Breathing profoundly affects every system in our body – circulatory, skeletal, digestive, nervous, and numerous others. The healthy function of all these systems is directly impacted by the oxygen we breathe, whether its saturation is adequate or severely lacking, or somewhere in between. At Dental Horizons, when we’re able to improve a patient’s oral anatomy with a dental appliance that increases breath capacity and therefore oxygen uptake, there is a direct correlation to improved overall health.
To initiate sleep apnea treatment with Dental Horizons, what is the first step?
Call our practice at (720) 526-3146. We’ll schedule a convenient intake appointment for you at which time we will complete a very comprehensive medical history and a couple questionnaires. We’ll also have a conversation with you so that we understand your main concerns about your nighttime breathing. A full head and neck exam, including photographs, digital impressions of your mouth, and a 3D scan of your airway will be completed.
What is the usual treatment period for sleep apnea?
While every patient is different, treatment typically lasts 15 to 24 months. Our approach is to assist the body to heal itself non-surgically. Treatment usually involves two appliances (upper and lower), both customized mechanisms to guide the body so it knows where to grow and where to expand. There are other appliances that you could choose (ones that you just wear at night), but those only manage the condition; they don’t treat it.
We’ll discuss all aspects of your treatment with you after complete assessment of your exam during your intake appointment – including length of care. The conclusion and success of your unique treatment plan will depend in great part in your fulfilling your prescription, i.e. wearing the upper appliance between 14 to 16 hours a day and the lower appliance only at night. Your 100% compliance will ensure the shortest treatment. If you do not wear the appliance as prescribed, or if you do not wear it at all, treatment duration will be indefinitely extended, and treatment may not be successful.
Why should I be treated if I only snore a little or only have mild sleep apnea that doesn’t seem to affect me?
There are many degrees of sleep apnea. Sleep apnea is often not diagnosed until the condition is severe because the symptoms don’t readily present themselves (except in the mouth). If we wait until the problem is severe before treatment begins, the treatments themselves also become severe and the condition will be well into affecting the cardiovascular system (increasing risk of heart attack and stroke), digestive system (causing acid reflux), nervous system (ramping up anxiety and depression) and the muscle/skeletal system (triggering chronic pain, headaches, and jaw joint pain).
If we treat the oral component of sleep apnea, then we are also preventing many other downstream, chronic health conditions.
Unfortunately, many patients wait until they’re sick to take action. So unfortunate, as in the case of sleeping and breathing, there are so many treatment options (some are quite simple) that we can provide to help you breathe better.
What is the cost of oral appliance therapy?
Because every patient presents a unique treatment need, cost of therapy depends on the type of appliance that is prescribed. When we prescribe your treatment, we will provide you with a predetermination – an estimate of cost. In the meanwhile, here is a very general idea. Nightguards are a few hundred dollars. A mandibular advance appliance is approximately a couple thousand dollars. A DNA or mmRNA appliance is the cost of your prescribed orthodontics. Our experienced insurance experts will work with you to help you maximize your medical and dental benefits in order to minimize your out-of-pocket expense.
Will medical insurance pay for oral appliance therapy?
There are many conditions that oral appliance therapy can help treat and it will often be covered – fully or partially – by medical insurance. We will work with you to maximize the medical benefits you have so that you benefit as much as possible from your plan.
Should I get tested for sleep apnea first and then see you, or should I see you first?
If your physician has tested you and you have been diagnosed with sleep apnea, we can immediate initiate treatment possibilities and work with your physician to determine if oral appliance therapy is appropriate for you. If you have any of the symptoms mentioned in the videos, e.g. feeling tired all the time, have crooked teeth, you’re snoring and clenching at night, then definitely call us for an appointment. By considering the symptoms you identify and any other signs that we discover after an oral exam, we will determine how best to initiate the sleep test. We always need a sleep apnea test before proceeding with treatment.
What does a sleep test entail?
Sleep studies are very easy. Typically, you don’t have to go into a lab; you can take the Home Sleep Test (HST) while you are comfortable own bed. There are also many sleep apps that you can download to your smartphone to record and gather preliminary sleep data. Many patients do not believe they snore until they record themselves.
What if I don’t know if I can tolerate a nightguard?
Oral appliances that are specifically designed for sleep apnea allow you to breathe so that you won’t unconsciously, or consciously, remove it. If you can’t tolerate a regular mouthguard, it is often a sleep apnea indicator, and you should be tested.
Is there an over-the-counter nightguard that you would recommend to start experimenting with before moving through treatment?
Most OTC nightguards are made of soft rubber-like material and are counter-productive to maximize your breathing. They may protect the teeth from clenching or grinding, but because they lock the lower jaw in place, they can strain and damage the jaw. The purpose of the custom-fit, hard acrylic, and flat-surfaced nightguard that we provide is to not only protect the teeth, but to allow your lower jaw to move into an optimum position – one that doesn’t lock it into place.
Can I use an oral appliance at the same time as a CPAP machine?
Yes. Oral appliances are very effective for treating mild to moderate sleep apnea. A CPAP may still be needed to treat severe sleep apnea, and there may be times when using both is helpful. We will work in conjunction with your physician to determine what is appropriate.
If you are a continuous mouth breather and your tongue is tied, how long does it usually take for teeth to shift into a correct position?
Many people make a considerable investment in orthodontics to maximize the appearance of their smile. Their treatment doesn’t stop there; a retainer is prescribed and is a critical part of care. For many patients, it just doesn’t happen. People get distracted, get out of the habit of wearing the retainer, or they move house and the retainer is in a box … somewhere… Meanwhile, muscles are continually and constantly pulling teeth back into their original position. The result? Beautifully aligned smiles revert to the crooked ones they once were.
Moving the teeth makes your smile look beautiful, but – and this is critical – unless you address the underlying issue (very strong muscles pulling teeth back to their original position), there will be a relapse of tooth alignment. The pace at which that happens is unique to each individual and depends on the force of the attached muscle.
For some patients, it’s a very minimal attachment. In others, the attachment is so strong, they can’t even stick their tongue out. But completing orthodontics and not addressing the tongue is often a common reason why orthodontics needs to be completed a second or even third time.
What age is “too old” for help from an oral appliance or any of those types of treatments?
The sooner, the better. If we can start helping kids with their growth and development, that’s certainly the best. There are many different types of appliances and no matter what the age, we can find something that will help you breath better. One caveat is that you need to have teeth for this appliance to be fitted.
What other things can I do to help me sleep and breathe better?
Before you go to bed, blow your nose three or four times to clear your sinuses as much as possible. The steam from a hot shower will help. Sleep with nasal strips or nose cones. Mouth taping can also encourage nasal breathing at night. We will coach you on nasal strips, cones, and mouth taping.
