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Snoring Appliances

How to fix “SNORING”

If you snore, and your spouse/significant other lets you know about it, then I may have a solution for you. OR, perhaps, you ARE the spouse/significant other and you can’t sleep because Dinglefritz is sawing logs on the other side of the bed…   The solution may be simple.

For the most part, people snore because of airway obstruction. The obstruction may be caused by many things including posturing, anatomy, or other medical issues. The most common cause is when people lay back to sleep, the lower jaw falls in a more retruded position (ie. under your ear, toward the back of your neck). This seals the posterior part of the tongue against the soft part of the palate. So when the lungs try to draw in air, its like the wind blowing a loose tarp, flapping it all over the place!

The consequence for this is “Sleep Apnea”. That is, you get less air (and, therefore, less oxygen!) into your body over the sleep period. And, I don’t know about you, but after running a full dental practice and coming home to three kids bouncing around like maniacs, I consider “sleep time” an EXTREMELY VALUABLE commodity! Time spent sleeping is more valuable than ANY material thing I know!  Not to mention, when you spend hours on end with broken sleep, unable to get your fair share of oxygen into your system over your “allotted” sleep time, there are a whole host of medical problems which may ensue including hypertension (high blood pressure), behavioral and mental problems, and overall well being. In fact, I can’ t think of one medical process in the human body that isn’t ultimately fueled by oxygen!

So, like I said, the solution may be simple. They sell those Breath Right strip things at the local drug stores. These may help A LITTLE if the problem is a more superficial nasal passage problem. But, if the problem is retruded jaw closing tongue against palate causing tarp to flap, then you’re only blowing more air against the flapping tarp.

The best and most common cure for simple snoring is to wear a prosthesis that physically holds the jaw in a more protruded position (ie. more to the direction of your chin.) This positioning breaks the seal of your tongue against the soft palate allowing air to pass freely into your lungs.

There are many devices that do this. But, the most simple and basic one (and a great majority of snoring cases ARE simple and basic!) is called the Silent Nite Snoring device (see photo).  Its like two night guards (upper and lower) connected on the side by a two semi-rigid plastic bands. The “guards” have a hard acrylic shell outside and a softer “squishy” inside for comfort. They slip over the teeth easily. Essentially the upper “guard” (upper jaw) holds the lower guard (ie. the lower jaw) forward through the bands.

Each Silent Nite kit comes with an array of band sizes. I always start the patient off on almost the biggest band size and let them wear it a few nights. If the patient is still snoring, I replace the band with a smaller band, ie. positioning the lower jaw further forward than previous. Again, I allow the patient to wear it a few more nights. If the person is still snoring, repeat the process with a shorter and shorter band.

One risk in pulling the jaw into a more protrusive position is TMJ issues. If the person’s joint begins to hurt due to  the lower jaw being in too much of a protruded position, I will then back them down to a larger band. The whole process is a balancing act between snoring and TMJ issues. However, in a lot of cases, I’ve had the more protruded position actually HELP TMJ issues. After all, Night Guards (which are intended specifically for TMJ problems) position the lower jaw in a more open, comfortable position for the joint. I take TMJ issues on a case by case basis. Its a conversation of treatment!

Another issue people may have is movement of teeth in the process. Due to the fact that these are “full arch” splints (meaning the “guards” go over all of the teeth from one side to the other) then the support of “teeth against teeth” prevent the movement of individual teeth. I would never reposition the jaw using the support of only a few teeth. All or none is the way to go. In fact, wearing these “full arch splints” probably will keep your teeth FROM moving (ie. there is normal movement and crowding of teeth that comes with age and jaw growth.) The splints may actually help with this!

The last issue that I will mention is Patient Compliance. Are someone who can physically wear these appliances on your teeth without is bugging the begeezies out of you?? My answer to that is:    You don’t know until you try.

And, what’s the alternative? Depriving your body from a lifetime of oxygen??  And, who knows what other medical problems are also related to your inability to sleep??? My assumtion is that its worth a shot. The mind can get used to a lot of things if it understands the alternative is worse.

Overall, these jaw positioning devices are great, but not for everyone. For example, heavy bruxers (or jaw grinders) SOMETIMES may crush these bands like they’re yesterday’s breakfast. But, in MANY cases, the device has actually helped with grinding.   Again, its a trial and error treatment “conversation”.

For SEVERE sleep apnea patients, this simple device may not cut it. For those people, you enter the world of “C-Pap” machines and positive pressure. If you think Silent Nite is obtrusive, wait until you see a C-Pap machine.  It’s a huge mask you wear over your face at night that physically blows positive pressure oxygen into your lungs. I will not get into the details of this treatment, but, even in those cases, I would implement  jaw positioning as a “first try” on fixing the problem.

Overall, the “silent night” device is not a “cure all” but its a non invasive, relatively inexpensive step that could potentially improve your quality of life in a drastic way. I offer this form of treatment. Please call my office if this sounds like something that could benefit you.

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