Obstructive Sleep Apnea for the Dental Team: Part of an Interdisciplinary Team
59th Medical Wing San Antonio United States
Pagination or Media Count:
The purpose of an oral appliance is to treat obstructive sleep apnea OSA, primary snoring, and associated symptoms. Oral appliances are intended to decrease the frequency andor duration of apneas, hypopneas, respiratory effort related arousals RERAs andor snoring events. Oral appliances have been demonstrated to improve nocturnal oxygenation as well as the adverse health and social consequences of OSA and snoring. Oral appliances are indicated for patients with mild to moderate OSA and primary snoring. Oral appliances are accepted therapy for patients with severe OSA who do not respond to or are unable or unwilling to tolerate positive airway pressure PAP therapies. Although oral appliances are typically used as a stand-alone therapy, they can serve as an adjunct to PAP therapy andor other treatment modalities for the management of OSA. For this definition, oral appliances refer to mandibular advancement devices because they are the most effective and widely used in clinical practice. Accordingly the function of an oral appliance is to protrude and help stabilize the mandible in order to maintain a patent upper airway during sleep. An oral appliance is custom fabricated using digital or physical impressions and models of an individual patients oral structures. As such, it is not a primarily prefabricated item that is trimmed, bent, relined or otherwise modified. It is made of biocompatible materials and engages both the maxillary and mandibular arches. e oral appliance has a mechanism that allows the mandible to be advanced in increments of 1 mm or less with a protrusive adjustment range of at least 5 mm. In addition, reversal of the advancement must be possible. The protrusive setting must be verifiable. e appliance is suitable for placement and removal by the patient or caregiver. It maintains a stable retentive relationship to the teeth, implants or edentulous ridge and retains the prescribed setting during use.
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