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How Oral Appliances Work
Adjustable oral appliances gradually and incrementally advance the mandible
to reduce the proximity of airway tissues that can beat together or close off
entirely during the increasing muscle relaxation of deepening sleep.
The fundamental principle of airway management in humans is jaw position. It
is the first step in CPR or in the intubation of a patient for anesthesia or for
ventilation. This principle is well known and indisputable. The increase in the
cross-sectional area of the airway from the epiglottis to above the soft-palate
is often profound.
- That dilation allows for a slower passage and greater volume of air to
the lungs. Bernoulli's principle states that the air pressure of the more
slowly moving air will be higher. Greater pressure yields a less collapsible
airway.
- When the jaw is protruded, the digastric muscle advances the hyoid bone
in the throat which increases the tension on the walls of the airway to
decrease its collapsibility.
- When the main chewing muscle of the face (the masseter muscle) is
stretched during the use of these types of appliances, there is a reflexive
increase in the tone of the tongue muscle. That increase in tone decreases
its level of paralysis during sleep, and reduces its obstruction of the
airway.
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