Many studies over the past years have shown that advancing the mandible with dental sleep appliances may provide relief from snoring by physically pulling the tongue forward and out of the airway. As simple as this would appear, there are a number of significantly relevant ideas that enter into the picture. An appliance needs to be fabricated that will be worn every night that will not compromise the TMJ, will not compromise the teeth, will not compromise the soft tissue, will not be bacterially invaded, and will not disturb the sleep partner while remaining comfortable to the wearer. You can see that designing and use of a intra oral sleep appliance for sleep apnea and snoring is very complex. In addition, the presence of bruxing on the part of most people who snore and who have sleep apnea is very important. Newer research has shown that a very significant portion of patients, who have sleep apnea and snore, also brux very vigorously during the night.

We use many appliances from many different sleep appliance fabricators, including the Silencer, TAP, EMA, MAS and Full Breath. Our choice is based on many factors which we will discuss with you at your appointment. We base our decision on whether or not you grind your teeth as well as the anatomy of your mouth and throat and the extent of your sleep breathing problem.

The office also offers many different oral appliances when appropriate for differing medical and financial reasons.

The American Sleep Disorders Association, at their annual meeting, adopted a resolution, which accepted dental appliance therapy for the treatment, not only of snoring and mild sleep apnea, but also extended their recommendation to include treatment for moderate and severe cases of sleep apnea, when the snorer rejects or can't comply with the Continuous Positive Air Pressure (CPAP) device. Additionally, the American Medical Association unanimously passed a resolution to study the issue of sleep disorders, and this should, hopefully, address the correlation between sleep disorders. and motor vehicle accidents in addition to work place accidents due to excessive daytime sleepiness.

The Silencer is a relatively new appliance in the field of dental appliances for snoring and sleep apnea, and it meets all the criteria for an ideal dental sleep appliance, as it is a two-piece appliance that is adjustable in five different positions, which are forward and backward. Each position can be advanced some two millimeters from each other, giving a more adjustable range of forward positioning of the tongue and mandible. With other appliances, the position is usually fixed, and there is no freedom for the bruxer to move the jaw in any direction. The advantage of having an adjustable appliance is, if the patient returns home and there is still some component of snoring or sleep apnea, which is noted by the sleeping partner, the patient can return to our office, and we can adjust the appliance in a more effective position, either forward or backward.

The repositioning can be repeated over several times until the optimal jaw and tongue position is reached, and it can be changed at any time in the future if there has been cessation of snoring in one position. This appliance eliminates the problem with older types of appliances when they did not totally eliminate the snoring problem. In the past, the older appliances either had to be re-done, or the patient just gave up on them as being not effective.