While snoring itself may be harmless, it can also develop into, or be a symptom of, a more serious medical condition known as obstructive sleep apnea (OSA).
What Causes Snoring?
Snoring is caused by a narrow airway. That's because air travels faster through a slender tube than through a broad one. This rapidly moving air causes the soft tissues of the throat (the tonsils, soft palate, and uvula) to vibrate. It is this vibration which is the sound of snoring. It's like putting a flag in front of a fan: the faster the fan, the greater the flutter. Why is the airway narrow in snorers? Many things can take up space in the airway reducing its diameter. These can include large tonsils, a long soft palate or uvula, and, in people who are overweight, excessively flabby tissue. The most common cause of a narrowed airway is a tongue that relaxes too much during sleep and gets sucked back into the airway with each breath taken.
What is Obstructive Sleep Apnea?
When the tongue is sucked completely against the back of the throat, the airway is blocked and breathing stops. Once that happens, the harder the sleeper tries to breathe, the tighter the airway seal becomes. It's like trying to drink through a straw that's stuck in a lump of ice cream. The harder you suck, the flatter the straw becomes. The airway obstruction won't clear until the brain's oxygen level falls low enough to partially awaken the sleeper. The tongue then returns to a more normal position, and the airway seal is broken - usually with a loud gasp.
What is a Dental Appliance?
A dental appliance is a small plastic device, similar to an orthodontic retainer or an athletic mouthguard. It is worn in the mouth during sleep to prevent the soft throat tissues from collapsing and obstructing the airway. Dentists with training in dental appliance therapy can design, construct, and fit these special appliances to meet their patients' individual situations and conditions. In recent clinical studies, physicians and dentists have found that, in a majority of patients, a well-made, well-fitted dental appliance will effectively reduce or eliminate snoring, and significantly relieve symptoms of mild and moderate OSA.
Dental appliances work in three ways: by bring the lower jaw forward, by holding the tongue forward, and by lifting a drooping soft palate. A combination appliance may perform two or more of these functions at the same time. Dental appliance therapy is not a new idea. It was in use as far back as the early 1900's. But it was not until the 1980's that physicians and dentists began to work together to study and develop this alternative form of treatment, enabling more patients to benefit from it.
Help for Snoring and Obstructive Sleep Apnea
Mild or occasional snoring and symptoms of OSA may be alleviated by lifestyle changes:
- losing excess weight
- getting regular exercise
- within three hours of bedtime, avoiding alcohol, heavy meals, and medications that make you drowsy
When symptoms are more severe, and these measures don't resolve the problem, other treatment options may include:
- surgery to the nose, throat, tongue, or jaw
- nasal CPAP (Continuous Positive Airway Pressure), a therapy in which an air compression device and a nose mask are used to force the airway open and aid breathing during sleep
- Dental Appliance Therapy, which is an effective way of treating snoring and OSA for many patients. It may be employed on its own, or in combination with other methods of treatment
Advantages of Dental Appliance Therapy
Dental appliance therapy offers many advantages:
- Dental appliances are relatively small, and easy to wear. The appliance weighs only a couple of ounces, and its small size makes it easy to use when travelling. Most people find it takes no more than a few weeks to become completely comfortable wearing the appliance.
- Dental appliances are relatively inexpensive. The total cost of therapy is considerably less than the cost of alternative treatments.
- Treatment with a dental appliance is reversible and non-invasive (it does not involve surgery).
What the Dentist Can Do
On your first visit, the dentist will thoroughly examine your teeth and mouth, with the aid of X-rays and dental molds. You may then be fitted with an appliance, which you will take home and try out for a week. Over succeeding weeks, if necessary, you may try out other types of dental appliances. Finally, your dentist will design and fit your custom-made appliance. Your dentist will show you how to place the appliance in your mouth and how to care for it when you are not using it. Once you have been using the appliance regularly, during sleeping hours, for two or three months, the dentist will refer you back to your physician or sleep specialist to determine how effectively the appliance is controlling your snoring and OSA. You will continue to visit the dentist at regular intervals, and he or she will work with you to modify and maintain your dental appliance to that it remains effective.
Interested? First See Your Physician
If you snore heavily and are interested in trying dental appliance therapy, it's very important that you are thoroughly examined by a physician or a sleep specialist first. The examination may involve staying overnight at a sleep study center. It's important that this examination is done first, because you may have sleep apnea without realizing it. In a study conducted at Stanford University in California, one out of three chronic, severe snorers was found to have a harmful degree of sleep apnea.