Oral Appliace Examples

Oral Appliance therapy was first endorsed as effective management of obstructive sleep apnea by the American Academy of Sleep Medicine in 1995. In 2005, the Standards of Practice Committee of the AASM updated the practice parameters for the use of oral appliances as appropriate first line therapy for snoring, mild and moderate obstructive sleep apnea. This includes up to 30-40 breathing interruption events per hour determined by overnight sleep test.

Most patients with narrowed airways will have increases in the volume of the airway and decreased resistance to airflow when the mandible is advanced. This is the fundamental principle of airway management, utilized in cardio-pulmonary resuscitation (CPR), where the tongue is moved from the airway by head and mandibular posture.

The base of the tongue is moved farther from the airway tissues to a position where contact and obstructions are less likely or unable to occur. Increased airway volume causes a slower rate of flow, which increases air pressure (Bernoulli's Principle), and increased tone is imparted to the tongue by the stretching of the masseter muscles.

Finally, as the hyoid bone is raised and advanced by the action of the digastric muscles, greater stability of the airway musculature is achieved and resistance to airflow is further decreased.
 

SomnoDent MAS

The SomnoDent MASTM treats both snoring and Obstructive Sleep Apnea (OSA) by advancing the lower jaw forward. It is custom made exclusively for each individual, consisting of upper and lower dental plates with a unique patented “fin” coupling mechanism. Your SomnoDent MASTM has components on both sides of the upper plate. These can be used to make the device adjustable by providing incremental lower jaw advancement to the necessary degree, depending on the distance required to alleviate snoring and reduce OSA.
 

OASYS®

For patients that have a restriction of airflow at the nostrils, a different type of mandibular advancement may be considered. The OASYS uses pads of acrylic underneath the lips at the corner of the nostrils to stretch the opening and thereby reduce resistance to airflow. That reduction can effectively increase the overall air pressure of the airway. Combined with an adjustable mandibular repositioning system, the OASYS can effectively reduce the collapsibility of the airway, improving symptoms of snoring and obstructive sleep apnea.