We’ve all been in a hotel room with a group of people where everyone is still awake in the middle of the night because of…no, not excessive celebration…I’m talking about the one person that is sawing logs – the infamous snorer. 

The simple definition of snoring is “obstructed air movement during breathing while sleeping.”  The not-so-simple part is how to stop it – UNTIL NOW!

Read on for a review of the 3 most common snore prevention appliances that your dentist…yes, your DENTIST!…can prescribe – the TSD (Tongue Stabilizing Device), Silent Nite, and the TAP (Thornton Adjustable Positioner).

But first, a little review on snoring…

Snoring affects about 30% of the population and can be caused by enlarged tonsils, sleeping on one’s back (the tongue drops to the back of the throat), nasal obstruction, malpositioned jaw, obesity, or throat weakness causing closure.   

The impact?  Not only is it keeping everyone awake, but it can lead to drowsiness and lack of focus and even increase your chances of heart attack and stroke.  It has also been proven to cause marital problems and increase your risk of dain bramage…I mean brain damage.

Snoring can only be truly diagnosed by a sleep study.  This is necessary to differentiate snoring from sleep apnea. 

A few words about sleep apnea…

Sleep apnea is abnormal pauses in breathing during sleep (or instances of abnormally low breathing).  There are 3 types:  central, obstructive, or combination, with obstructive sleep apnea comprising about 84%.  In central sleep apnea, breathing is interrupted by a lack of respiratory effort (from the central nervous system – aka brain).  In obstructive sleep apnea, breathing is interrupted by a physical impediment (obesity, enlarged tonsils, malpositioned jaw, etc). 

Treatment

Treatment options vary based on the severity of either the snoring or sleep apnea and range from oral appliance therapy, CPAP (continuous positive airway pressure), or surgery to name a few.  The appliances described below are in the “oral appliance therapy” category and are mainly used to treat snoring and mild obstructive sleep apnea.  If after a sleep study you are diagnosed with central sleep apnea or moderate/severe obstructive sleep apnea, oral appliance therapy will have little benefit.  This is the reason that it is important to be properly diagnosed in a sleep study so the necessary treatment can be applied.

Oral Appliance Therapy

TSD (Tongue Stabilizing Device)

The TSD works by holding the tongue forward by gentle suction which prevents it from falling back in the throat, thus keeping the airway open during sleep.  There is no attachment to teeth and there is no required “fitting” by a dentist.  If you’re thinking that it looks like an adult pacifier, you’re right!  It’s very attractive!  But, it really works and claims to have a 92% success rate.  This success, or course, depends on the etiology of the problem.  If the tongue falling to the back of the throat is the primary culprit in the patient’s snoring, this is a great treatment modality.  The price for the TSD is in the $200 range and may be purchased over-the-counter.

Silent Nite

The Silent Nite is a custom fabricated mandibular advancement appliance that moves the lower jaw forward which helps open the airway.  The lower jaw is positioned forward by special connectors that are attached to flexible custom fitted trays. 

TAP (Thornton Adjustable Positioner)

The TAP works the same way as the Silent Nite, with the only difference being the way the jaw is held forward (see the pictures).  Like the Silent Nite, your dentist must take impressions for a dental lab to fabricate the appliance. 

The price for the Silent Nite and TAP is from $400 to $800, and you must see a dentist to be fitted for the trays and for adjustments.

Note:  All 3 oral appliances described above work by holding the lower jaw forward, which can can cause spasms in the lateral pterygoid muscles (the muscles which move the lower jaw forward and side to side).  If you begin experiencing jaw discomfort, see your dentist.

Patient Protocol

The American Academy of Dental Sleep Medicine came out with an oral appliance therapy protocol in 2009 which states:

If you suspect you have sleep disordered breathing (snoring, obstructive sleep apnea, upper airway resistance syndrome, etc), you must first see a physician for a diagnosis.  If the physician thinks oral appliance therapy may be the treatment of choice for your condition, he or she will then refer you to a dentist for treatment.  The dentist and physician must communicate regarding the treatment approach, the progress, and necessary follow up examinations. 

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But, does the light actually do anything?

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In the dental office, we never mention the “n” word…the one that rhymes with beedle.  If it weren’t for the “beedles,” maybe we dentist would be more popular.  Nobody likes “beedles,” but if we didn’t numb your tooth, we definitely wouldn’t remain friends. 

But what if we could numb your tooth without you even knowing it?  Or, better yet, what if we could do some procedures without the use of “beedles” altogether.

At Greystone Smile Design, we are on the cutting edge of dental technology.  Our goal is to make dentistry comfortable – we don’t just treat teeth, we treat people.  That’s why I’m excited to announce one more advancement in our pursuit of pain-free dentistry – Profound topical anesthetic.  This is one of the strongest topical anesthetics on the market. 

Do your gums hurt when you get your teeth cleaned?  Those days are over!  All we have to do is simply apply the Profound topical to the sensitive site and waaalaaa – painfree without a “beedle!”  This can also be used for deep cleanings and several pediatric procedures including simple baby tooth extractions and most baby tooth fillings.

For procedures where we do have to use a “beedle,” the vast majority of patients do not feel anything.  After applying the Profound with a Q-tip and waiting about 2 minutes, you will already begin to feel the numbness.  The top teeth are easy – you will rarely feel anything on these.  Even the dreaded “roof of the mouth” injection can be relatively painless.  For the bottom teeth, we can virtually eliminate the injection that numbs your lip and tongue.  Profound is so strong that we can place it around the tooth to be treated and inject only around that tooth – no fat lip, no fat tongue, no drooling, and no slurred speech!

In those situations where we do have to numb your whole head, our anesthetic reversal agent can reverse the numbness in about half the time so you can get on with your day. 

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Greystone Cosmetic Center, Alabama’s premier center for cosmetic enhancement, features board-certified physicians, highly-qualified staff and the most sophisticated facilities and equipment available today.  This new world-class facility brings together professionals in a broad range of cosmetic specialties who can help you achieve a healthy, beautiful new look. At Greystone Cosmetic Center, you can rest assured that you are in caring, skilled hands and will receive the care and attention you deserve.

Greystone Cosmetic Center is home to Hedden Plastic Surgery, Spa Greystone, and Greystone Smile Design (opening in November).

Greystone Cosmetic Center is located in the Greystone area near Birmingham and Hoover. Click here to view map and directions!