Dental treatment
of snoring and sleep apnea

Treatment of obstructive sleep apnea

There are numerous therapeutic approaches for the treatment of obstructive sleep apnea, each of which has advantages and disadvantages.

Patients with obstructive sleep apnea may benefit by following certain general practices, which relate to modifying habits and situations that affect apnea. The second category of treatment options are specific, specialized treatments performed by qualified medical personnel.

Common general practices

The practices which benefit patients with obstructive sleep apnea are:
• Weight loss if the affected person is overweight
• Avoidance of alcoholic beverages before bedtime
• Avoidance of hypnotics and sedatives
• Avoidance of smoking
• Adoption of a side or face down sleeping position

Specific treatments

Specific therapies for the treatment of obstructive sleep apnea are continuous positive airway pressure (CPAP) using a nasal mask, surgery, and dental treatment of sleep apnea with intraoral appliances.

In CPAP, the patient wears a special plastic nasal mask during sleep. An apparatus blows air with pressure in the nasal mask via a pipe. The air passes through the nose and reaches the pharynx, keeping it open during sleep, and allowing the individual to breathe and sleep normally. Using CPAP is considered the most effective treatment for obstructive sleep apnea. It is 100% effective even for treatment of severe apnea (apnea with an AHI index value greater than 30), provided that the patient wears the device daily.

Despite the high efficiency of CPAP, its disadvantage is that a significant percentage of patients do not comply with the use of the respirator. Causes of non-acceptance of this treatment by patients include irritation to the nose, eyes, or ears, caused by the mask, dryness in the nose and throat, psychological and social problems that have to do with the appearance of the patient during sleep and the impression made to his/her spouse, the noise from the appliance, the need to move the device when the patient travels, allergies to materials of the nasal mask, etc.

Sleep Apnea Treatment - Surgical Procedures

Surgeries that correct anatomical abnormalities of the jaws and the tissues that form the walls of the airway, are another option for the treatment of obstructive sleep apnea. The removal of large tonsils, the resection of polyps and adenoids (adenoids) from the nasal cavity and the correction of nasal septum deviation are procedures that significantly reduce or eliminate snoring and assist, to some extent, in the treatment of obstructive apneas. Aother surgery utilized for the management of obstructive sleep apnea is called pharyngoplasty. In this procedure the rear portion of the soft palate and the uvula are surgically removed. This surgery offers doubtful clinical results while a significant  percentage of patients presents multiple  postoperative complications.

In patients with skeletal discrepancies of the jaws, such as retrognathism and micrognathia, performing orthognathic surgery to correct these problems also treats obstructive apnea.

Generally, surgical practices have the advantage of offering treatment without requiring the patient to use equipment and machinery. Their main disadvantage is the occurrence of intraoperative and postoperative complications, as well as the irreversibility of the anatomical changes they impose.

Sleep Apnea Treatment - Intraoral Appliances

Intraoral devices that precisely adapt on the dental arches are the first line treatment for snoring and mild to moderate obstructive sleep apnea. More information about the characteristics and the function of intraoral devices are presented in the “dental treatment” section.