Snoring causes distress and sleeping problems for the person who snores as well as anyone else who shares the same room. It has also been linked with a number of metabolic conditions, including heart disease.
Treatments for snoring can be either surgical or non-surgical; which type is adopted depends on the root cause of snoring.
Inspiration is defined as the development of negative pressure, and partial collapse of the airway in the pharyngeal, in those who snore. The reason for the snoring lies in the blockage of airways in the upper. Nasal devices can aid in keeping the airway open and ease the snoring. It is the Afrin test is one method to determine if a patient will use these appliances.
Snoring is typically eased by using nasal stop snoring aids like nasal strips, nasal strips or dilators. They both keep the nostrils open during sleep.
Nasal strips are self-adhesive strips that are designed to separate the nostrils.
Nasal dilators consist of metal or plastic and work by opening the nostrils while you sleep. They can be used as their efficacy is not yet confirmed.
Obstructive sleep apnea syndrome (OSAS)
OSAS may be treated by any of the following:
Continuous positive airway pressure (CPAP)
Oral appliances may be used instead of CPAP, or if the latter fails or is not acceptable to the patient. They could also be recommended in mild or moderate OSAS with no daytime sleepiness.
Chin strips are self-adhesive tape that are positioned under the chin in order to keep the mouth shut while you sleeping.
The device made of plastic is placed inside the mouth to obstruct airflow in it and improve breathing through the nose, which usually prevents breathing problems and snoring.
Both of these devices are similar to each other in terms of available research.
Mandibular advancement devices (MAD)
The devices are designed to reduce snoring that is caused by the vibrations in the base of the tongue. They move the jaw and tongue in order to expand the area to allow airflow into the pharynx. This stops the tongue from moving in this region.
A thermoplastic MAD may be ordered ready-made and fitted to the patient’s home. They may not be suitable for people who suffer from a strong gag reflex or those who are unable to sleep with devices in their mouth. It may cause pain in the jaw and face during the first few days. A custom-designed MAD by a dentist is recommended for those suffering from OSAS, however, these are more costly.
Modern MAD are less heavy, lighter and bulky, and they are also micro-adjustable, which allows each person to modify the amount of jaw protrusion to stop snoring without causing undue tension on the jaw or facial muscles. These devices should be replaced approximately every 18 months.
Tongue-retaining devices (TRD)
The TRD is another oral appliance that prevents the falling back of the tongue that usually happens during sleep, causing sleep snoring for many. It holds the tongue’s tip in place using an unnatural suction. The associated mouthpiece creates mandibular protrusion however, it is reduced to comfortable levels based upon the feedback from the patient.
The risk of this can be increased when snoring persists despite usage. The TRD has orifices in the lateral side to allow mouth breathing in the event that the nose is blocked. This can lead to some discomfort at first, but it’s quite secure and is reported to be effective for a variety of sleepers. It also reduces sleep apnea and nighttime somnolence.
Benefits as well as disadvantages to dental appliances
Oral appliances can cause discomfort or a foreign body sensation, excessive salivation or dry mouth. They should typically be used after a sleep study is conducted to determine the most likely risk factors for OSAS and to determine if it is a cause, if the symptoms are present, as well as to provide a baseline to assess progress with the use of the appliances. They are reversibleand simple to use, inexpensive and efficient, and therefore offer a viable alternative to CPAP for numerous patients.
Adjustable oral appliances require orthodontic techniques and are, consequently priced higher than fixed ones. They take more time to design and build up tolerance slower. However, these devices are much better in the reduction of snoring for all types of patients suffering from OSAS. The highest success rates can be observed in younger patients with smaller build and a less weight, and who suffer from mild to moderate OSAS.
Fixed appliances are more economical, are easy to put in by the patient and work more quickly. They are not adjustable to give a greater or lesser mandibular protrusion and thus fail to eliminate snoring.
Overall the oral appliance is more acceptable than CPAP for people with OSAS.
A more recent device is based on the ability to acquire a learned reflex. It vibrates when the first sign of snoring, which causes the sleeper in turn to sleep on the side. It assists in improving daytime sleepiness, without affecting or enhancing sleep quality.
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