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Snoring, Sleep, & TMJ

While snoring itself may be harmless, it can be a symptom of a more serious condition known as obstructive sleep apnea (OSA). Drs. Pierce, Crabtree, and Deshmukh in Warwick and Narragansett, RI offer sleep apnea treatment. Regular snorers have a 33% increased risk of cardiovascular disease, and patients with OSA are four times more likely to suffer a heart attack. The condition often involves a narrow airway caused by factors like large tonsils, a long soft palate, or a tongue that relaxes too much during sleep, leading to vibrations that cause snoring. Connect with us today to discover the best sleep apnea treatment for you. Even if you are not diagnosed with sleep apnea and are a primary snorer, there is a dental device that can be made to eliminate the snoring.

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Obstructive Sleep Apnea

OSA occurs when the tongue blocks the airway, stopping breathing. This results in a lower oxygen level that partially awakens the sleeper to unblock the airway, often with a gasp. OSA greatly affects quality of life and can strain personal relationships. Symptoms include loud snoring, daytime sleepiness, depression, and fatigue. Mild cases may improve with lifestyle changes such as weight loss and avoiding drowsiness-inducing substances before bed. Severe cases might require treatments like surgery, nasal CPAP, or Dental Appliance Therapy for effective management.

TMJ

Temporomandibular Disorders (TMD) involve a complex system of muscles, ligaments, and bones that can cause symptoms such as pain in the jaw region and limited mouth movement. We focus on creating an individualized treatment plan that aims to alleviate pain and restore function rather than addressing accident-related cases or the causes of TMD. Diagnosis typically involves a thorough history and clinical examination, and on occasion, might necessitate specialized imaging, such as an X-ray or MRI, to inform our treatment approach. Our goal is to manage symptoms effectively through various treatment modalities tailored to each patient’s specific needs.

Treatment Options

Oral Appliance Therapy

A dental appliance is a small plastic device worn during sleep to prevent throat tissues from collapsing and obstructing the airway. Designed by trained dentists, these appliances help reduce snoring and relieve symptoms of mild to moderate obstructive sleep apnea (OSA) by bringing the lower jaw or tongue forward or lifting the soft palate. They are small, easy to use, and non-invasive. During the initial visit, a dentist examines your mouth and custom-fits the appliance. Regular follow-ups ensure the appliance remains effective, offering a convenient and cost-effective alternative to surgery and other treatments.

Common Misconceptions

Myth #1: Oral Appliances Cause Bite Changes.
Long-term oral appliance use can cause bite changes, but a morning exercise program involving clenching teeth four times per minute is effective in minimizing these changes by stimulating temporomandibular joint tissue and reducing the likelihood of a posterior open bite.
Myth #2: Oral Appliances Cause Teeth Loosening.

Teeth loosening can be an issue with long-term oral appliance use, but careful initial examination, periodic monitoring, and, if necessary, splinting have prevented significant problems.

Myth #3: Oral Appliances Are Only For Mild Cases Of OSA.

The American Academy of Sleep Medicine states that oral appliances are suitable for patients with mild to moderate OSA who prefer them to CPAP or cannot use CPAP; in our practice, many moderate OSA cases have resolved completely with oral appliances, and even some severe cases have seen significant improvements, with additional treatments used as needed.

Myth #4: There Is Only One Appliance That Is Used And Can Be Used For OSA.
The claim is false; there are many different oral appliances in our office — including the Herbst, TAP 3, EMA, SomnoDent — each chosen based on the specific needs of the patient.
Myth #5: Oral Appliances Cause Temporomandibular Joint Issues and Muscle Pain.

For over 35 years, our office has specialized in treating temporomandibular joint disorders, carefully examining all patients for symptoms, constructing appropriate sleep appliances, and monitoring and adjusting treatment to ensure most patients can successfully use their appliances long-term, although a few with advanced conditions may not.

Herbst Appliance

The Herbst Appliance effectively treats chronic snoring and mild to moderate obstructive sleep apnea, allowing lateral and vertical movement without disengagement. It has two adjustability options: traditional hardware with 1-3 mm shims and a Telescopic version enabling ¼ mm adjustments up to 6-8 mm. Fabricated from hard acrylic, thermoactive, or soft materials, it is tooth-retained via friction grip or clasps.

Tap 3
The Thornton Adjustable Positioner (TAP®) is a custom-made two- piece sleep appliance that is attached in the front with a fixed mechanical hinge to hold the lower jaw forward and keep the mouth closed. Its simple design provides tongue space and is titratable so an effective position can be achieved.
SomnoDent Appliance

The SomnoDent Appliance is a two-piece custom-made Mandibular Advancement Splint (MAS) treating snoring and mild to moderate obstructive sleep apnea (OSA) by moving the lower jaw forward. This movement tightens the soft tissues and muscles in the upper airway, preventing obstruction and reducing snoring. It includes upper and lower dental plates with a patented fin-coupling component allowing normal mouth movement. The adjustable design enhances efficiency and comfort. Suitable for those intolerant to CPAP therapy, it has shown high patient acceptance and compliance.

EMA

The Elastic Mandibular Advancement appliance is a tailored device that incrementally moves the lower jaw forward and elevates the bite, facilitating improved airflow during sleep. This customizable appliance employs elastic straps of varying sizes to gradually advance the mandible by precise one-millimeter increments.

Other Treatment Options
  • Continuous Positive Airway Pressure (CPAP)
    CPAP is a machine that blows air at a prescribed pressure via a hose to a nasal pillow, a nose mask, or a full-face mask, keeping the airway open by air pressure in order to reduce airway resistance.
  • Uvulopalatopharyngoplasty (UPPP)
    A surgical procedure to widen the space in the back of the throat to reduce the collapsibility of the airway.

FAQs

Why do I snore even when I feel healthy?
Snoring can be caused by relaxed tissues blocking airflow during sleep. It’s sometimes a sign of sleep apnea. If snoring is affecting your rest or your partner’s, we offer safe, effective solutions.
What is sleep apnea and why should I take it seriously?
Sleep apnea occurs when you stop breathing for at least 10 seconds at a time throughout the night .It can lead to fatigue, headaches, and affect many aspects of your health including your heart. We offer dental appliances that can help keep your airway open and improve your quality of sleep.
Can a dentist help with snoring or sleep apnea?
Yes. We create custom oral appliances that reposition your jaw or tongue to prevent airway obstruction. Many patients prefer this to bulky CPAP machines. Let us help you find the right fit.
What are the signs that I might have TMJ issues?
Symptoms may include jaw pain, clicking or popping sounds, headaches, and difficulty opening your mouth. If any of these sound familiar, schedule an evaluation with our team.
Is a mouthguard the same as a sleep apnea appliance?
No. Sleep apnea appliances are designed to move the jaw or tongue to keep your airway clear, while mouthguards are mainly for teeth grinding. We’ll help you choose the right device for your condition.
Are there side effects to using a dental sleep appliance?
Some patients notice bite changes or jaw soreness, but we monitor your appliance along with your bite and make adjustments as needed. Our experience helps us ensure your comfort and safety throughout treatment.
What if I tried CPAP and couldn’t tolerate it?
You’re not alone. Many patients find oral appliances more comfortable and easier to use. We offer several designs based on your specific needs, and we’ll help you find the one that works best.

Your healthy smile awaits — call today!

Call Warwick Location

401-781-2742

Call Narragansett Location

401-783-8464