep Apnea - OSA - Snoring- Breathing - Illustration

This can affect mood and impact the sufferers’ ability to remember basic tasks. Other symptoms may include a sore throat, waking up several times during the night gasping for air, and signs of enlarged tissue in the throat or oral cavity.

Sleep apnea can have a direct effect on a person's quality of life.  It can harm a person's relationships both by affecting the sleep of significant others and promoting moodiness in the sufferer. The condition causes a drop in the amount of oxygen entering the bloodstream, creating an environment for stroke and heart attacks. Other side effects often include kidney disease, diabetes, and obesity. In addition, the constant interruption in sleep can affect the sleep cycle, which significantly affects brain function, such as remembering basic things and staying focused.

Routine dental appointments can offer excellent opportunities for these types of cases to be diagnosed. The diagnosis often occurs through a comprehensive patient exam. This may include a complete medical history where snoring, choking, or gasping for air while sleeping are uncovered. A physical exam can then reveal if the patient shows physical signs often associated with OSA, such as a large tongue and neck. Once a patient is diagnosed, Burbank Dental Lab offers excellent options for oral appliance therapies that will provide relief to blocked airways.

EMA Appliance
EMA - Elastic Mandibular Advancement

The Elastic Mandibular Advancement (EMA) is a great option that consists of a pressure-formed construct for both the lower and upper jaw.

This appliance allows for lateral movements with a gradual advancement of the lower jaw until the desired results are met. The straps on both sides of the appliance provide for easy adjusting. The design allows for the palate to remain free from obstructions. The benefits include:

  • FDA and ADA approve of its use in OSA treatment.
  • Reduces the occurrence of Temporomandibular Joint issues (TMJ).
  • The EMA is indicated for patients with either a full or partial set of natural teeth.
  • Additional airway opening due to added posterior stops in the design.
  • Lateral movements are possible due to elastic straps.

When prescribing an EMA appliance, Burbank Dental Lab requires both a mandibular and maxillary model.

The edentulous ridge must be captured in the impressions. Use a pencil to mark the model, indicating any implants, dental prosthesis, or any areas where the patient exhibits sensitivity.

Open the bite 8mm incisally and ensure the hinge opens from the centric. It is important to note that the patient must have either a full or partial set of natural teeth to be considered for an EMA appliance. The natural dentition must have sufficient height of contour for adequate retention.

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TAP 3 Appliance
TAP 3 Appliance - Sleep Apnea - Bruxism
TAP 3 Appliance

Another appliance option is the Thornton Adjustable Positioner or TAP 3 appliance.

The Tap 3 is a two-piece device that consists of a fixed hinge and a pivot point that does not separate.

The appliance's interchangeable hooks can be used for class I, II, and III bites.

The vertical distance between the mandibular and maxillary teeth can be increased.

The design prevents uneven bilateral changes because of a single point of central adjustment. This central adjustment eliminates the possibility of irregular bites minimizing jaw pain. This appliance also allows for maximum tongue space with no obstructions providing greater comfort and ultimately better sleep.

This device can be adjusted at home by the patient to dial in comfort and ensure effectiveness.

The benefits of the TAP 3 appliance include: 

  • Unlimited ability to make adjustments
  • Excellent fit
  • Advancement is controlled
  • Lips can close while wearing the device.
  • The tongue has adequate room.
  • Hooks are interchangeable.
  • Able to make lateral movements

When prescribing the TAP3 appliance, Burbank Dental Lab requires both a mandibular and maxillary Vinyl Polysiloxane (VPS) impression.  A centric bite is necessary and also a measurement recording the maximum protrusive position.

Success Guides of Burbank Dental Lab
Other Treatment Options

There are alternative treatment options such as PAP devices.  These devices use air pressure to maintain a flow during sleep. These are effective and can improve sleep but rely on compliance to be effective. Many patients find this treatment uncomfortable, which causes issues with compliance.  Surgery is another option that is used to adjust either bone or soft tissue to reduce or remove any obstruction. The most common remedy is the use of an oral appliance. OSA is a common sleep disorder and can be dangerous if left untreated.

Unfortunately, OSA is often missed and underdiagnosed.

Dental practices have a unique opportunity to identify these patients in the clinical setting. The treatment of OSA requires a multidisciplinary approach that may consist of physicians and sleep specialists as well as the dental team. This approach will help to ensure a proper diagnosis, as well as the best appliance for a particular patient. Burbank Dental Lab is available to answer any questions on OSA appliance options; simply click the chat button to reach a team member.

OSA - Sleep disorder
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Fabrication
of the future
is here!

Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

Our New
State-Of-The-Art
3d Printers

Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.

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