Although dentists like Dr. Abdulla have been treating obstructive sleep apnea (OSA) with oral appliances for decades now, for a long time, they were often seen mainly as suited for mild or moderate cases. For severe cases – in which a person stops breathing more than 30 times an hour – CPAP remained the go-to treatment.
But that was then.
We now know that oral appliance therapy (OAT) is effective in treating severe OSA, too – something highlighted last month by a new review of the science in the journal Otolaryngology – Head & Neck Surgery. (“Otolaryngology” is more commonly known as ear, nose, and throat medicine, or ENT.)
Its authors began by searching three major medical databases for studies on the efficacy of two types of appliances: mandibular advancement devices (MADs), which hold the jaw in a slightly forward position to keep the airway clear, and tongue retention devices (TRDs), which hold the tongue forward so it doesn’t fall back and block the airway.
Forty-two studies involving 2265 patients were included in the review. Analysis of those studies found that, overall, oral appliance therapy improved AHI scores – a measure of OSA severity – by 48% in mild cases, 67% in moderate cases, and 62% in severe cases.
There were some differences depending on the type of device used. For instance, MADs were more effective than TRDs for those with mild apnea. Improvement with MADs was also a bit higher for those with severe apnea, although not enough to be considered “significant.”
No differences were found with respect to daytime sleepiness, oxygen desaturation index scores (ODI, a measure of how often a person’s blood oxygen level drops during sleep), and lowest oxygen saturation (LSAT).
“Overall,” the authors concluded,
both TRD and MAD are effective treatments for moderate and severe OSA. MAD is efficacious in mild OSA, while TRD requires further validation. Furthermore, mild-moderate and severe OSA received similar improvements in sleepiness, ODI, and LSAT. This study complements the evidence for the efficacy of OA.
In other words, oral appliance therapy works…and works well.
Of course, we know this as well with what we see in our patients every day here at the Laguna Hills Center for Sleep Apnea & CPAP Intolerance. Here’s what just one had to say about using the ProSomnus device – one of Dr. Abdulla’s go-to appliances, effective for a great many patients with differing levels of sleep apnea:
This patient’s wife also confirms that the device absolutely does work as advertised and is “worth every penny.” Both are sleeping better now.
Ready to see if oral appliance therapy might be a better solution for your – or your sleep partner’s – OSA, too? Give us a call now to schedule a consultation with Dr. Abdulla: 949-420-9669