Principles of oral appliance therapy for the management of snoring and sleep disordered breathing.
Oral appliance (OA) therapy for snoring, obstructive sleep apnea, or both is simple, reversible, quiet, and cost-effective and may be indicated in patients who are unable to tolerate nasal continuous positive airway pressure (nCPAP) or are poor surgical risks. OAs are effective in varying degrees and seem to work because of an increase in airway space, the provision of a stable anterior position of the mandible, advancement of the tongue or soft palate, and possibly a change in genioglossus muscle activity. This article provides a detailed clinical protocol and titration sequence for OAs, because this clinical procedure is often not well understood by practitioners new to the field. Prediction of treatment success is addressed, OA treatment is compared with surgery and nCPAP, OA compliance is described, and the possible adverse effects associated with this type of therapy are discussed.
Almeida
Fernanda R
FR
Department of Oral Biological and Medical Sciences, The University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada. falmeida@interchange.ubc.ca
Lowe
Alan A
AA
D006801:Humans; D019186:Mandibular Advancement / Q000295:instrumentation; D016382:Orthodontic Appliance Design; D009967:Orthodontic Appliances; D010347:Patient Care Planning; D010349:Patient Compliance; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000628:therapy*; D012913:Snoring / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome