How A Dentist Can Cure Your Sleep Apnea

Oftentimes, I recommend a referral to a dentist to treat obstructive sleep apnea. Most patients will ask me, “How is a dentist going to help me?” My answer is that since obstructive sleep apnea is mainly a problem from small jaws and crooked teeth, they have a variety of different ways of helping you to breathe better and sleep better.

I just came back from presenting at an Airway Dentistry conference in Laguna Hills, CA. It was definitely one of the most exciting and rewarding conferences I have ever attended. All the speakers and the attendees are at the forefront of not only potentially better treatment, but also better prevention of obstructive sleep apnea. 

The most common way dentists can treat obstructive sleep apnea is by making a retainer-like appliance that pulls your lower jaw forward. Since the muscle that attaches the base of your tongue connects to the lower jaw, moving the jaw forward will pull the tongue forward. This option works well for most people and is usually better tolerated than CPAP. However, because it’s a device that sits in your mouth, protruding your lower jaw, it can sometimes cause problems like profuse salivation, jaw pain and shifting teeth. It uses the upper teeth as a lever to pull the lower teeth forward, so the upper teeth can shift back to various degrees. Fortunately, this is unusual, and can be adjusted for by your dentist. In many cases, people don’t mind because sleep is so much improved.

Now there are a newer generations of dental appliances that work not by pulling forward your lower jaw, but by expanding your jaw wider and more forward, all without surgery. Granted, it can take much more time, similar to braces. However, it’s different from braces in that rather just straightening teeth, the entire jaw structure is significantly expanded, opening up the airway. 

The downside to these newer options is that because they are so new, not too many dentists know about it,  and it’s not generally covered by insurance. It’s also important to remember that there hasn’t been large-scale studies on obstructive sleep apnea treatment effectiveness. Hopefully, studies will be forthcoming. Currently, most dental appliances that are FDA approved for obstructive sleep apnea are the advancement devices. 

Up to date dentists are also incorporating orofacial myologists who train your tongue and throat muscles properly. Since your tongue is your most important orthodontic appliance, how it’s used (along with the lips and throat muscle) can have a profound effect on the eventual size of your jaws and your upper airway. 

I challenge everyone reading this post to find out how much they know your dentist knows about obstructive sleep apnea. Does he or she appreciate how important the teeth are in relation to your upper airway? Does your orthodontist still remove teeth before applying braces for your child? If not, at the risk of possibly offending your dentist, please direct them to the American Academy of Physiologic Medicine and Dentistry, and the American Academy of Dental Sleep Medicine.

What has your experience been with your dentist? How well are they versed in the importance of the airway?

Please note: I reserve the right to delete comments that are offensive or off-topic.

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12 thoughts on “How A Dentist Can Cure Your Sleep Apnea

  1. I’ve asked around about those products, among orthodontists and top oral surgeons. Consensus seems to be that they’re snake oil, even for children. They tell me that they appear to work by tipping teeth, rather than modifying growth. The only devices that really work are expanders and headgear. I’m told the mandible fuses at 1yr and there’s only slow growth after that, which is why efforts always focus on the maxilla.

    There may be one exception on the horizon, which is LIPUS. I haven’t been able to get a clear answer as to whether something like Exogen could be used in combination with reverse-pull headgear to squeeze out a little more growth in a child. Doing something like this, though, you don’t want to be the first patient. You want someone who’s done it on hundreds of people before you.

  2. My dentist did not know very much about airway. So I showed him parts of Dr. Singh’s video “DNA Appliance Made Simple”. He was very interested in it and commented that he has treated patients from all over the world and has noticed that people’s jaws are getting smaller and noones teeth fit in their mouth anymore. He said he’s even noticed it in people from Africa-those from the city have small jaws and only those from the bush still have the large jaws. It was interesting to hear his experience with those issues. When the other dentist asked what we were talking about, he told him that I was, “teaching him something”. His humility and willingness to learn new things made him seem even more intelligent.

  3. I am currently being treating with the Crozat appliance by an orthodontist and it has helped a lot with lowering my cpap pressure and it has expanded my jaw (there are gaps between my teeth too). I recently read that dental practitioners’ insurance has increased due to the number of dentists practicing orthodontics with lightwire appliances. One should really seek out an orthodontist for the ALF, Crozat, Biobloc, Homeobloc, and other lightwire appliances because you will be moving teeth. The ALF, for instance, was really peddled to dentists as a way for them to make extra money; but really a dentist is useless when using lightwire appliances because you will be moving teeth. An appliance that merely moves the lower jaw forward while sleeping, however, is perfectly suitable for dentists.

  4. I bought one of the TAP dental devices a few years ago and unfortunately it was a total waste of several thousand dollars, it did nothing for me. If the TAP device doesn’t work for me does that imply my issue is not related to my jaw and these new devices and tongue training you mention above probably won’t be as effective either?

  5. Mike,

    The TAP is a mandibular advancement device which is very different from the other devices that can widen the airway. There are a number of different reasons for an advancement device not working. In some people, moving the lower jaw forward doesn’t move the tongue much at all. I see this occasionally using a fiberoptic endoscope with the appliance in place, with the patient on his or her back. IF you have nasal congestion or severe obstruction behind the soft palate, moving the tongue forward won’t help. Pain or discomfort from using the device can keep waking you up even though the airway is bigger. Devices that open the mouth too much can also narrow the airway more. It’s also been shown in various studies that being very overweight, severe sleep apnea and similar sleep apnea severity while on the back and the side are poor predictors for mandibular advancement device success.

  6. BA,

    Thanks for sharing. If you’re not familiar with Dr. Weston Price’s book, Nutrition and Physical Degeneration, it’s a must read (especially for dentists). Dental crowding (and upper airway narrowing) is epidemic in developed and developing countries. It’s important for patients to continue to teach the mainstream medical and dental professionals about this important, and ominous phenomenon.

  7. Uri,

    What you’re being told is the standard explanation which is still mainstream thinking. These “renegade dentists” have been expanding adult jaws for decades with success. I’ve seen the results myself, including significantly enlarged airways. If it’s only causing the teeth to tip out, how can you explain the significant chin growth and hard palate widening? The airway x-rays are also pretty convincing. Unfortunately, mainstream orthodontics is still extracting multiple teeth, and I see the consequences almost daily with the tiny airways that result, leading to poor sleep quality and numerous chronic medical conditions. It’s only a matter of time before these new options become mainstream.

  8. As a RPSGT I’ve seen numerous patients who have used Mandibular Advancement Devices. Some have had really bad experiences. I would never use one of these unless it was built by a dental professional with specific training on how to do them. There is a board certification for this which I understand requires lots of extra training. Also, I think patients for this and surgery need to be told that RARELY will this work throughout their life. As age factors take over nearly all of them will end up with CPAP. I myself would never have surgery knowing that it’s only a temporary fix (with the exception of tonsil removal for kids to get them through their young years without CPAP).

  9. Mr. Cabral, since there are no head to head studies looking at CPAP and Provent, I can’t say for sure. Although the overall “success” rates for Provent are much lower, if you’re one of the few who respond to Provent and you can’t use CPAP, then it is better for you. Unfortunately, the only way to tell is to try both to see.