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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Silent Nite Anti-Snoring Device

Is your snoring keeping the neighbors awake?  We have the answer for you!  With a success rate of over 80%, the Silent Nite Anti-Snoring device is the most popular on the market.  It can not only help with the noise, but also make you feel more refreshed in the morning.

Studies estimate that 45% of men and 30% of women snore on a regular basis.  Occasional snoring is usually not very serious and is mostly a nuisance for the bed partner of the person who snores. However, the habitual snorer not only disrupts the sleep patterns of those close to him, he also disturbs his own. Habitual snorers snore whenever they sleep and are often tired after a night of what seems like quality rest.

The Silent Nite works by moving the lower jaw forward, thus, opening the airway for unimpeded air flow.  Some patients are unable to move their lower jaw forward, at which case a Silent Nite is not suitable. 

The Silent Nite should be fully seated with finger pressure.  Never bite the Silent Nite into place as this may cause damage.  The device should stay firmly in position without causing undo pressure or discomfort.  If it’s too tight, remove it and place in warm tap water, then re-seat.  When removing the Silent Nite, carefully pull from the area where the connectors connect to the device.  Your dentist may need to make minor adjustments as needed.  The Silent Nite may be cleaned with soap and water or brushed with toothpaste.

Making the Silent Nite is easy and pain-free!  Your dentist only has to take an upper and lower impression.  If snoring persists, more adjustments may be needed by your dentist.  This device is not indicated for severe sleep apnea.

Greystone Smile Design is proud to offer the Silent Nite Anti-Snoring device!

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