1. Why is my snoring getting worse?
Snoring, in addition to disturbing the sleep of a bed partner, has been known to progress to sleep apnea. Sleep apnea may progress in severity. Loud repetitive snoring and obstructive sleep apnea (the gasping and momentary stopping of breathing while sleeping) is a SERIOUS MEDICAL DISORDER and is associated with HIGH BLOOD PRESSURE, STROKE, HEART DISEASE, HEADACHES, WEIGHT GAIN, TYPE 2 DIABETES, SEXUAL DYSFUNCTION, MISTAKES AT WORK, EXCESSIVE DAYTIME SLEEPINESS, AND MOTOR VEHICLE ACCIDENTS.
2. How much does Oral Appliance Therapy cost?
Managing Obstructive Sleep Apnea with Oral Appliance Therapy is an investment in your health and general well-being that can significantly improve your quality and length of life.
Oral Appliance Therapy is not just impression taking and delivering an appliance.
Managing snoring and sleep apnea with Oral Appliance Therapy requires knowledge of evidence-based protocols that optimize patient outcomes. This includes more that just calibrating (adjusting) the appliance, but also further steps that may be taken, such as weight loss, positional therapy, myofunctional therapy, combination therapy and alternating therapy with CPAP.
This is why it is so important that the dentist has taken time to be qualified in Oral Appliance Therapy otherwise known as Dental Sleep Medicine.
Depending on the nature and severity of your obstructive sleep apnea, fees for oral appliance therapy range from approximately $2500-$3500 in both Canada and the United States.
Fees include examination, x-rays, impression taking or scanning of your mouth for appliance fabrication, bite registration, lab costs involved in making the appliance, delivery of the appliance, calibration of the appliance over several appointments, administering Home Sleep Testing, facilitating other therapies in combination, and letters/emails in collaboration with your medical sleep specialist and/or family doctor.
It is imperative that the dentist involved in your treatment is properly trained in Dental Sleep Medicine from an accredited school such as a University or the American Academy of Dental Sleep Medicine (as per the Canadian Sleep Society Recommendations). This will enhance treatment outcomes.
3. Does insurance cover Oral Appliance Therapy?
This depends on your insurance policy.
OHIP does not cover Oral Appliance Therapy.
Your dental insurance may cover examination and x-ray fees.
However, Snoring and Sleep Apnea is a medical disorder and is not covered under dental insurance.
You may have benefited through your private medical insurance for Oral Appliance Therapy.
Due to privacy laws, it is best for you to contact your medical insurance carrier directly and ask if you have benefits for Oral Appliance Therapy. We can help you with form completion as required.
4. I heard that Oral Appliance Therapy don't work
Research confirms that a clinically significant result is successfully obtained in approximately 70-80% of those treated with Oral Appliance Therapy for Snoring and Obstructive Sleep Apnea.
Many factors, such as the size of your tongue, the size of your airway, the angle of your jaw, how your bite comes together and the size and relationship of your upper and lower jaws are determinants when considering Oral Appliance Therapy.
Your sleep study results and your ability to breathe through your nose are also very important. There are many other factors to consider as well.
This is why it is important that the dentist treating you has had formal training in Dental Sleep Medicine, ideally the completion of board certification requirements as stipulated by the American Academy of Dental Sleep Medicine. (as per Canadian Sleep Society Recommendations)
5. Can an oral appliance hurt me?
There may be transient symptoms when using an oral appliance. They include tooth and gum discomfort, jaw joint aching, excessively dry mouth or drooling when sleeping. These symptoms happen while you are getting used to the appliance and in a short time will go away.
Long term appliance use can result in minor tooth movements and a slight change in your bite. This is the “trade off” for improved sleep, managed snoring, feeling refreshed the next day and having more energy. More importantly, the reduction of RELATED SERIOUS HEALTH RISKS (as listed in #1 above), are vital to maintaining good health and general wellbeing.
This is why it is so important that the dentist treating your snoring and sleep apnea has had formal training, ideally completion of board certification requirements as stipulated by the American Academy of Dental Sleep Medicine. (in keeping with Canadian Sleep Society Recommendations)
A trained dentist will monitor side effects and maintain ongoing communication with your sleep specialist.
6. Why is Oral Appliance Therapy not routinely prescribed and CPAP is?
CPAP has been known as the gold standard for treatment of snoring and obstructive sleep apnea. It is highly efficacious, meaning it works pretty much 100% of the time.
However, health benefits from CPAP therapy have recently been in question by the American Agency for Health Research and Quality (AHRQ) because of the lack of patient compliance with CPAP use.
If you cannot tolerate CPAP or refuse to wear CPAP, then Oral Appliance Therapy is a convenient and viable treatment alternative. Although Oral Appliance Therapy may not be as efficacious as CPAP, it is effective because patients wear oral appliances all night, every night.. When properly administered, Oral Appliance Therapy does improve many SERIOUS HEALTH RELATED RISKS similar to CPAP (see risks in #1 above).
7. I have not heard of Oral Appliance Therapy. Is this something new?
Oral Appliance Therapy has been around for decades, but previously not well researched and hence not often prescibed.
When CPAP was first discovered in the 1980’s, research became abundant for this therapy. However, over some 20 years since it’s invention, it became apparent to the medical community that CPAP is not as effective as thought in improving health benefits for snoring and obstructive sleep apnea, because most people will discontinue using CPAP. Alternative therapy research began.
During the following 20 years there has been an explosion in Oral Appliance Therapy research and this treatment alternative is gradually becoming embraced by sleep specialists and the general public.
In some countries like France, Sweden and USA, Oral Appliance Therapy is covered by socialized medical benefit plans.
8. How long does Oral Appliance Therapy take?
Managing snoring and sleep apnea is lifelong. Treatments may involve CPAP, Oral Appliance Therapy, Positional Therapy (sleeping on one’s side), behavioural therapy (losing weight), or surgical therapy when all else fails.
It may take up to 6-12 weeks to fully calibrate (adjust) an oral appliance so that it is managing your snoring and apnea. Treatments may also be combined. For example, Positional Therapy (sleeping on your side) in combination with Oral Appliance Therapy.
It takes time to gradually move your lower jaw forward so as to optimize the potential benefits of wearing the appliance while sleeping. This time may also involve you undergoing Home Sleep Testing that is delivered from the dental office. This testing is used only to help calibrate the oral appliance. Once the most optimal jaw position is reached, you will need to return to your sleep specialist for verification that your apnea is being managed.
In most cases the sleep specialist conducts an overnight sleep study on Oral Appliance after it is calibrated.
9. What is involved with secure online virtual consultations?
From the Home page on my website lovemysleep.ca, simply click on the consultation most appropriate to you.
You may also phone our office number (289-834-3560) and Mandy will book an online consultation with you.
Some of the consultations will trigger intake forms being sent to you through a secure virtual online portal at the time of booking your consultation appointment. You will be able to fill these forms out right there on your computer screen and send them back immediately or whenever time permits prior to your appointment. Please ensure that you click on ‘FILL OUT INTAKE FORM” button in the appointment confirmation e-mail that you receive.
When the appointment time comes, just click on the reminder that is sent to you, and we will see each other on the screen! Easy!
Please be re-assured that all electronic transmission is done securely through a secure commercial online virtual portal program that specializes in medical electronic transmission (Jane App).
Having said that, and despite significant high level security measures, there may exist risks related to unauthorized disclosure and interception of personal health information.
Most consultations before, after, and follow-up, may be done virtually. This is convenient, as well as cost and time efficient.
Payments may also be made through this secure virtual online portal.
Encryption level is similar to that used by financial institutions for fund transfers.
Documents like a sleep study or prescription for Oral Appliance Therapy may be sent to us via secure fax (855-395-0788).
We will be involved in guiding you through the process and helping should there be a need. However, the program is very user friendly and easy to use.
Please note that in office visits will still be required for in person oral examination, x-rays, and the taking of impressions or an oral scan for appliance fabrication.
For hospital consultations, if possible, please bring Special Needs patient to the virtual appointment.