Appliances

Introduction

You are not alone in your desire to find a solution to your problem with snoring and or obstructive sleep apnea. Sleep-breathing problems affect people in all walks of life on every continent of the globe.

Dr. David Stern practising in Richmond Hill as a Board Certified member and a Diplomat of the American Board of Dental Sleep Medicine works together with medical doctors specializing in Sleep Medicine to treat this potentially life threatening condition. As a practising dentist for 28 years, Dr. David Stern has been treating snoring and sleep apnea for the last 24 years and has successfully treated this bothersome and potentially life threatening condition with non invasive, non surgical oral appliance therapy treatment with extremely high rates of success.

Oral appliance therapy is recommended by The American Association of Sleep Medicine as the first line of treatment for mild or moderate sleep apnea and for severe sleep apnea when cpap is not tolerable or indicated.

What can a small, professionally custom fitted dental sleep mouthpiece do for you?

  • Ensure a good night’s sleep for your bed partner and ensure that you spend the night in the same room
  • Help prevent heart disease, sudden cardiac death, high blood pressure, stroke, diabetes, depression, memory loss and even erectile dysfunction
  • Help prevent driving and work-related accidents caused by the excessive daytime sleepiness related to sleep apnea
  • Provide an alternative for the 25 – 60% of people with sleep apnea who cannot tolerate or would rather not use a CPAP device

To find out if oral appliance therapy is right for you, contact a qualified dentist who has been Board Certified by the American Board of Dental Sleep Medicine today.

ORAL APPLIANCE THERAPY… LIKE A BREATH OF FRESH AIR.

Oral appliance therapy

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 our office and your sleep physician.

Types of Oral Appliances

Currently, over 80 different types of 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.

Mandibular Repositioning Appliance

Mandibular repositioning appliancesMandibular 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.

Currently, there are over 80 different types of oral appliance available. Oral appliances may be used alone or in combination with other means of treating OSA, including general health and weight management, surgery or nasal continuous air pressure (CPAP).

How Oral Appliances Work

Oral appliances work in several ways:

  • By repositioning the lower jaw, tongue, soft palate and uvula
  • By stabilizing the lower jaw and tongue
  • By increasing the muscle tone of the tongue
  • By dilating or increasing the size of the airway

By virtue of our education and training in oral appliance therapy, we are familiar with the various types and designs of appliances and can determine which one is best suited for your specific dental and medical conditions. Our office will work closely with your sleep physician as part of the medical team in your treatment and on-going care.

Even after the initial phase of treatment is complete, we will continue to follow you to be sure that treatment remains successful and to evaluate the response of your teeth and jaws.

Appliances Used in Our Office

We use several oral appliances in our office depending on the size and shape of your mouth and tongue. Dr. Stern will discuss the advantages and disadvantages of each with you before making a final choice.

The Narval CC©. Narval ResMed Appliance

Narval ResMed The Narval CC© by ResMed uses technology that has been developed and refined for a decade, with the help of multi-disciplinary medical teams. The unique innovation is the jaw relationship, which minimises the physiological joint-stress and limits the risk of dental side-effects. Instead of pushing the mandible forward, it is retained in a forward position. This mechanism design allows the use of semi-rigid plastic materials, which enable greater flexibility and comfort for the patient.

CADCAM

In March 2009 Laboratoires Narval introduced the first custom device, made by Computer Aided Design (CAD) and Computer Aided Manufacture (CAM). Using selective laser sintering of a biocompatible polymer, CAM guarantees consistent, industrial-strength manufacturing. The unique CAD/CAM technology delivers a highly adjustable (15 mm) bi-bloc, custom-made design, which gives the patient more time to adapt to wearing the device in a passive non-protruded position. Once they have become used to wearing it, the device can then be gradually adjusted to increase the effect.

The Narval CC is custom made for each patient using CADCAM technology

Narval CC with CADCAM

  • Computer-aided design (CAD) enables precise customisation to suit the dental anatomy of each patient
  • Computer-aided manufacturing (CAM), through selective laser sintering, guarantees consistent industrial-strength manufacturing

As a result the Narval CC is:

  • Metal free, small and light
  • Highly resistant and made using a durable, biocompatible polymer material

SOMNODENT© MAS

SomnoDent The SomnoDent© MAS is a custom-made device, consisting of upper and lower dental plates with a unique patented fin-coupling component, which allows normal mouth opening and closing.

This feature provides incremental and adjustable levels of lower jaw advancement, which improves the effectiveness and comfort-level of treatment as the jaw is moved only as far as is required to alleviate snoring and reduce OSA.

SOMNODENT© KEY FEATURES

Key features and benefits of the device include: Permits normal mouth opening Allows speech and drinking Easily adjustable Safe and effective Clinically proven Custom-fitted Additionally, the SomnoDent© MAS is made from durable fade-proof acrylic that retains its shape and color for at least four-five years and is covered by a limited two year manufacturer’s warranty.

In order to increase both the efficacy and comfort of the device, the SomnoDent© MAS is fully incrementally adjustable, forward and backward. Allowing it to be adjusted to the optimum position for comfort and effective treatment. Most patients generally find that it only takes a couple of nights to adjust to wearing the device for a full night sleep.

SILENCER

The Silencer Dental Appliance The Silencer is a laboratory fabricated fully adjustable oral appliance for the treatment of sleep apnea and snoring. The appliance features a titanium precision attachment, which controls the anatomical settings of the appliance. It is capable of anteroposterior adjustment as well as vertical adjustment through a range of 10mm, in both dimensions. The design of the precision attachment also allows lateral movement of the mandible which respects and protects the TMJ. The titanium Halstrom Hinge© is made of implant grade titanium.

KLEARWAY APPLIANCE

Klearway Dental Appliance Klearway© is a fully-adjustable oral appliance used for the treatment or snoring and Obstructive Sleep Apnea. Fabricated of thermoactive acrylic, Klearway© becomes pliable for easy insertion and confirms securely to the dentition for an excellent fit while decreasing soft tissue and tooth discomfort. Small increments of forward lower jaw advancement are initiated by the patient under the direction of a dentist and this helps avoid rapid jaw movements that can cause patient discomfort. Once warmed under hot water and inserted, the acrylic resin hardens as it cools to body temperature and firmly affixes itself to both arches.

THE TAP©

The Tap Dental Appliance The TAP© (Thornton Adjustable Positioner) uses a hook and socket mechanism to shift the lower jaw forward. An adjustment key for the TAP© permits the patient, after consultation with their dental specialist, to adjust the protrusion of the lower jaw to the most effective and comfortable position. The metal components found in the TAP© are composed of medical grade stainless steel.