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Dental Sleep Appliances
I have made close to 200 dental appliances for sleep apnea. I am a dentist who has taken a big interest in this field. I have attented hours of lectures on the topic. I have had 100% success not one patient doesn't like the appliance. Everyone and studies show improvements. It is a option that anyone who can't wear CPAP should look into.
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Replies to This Discussion
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Permalink Reply by Dr. Richard Charmoy DMD on
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Dan, you have done your research however without an oral exam I wouldn't go out on a limb about what appliance is best for you. Some are major devices to be placed in the mouth thesenecesarrly aren't any better then some which maybe seen on tv. Finding a dentist who specializes in sleep dentistry is really the best way to go. 1. A sleep study that gives info on sleep patterns etc is needed for a starting point. This can be done in a sleep lab or a ambulatory study.ffrom there a exam of younoral cavity tongue uvala tonsils nasal passage etc are all important. Condition of teeth TMJ ( my applinaces which I chose to make takes the TMJ into consideration. The tap is great if you are a heavy grindr/ bruxer of the teeth however this applance locks lower and upper Bea together and I feel there can be some tooth movement over time. People who are true cpap wearers will end up with tooth movement particularly the upper teeth will be pushed inward creating a bulldog effect of there teeth. If I can help any more let me know because a oral appliance will help you
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Henning said:I don’t know what you were looking to tell.
What I thought was that my dentist could take the imprint of my teeth and send them to a dentist with Somnomed experience, and then made an oral appliance. Subsequently, this could be adapted with a communication between my dentist and the experienced Somnomed dentist.
Meanwhile, I have been informed by Somnomed that there is a dentist with a great deal of experience in the north of Germany. It takes me one day for each visit. But it may be the solution.
Here in the country, I have only seen uncomfortable appliances. But I know that Somnomed has planned to establishing here and in the other Scandinavian countries next year.
Henning
Dr. Richard Charmoy DMD said:Henning said:Is this what is called a TAP device. I have communicated with Somnomed and they have regrettably no dentists here in Denmark.
Is it the case that it is possible to communicate experiences between a good dentist here in the country and one with experience in Somnomed?
Henning
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A dentist can take impression and have the appliance made. With the help of a sleep dentist your dentist may be able to place appliance and aid you in adjustments. However your dentist will not have equipmentt to really test the appliance and chances are that the tech at a sleep lab will have no idea what to do.
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Henning said:I think I have decided to go to the specialist in Germany.
Henning
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I am sure if he is a qualified sleep dentist he will be able to help you. Let me know how you make out!
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currently my husband is using a tongue retainer which pulls his tongue forward. It seems to be helpful,but he also has a form of restless leg syndrome so he's taking a sleeping pill or a half of one every other night. I feel like there must be better alternatives for him.
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unfortunately for people who are edentuolos there isn't much we can do a tongue retaining device is very good. Some appliances are made like dentures and can work but my experience has been that tey tend to be unstable for the patient
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Dr. Richard Charmoy DMD said:I am all in favor of mandibular advancement appliance provided the dentist is aware of what he is doing. We are constantly getting flyers about making these appliances to help our patients.. I have studied this extensively with some of the top sleep dentist in the country. If the proper appliance is made and considerations for TMJ situation you should have
no problems. All of the appliances I make I take this into consideration therefore avoiding TMJ problems. If they do occur most resolve themselves within a week or two. I am in Central Jersey it takes me 45 minutes from NYC, my practice is in Somerville. I use both lab testing at our local Sleep for life Center apart of Somerset Medical Center and also ambulatory sleep studies. Obviously if a patient has cardiac or other medical conditions I would prefer a sleep lab test.Since sleep apene is a life threatening condition there are not many dental situation to prevent the fabrication of these appliances. I have made them on patients who have no teeth and patients who have periodontal conditions. I define success two ways one by patients epsworth and berlin tests, family and the patients reporting back to me. Secondly I like a lab or ambulatory test to quantify my numbers and compare to original sleep study, RDI/ AHI etc.Insurance is a trety situation they look at a dentist making a medical device, however I have a computer program that will generate a 30 page report including pictures and sleep studies, and all oral cavity related situations that can be a cause of sleep apnea. Over 15 years of making these appliances with really the majority within the last 5 years not one patient on follow up tell me they are not using the appliance. I get quotes of you have changed my life and my families. My spouse now sleeps with me, I am rested, I am now excersizing everyday and am rested. If you wish to contact me further my e-mail is rcharmoy@drcharmoydmd.com.
I am here to help you and your patients in anyway.
Dr. Charmoy
I am about to start CPAP this week (baseline AHI =40, min 02 =84%). I had a consultation yesterday with a dentist who is recommending a Somnomed, which I will receive on March 12. I have TMJ and bruxism (am currently using an NTI) and the dentist assured me we will proceed slowly with Somnomed use and adjustments, but I still have concerns that it may aggravate the TMJ. Still is there much risk of worsening the TMJ even with gradual acclimatization or would the Somnomed be likely to improve the TMJ by reducing grinding. I am, however, interested in the potential for eliminating the CPAP at least during travel if not on a daily basis -- how realistic is this with severe obstructive apnea and normal weight (5'6", 138 lb)?
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I have been searching for an alternative to the CPAP machine which I hate by the way. I end up fighting that all night. I live in the midwest and have searched for local dentists but only one locally and the appliance wasn't covered under insurance.
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I have moderate sleep apnea & have successfully used a CPAP machine with a nasal mask for around 5 years. I will not try to sleep without it. Although I am a compliant patient, it would be nice to be able to switch to a dental appliance. Years ago I had asked my doctor about dental appliances and he recommended the CPAP over dental appliances although he was willing to refer me to someone to a dental appliance specialist.
He had some concerns about TMJ at my then young age of 30 something (age & length of use was a factor to him). When I asked about using it part time such as on vacation etc. he was not keen on the idea. His opinion was either one or the other.
My questions are:
1) Have dental appliances improved over the past 5 years?
2) If I am currently a successful compliant CPAP user, is it better to keep using the CPAP & not try the dental appliance (I'm not concerned about the expense if there is a good possibility of improving quality of life).
3) Do you agree that I shouldn't try to switch back & forth between these 2 types of sleep apnea solutions? The only reason 2 swtich back & forth would be to help prevent TMJ.
4) Is TMJ or other dental issues a valid concern when using dental appliances?
Thanks for you help,
Juanita
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