1. Why is my snoring getting worse?
Snoring has been known to progress to sleep apnea. Sleep apnea may progress in severity. Loud repetitive snoring and obstructive sleep apnea (the momentary stopping of breathing while sleeping) is a SERIOUS MEDICAL DISORDER and is associated with HIGH BLOOD PRESSURE, STROKE, HEART DISEASE, HEADACHES, WEIGHT GAIN, SEXUAL DYSFUNCTION, MISTAKES AT WORK AND MOTOR VEHICLE ACCIDENTS.
2. How much does an oral appliance cost?
Managing sleep apnea is an investment in your health and general well-being that can significantly improve your quality of life.
Fees for oral appliances range from $2500-$3500 in both Canada and the United States. This largely depends on the appliance that is used. Trial transitional appliances may be fabricated for much less, but are not a long-term solution.
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, and multiple letters/emails to your sleep specialist.
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 (Canadian Sleep Society Recommendations). This will enhance treatment outcomes.
3. Does insurance cover oral appliances?
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 benefit 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 benefit for Oral Appliance Therapy. We can help you with form submission as required.
4. I heard that oral appliances don't work
Research confirms that a clinically significant result is successfully obtained in approximately 70% 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 jaw are determinants when considering an Oral Appliance.
Your sleep study results and your ability to breathe through your nose are also 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. (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 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. The reduction of related serious health risks (as listed in #1 above), are vital to maintaining good 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. (Canadian Sleep Society Recommendations)
A trained dentist will monitor side effects and maintain ongoing communication with your sleep specialist.
6. Why are oral appliances not routinely prescribed and CPAP is?
CPAP is 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, if you cannot tolerate CPAP or refuse to wear CPAP, then Oral Appliance Therapy is a convenient and viable treatment alternative. Although oral appliances may not be as efficacious as CPAP, they are effective. When properly administered, oral appliances do improve many serious health-related variables (see #1 above), similar to CPAP.
A prescription from a sleep specialist is required for a trained dentist to fabricate an oral appliance for you.
7. I have not heard of oral appliances. Are they something new?
Oral Appliance Therapy has been around for decades, but previously not well researched and hence not often used.
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 6-12 weeks to fully calibrate (adjust) an oral appliance so that it is managing your snoring and apnea. Treatments may also be combined.
It takes time to gradually move your lower jaw forward for wearing the appliance while sleeping, to effectively manage your snoring and apnea. This time may also involve you undergoing a Home Sleep Test that is delivered from the dental office. 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.
9. What is involved with secure online virtual consultations?
From the Home page on my website lovemysleep.ca, simply click on the consult most appropriate to 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 consult appointment, you will be able to fill these forms out right there on your computer screen and send them back immediately. Please ensure that you click on ‘fill out intake form” button. 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.
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.
Documents like a sleep study or prescription for Oral Appliance Therapy may be sent 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 oral examination, x-rays, and the taking of impressions or an oral scan for appliance fabrication.
For hospital consultations, please bring the special needs patient to the virtual appointment. My assistant, Mandy, will help you with forms, insurance and fees.