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Permalink Reply by Kim Walters on March 18, 2009 at 10:58pm

I just made an appointment with a Dentist who specialize in the TAP appliance. I really like my teeth, and have no problem with TMJ. I hate, hate, hate, CPAP, and am totally non-compliant. I have a hard time breathing through my nose. The girl at the desk said the congestion thing shouldn't be a problem, and that they adjust the lower jaw slowly so that there is an adjustment period. I am sick of being tired.

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Permalink Reply by John J Sullivan IV, DMD on March 18, 2009 at 11:29pm

It's tough to give advice online, but appliances do wear out and your body does change. There are over a dozen oral appliances with many variations that can be made. Another appliance may work.

Cuddleydoc said:

Thanks for your comments on this issue. I originally posed the question about side effects because I am experiencing a change in my bite, movement of my teeth, and possibly some TMJ (clicking on one side when chewing but no pain). The appliance works great for my sleep apnea but I wonder if it is safe to continue using in spite of these side effects. Put another way, how severe do the side effects need to become before it would be recommended to stop using the appliance (a TAP appliance)?


Cuddleydoc said:

John J Sullivan IV, DMD said:

Hopefully this can answer some of your questions with sleep apnea and dental appliances.
If you have bruxism [grind or clench your teeth] an intra-oral appliance is difficult for the patient to get used to. In lieu of a sleep study an anti snoring appliance can be made. If you have had a sleep study and are diagnosed with sleep apnea you can have a more substantial appliance made you can wear while you are sleeping that may be paid by your medical insurance. Dental benefit plans usually do not pay for either sleep apnea or snoring appliances. Your TMJ should be in good health as your lower jaw will be pulled forward much the same way you would open the airway during CPR,- thrusting the lower jaw forward to open the airway. Fees for an anti-snoring appliance will run $450-650 and for sleep apnea $1200-1500. Any other fees or tests are not neceesary assuming the patient has had a complete set of radiographs and a comprehensive exam to eliminate any restorative and periodontal issues.

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Permalink Reply by sleepycarol on March 19, 2009 at 8:20am

It would appear to me that you would want another sleep study to provide accurate data that the device was actually working. I wouldn't think that there were any ways to determine how effective a dental device was in determining if treatment is effective. Each individual is unique and so what works for one may or may not work for another. What about central apnea? Dental devices can not help with that type of sleep apnea. Saying a dental device will stop sleep apnea in one swoop is reckless in my opinion. If one were to believe your statements, if I read them correctly,-- if you think you have sleep apnea just go get a dental device (of course with the appropriate radiographs and a comprehensive exam that I assume mean some dentist will do) and no sleep studies are needed.
I think this is misleading -- if not please post peer reveiwed scientific data indicating that no sleep studies need to be done and an accurate diagnosis can be made that a dental device stops sleep apnea without follow up sleep studies to determine this.

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Permalink Reply by Mike Amos on March 22, 2009 at 12:50pm

I have been using a Somnomed MAS for about one year.I agree with sleepycarol that the only way to determine the effectiveness using a oral device is a sleep study. A sleep clinic PSG should determine the severity of the obstructive apnea or whether any central apnea is indicated. It will also determine any other problems causing sleep disruption. If OSA is indicated as the main cause for the sleeping problem then treatment can be prescribed. Just like CPAP is not for everyone neither is a dental device. Testing during the adjustment period is a must to determine at what point the dental device is most effective without causing complications. After final adjustment then a routine dental exam at least twice a year for problems should be followed.
So far I have experienced no problems using my Somnomed device. Although I was first tested with a AHI of 49.9 and my AHI has been reduced to 9.9, I still am considering a combo treatment approach. My O2 stats average 92% now and all my apnea symptoms are gone.

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Permalink Reply by Chris H on May 25, 2011 at 8:10pm

Hi Doc, Was wondering how the dental device is working for you after all this time?? Good sleep,Chris

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