Having sleep apnea himself, and having managed hundreds of patients with sleep apnea, Dr. Perry has a great appreciation of the physical and mental impacts of sleep-disordered breathing, snoring, and sleep apnea. A lack of quality sleep and sufficient oxygenation can lead to health and mental issues that often go unchecked and continue to spiral downward. The effected often don’t realize that they aren’t sleeping well and that their body is literally being starved of oxygen.
The most important thing for Dr. Perry and his team is that people are treated, regardless of the treatment used. There are two excellent modalities for treatment; continuous positive airway pressure (CPAP) and dental devices called mandibular repositioning devices (MRD). Dr. Perry is a big believer and supporter of both therapies and suggests all of his patients have both devices on hand for treatment. That way, patients can rotate between the therapies and mitigate the negative side effects that both inherently have.
For example, if someone has a sinus infection, they will find it hard to use a CPAP, but that doesn’t mean they should go untreated for the duration of the infection. In fact, proper sleep and oxygenation will help combat the infection. So the patient can turn to their MRD during those times. If, on the other hand, the patient is having some mild jaw discomfort from wearing their MRD for an extended period of time, then they can take a break from the MRD and wear their CPAP for a while. The key is that sleep and oxygen are critical to good health and quality of life. Let us help you on the road to wellness.
Let’s look more in-depth at each treatment.
What is CPAP?
Continuous Positive Airway Pressure (CPAP) was developed in the early 1980’s and was the first viable solution for treating the CPAP examples for treating obstructive sleep apneainsidious disease of Obstructive Sleep Apnea (OSA). Most physicians prescribe CPAP as a first treatment option, though many physicians now utilize dental devices as a first line of therapy for mild to moderate disease OSA. CPAP treatment consists of a pump that delivers positive air pressure to a mask that is fitted over the nose and/or the mouth. The air pressure is adjusted until the airway is forced open, much like blowing up a balloon.
Disadvantages of CPAP
CPAP is a very effective therapy WHEN it is used. If you’ve been diagnosed with sleep apnea and were prescribed a CPAP by your physician, you know exactly what we mean when we say WHEN it is used; compliance is the biggest challenge with this therapy. Most people find that wearing a mask and having air pushed down their throat is a challenge. The problems patients complain about from CPAP therapy are very real and often difficult, if not impossible, to overcome.
A partial list of the most common patient complaints from CPAP:
- Mask leaks
- An inability to get the mask to fit properly
- Discomfort or interrupted sleep caused by the presence of the device
- Noise from the device disturbing sleep or bed partner’s sleep
- CPAP restricted movements during sleep
- CPAP does not seem to be effective
- Pressure on the upper lip causes tooth related problems
- Latex allergy
- Claustrophobic associations
- An unconscious need to remove the CPAP apparatus at night
CPAP Alternative: Mandibular Repositioning Devices (MRD)
The key element to successful sleep apnea treatment is an opening of the airway. The airway is most commonly closed due to laxity of the airway itself during sleep and negative pressure created upon inhalation, which makes it collapse. During the day, the muscles that line the airway keep it open, but at night those muscles become more relaxed and may allow the airway to close upon itself. The other major culprit is the tongue itself. The tongue is a huge muscle that fills the entire lower jaw (the mandible) and originates from deep in the throat. The tongue can physically block the opening of the airway very easily.
This is where mandibular repositioning devices (MRD) come into play. The device gently moves the lower jaw forward, physically bringing with it the tongue so that it doesn’t fall back and block the airway. It also supplements the job of the muscles that line the airway by spatially widening the airway itself. The result is a much wider airway and more continuous flow of air and life-giving oxygen.
Disadvantages of MRD
There are a few minor, though important to recognize, disadvantages of MRD’s. First of all, it takes a little getting used to. If it is your first time wearing an MRD, you may feel a little funny with all the material in your mouth. Our patients routinely comment that after the first few nights, they simply put the device in, fall asleep and don’t wake up until the morning.
The device fits intimately to your teeth so it is very important that your oral health be stable. If you have gum disease or active cavities, they should really be addressed prior to fabrication of a device that is relying upon the teeth for support. This is another reason why Dr. Perry’s philosophy of having both CPAP and MRD’s available is great. You can wear your CPAP while your oral health is stabilized and your MRD is being fabricated.
Since the device gently brings your jaw forward you may feel some tension or pain in your jaw joint. This is usually transient and well controlled by adjusting the device, but is another a good reason to have CPAP on hand to change out when needed.
Contact Perry Dental Health for more Information
No one treatment fits every patient. Dr. Perry and his team’s primary goal is the health and well-being of our patients. We want to be your resource and advocate for treatment of your snoring and sleep apnea. Dr. Perry understands, first-hand, how the management of these conditions can improve one’s quality of life. Please don’t feel that we are here solely to “sell” you a dental device. If you are doing well with CPAP, that’s great! We are here to help you manage your condition and show you adjunctive treatments. The best way you can thank us is to let your friends and family know that we helped improve your quality of life. Please don’t ever hesitate to ask us questions!!! You can reach Perry Dental Health today at (210) 377-3779.