What is Snoring?
Snoring is the vibration of respiratory structures and the resulting sound, due to obstructed air movement during breathing while sleeping. In some cases the sound may be soft, but in other cases, it can be loud and unpleasant. Snoring during sleep may be a sign, or first alarm, of obstructive sleep apnea.
Generally speaking the structures involved are the uvula and soft palate.
The irregular airflow is caused by a passageway blockage and is usually due to one of the following:
- Throat weakness, causing the throat to close during sleep.
- Mispositioned jaw, often caused by tension in the muscles.
- Fat gathering in and around the throat.
- Obstruction in the nasal passageway.
- Obstructive sleep apnea
- The tissues at the top of airways touching each other, causing vibrations.
- Relaxants such as alcohol or drugs relaxing throat muscles.
- Sleeping on one's back, which may result in the tongue dropping to the back of the mouth
Oral Appliance Therapy for Snoring
Oral Appliances are placed in the mouth and are worn much like an orthodontic appliance or sports mouth protector. They are worn during sleep to prevent the collapse of the tongue and soft tissues in the back of the throat so that the airway stays open during sleep. The appliances promote adequate air intake and help to provide normal sleep in people who snore and have sleep apnea. Oral appliances can be used alone or in conjunction with other means of therapy such as continuous positive air pressure (CPAP). Determination of proper therapy can only be made by joint consultation of your sleep apnea dentist and sleep physician.
Types of Sleep Apnea Dental Appliances
Currently, over 80 different types of sleep apnea dental devices for snoring and sleep apnea are available to specially trained dentists to treat sleep disordered breathing. At first glance, this number appears overwhelming but on close examination each of the appliances falls basically into one of two categories and the diverse variety is simply a variation of a few major themes. Oral appliances can be classified by mode of action or design variation.
Tongue Retaining Appliances
There are very few tongue retaining devices available, but they have been well studied and shown to be effective in many patients. Tongue retainers function by directly holding the tongue in a forward position by means of a suction bulb that holds the tongue. When the tongue is in a forward position, the back of the tongue does not collapse during sleep and obstruct the airway in the throat. The tongue is held in the suction bulb that protrudes from between the teeth in the above model.
Mandibular Repositioning Dental Appliances
Mandibular repositioning appliances are by far the most numerous type on the market. They all function to reposition and maintain the lower jaw (mandible) in a protruded position during sleep. It is felt that this serves to open the airway by indirectly pulling the tongue forward since the tongue is attached to the lower jaw, by stimulating activity of the muscles in the tongue and making it more rigid, and by holding the lower jaw and other structures in a stable position to prevent opening of the mouth. Thin shells are placed over the upper and lower teeth and a device is incorporated that will pull the lower jaw forward as necessary to open the airway.
Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease.