Thursday, November 12, 2009

Oral Appliances: Custom Made Verses Boil-and-Bite

So you’ve decided to try an oral appliance.

There could be a few reasons you are considering this option.

You could be a mild to moderate sleep apnea patient who thinks that you would prefer an oral appliance to CPAP, the standard treatment therapy. You do not tolerate CPAP. Or you are unable to use positional therapy or weight loss to control your apnea.

Or you could be a severe OSA patient who cannot tolerate CPAP. Note, if you have severe OSA, you should always try CPAP before seeing a dentist about an oral appliance.

Supposing you are in one of these categories, now is a good time to find a dentist in your area who is trained in dental sleep medicine.

Your dentist may recommend that you wear a mandibular advancement device (MAD) to treat you OSA. A MAD will reposition your lower jaw and keep your airway clear to help you breathe during sleep.

There are custom made MADs, which require your dentist to make a plaster cast of your teeth. And there are thermoplastic boil-and-bite devices which cost less and take less time to make. The boil-and-bite devices work much like sports mouth guards.

So which should you choose?

This cornerstone study from 2007 indicates that the custom made device is definitely the best way to go.

It may cost more and take more time to make, but in the end, the custom made device will treat your apnea significantly better.

Custom made devices are much more effective at lowering patients' Apnea-Hypopnea Indexes. Patients also comply with custom made devices more than they do with the boil-and-bite devices.

This is a good statistic to think about. In the study, almost 70 percent of patients were not successfully treated with the boil-and-bite. But the majority of these people were successfully treated with the custom made device.

It may cost more and take more time to make, but remember: sleep apnea is a serious condition and getting successfully treated is your ultimate goal.

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The Official Blog of the American Academy of Dental Sleep Medicine (AADSM) is intended as an information source only. Content of this blog should not be used for self-diagnosis or treatment, and it is not a substitute for medical care, which should be provided by the appropriate health care professional. If you suspect you have a sleep-related breathing disorder, such as obstructive sleep apnea (OSA), you should consult your personal physician or visit an AASM-accredited sleep disorders center. The AADSM, and the American Academy of Sleep Medicine, as the managing agent of the AADSM, assume no liability for the information contained on the Official Blog of the AADSM or for its use.