As seen on Channel 9’s “Today Show” on Thu 08 Dec 2011 with Karl and Dr Rick Gordon. Snoring really can affect you and those around you!

See “The Today Show” video!

Snoring can be treated here at MLC Centre Dental Surgery, Sydney, CBD.

Dr Adam Alford has been practicing dentistry and treating sleep disorders for over 10 years now and takes pride in offering solutions for a better night’s sleep for you.

Wheezing, rumbling or rasping could all be signs of sleep apnea or snoring which is a treatable condition.

We don’t only treat the symptoms, rather the cause of snoring, which may be diagnosed as obstructive sleep apnea. We use a team approach involving Ear Nose and Throat Surgeon’s or a sleep disorder service where a sleep study will allow for correct diagnosis and appropriate treatment options for you.

Snoring and Obstructive Sleep Apnea

A recent study by Pancer et al asked a clinical trial group some simple questions;

1. Does your husband/wife snore loudly?
2. Does your husband/wife snore in any position?
3. How often were you kept awake by snoring?
4. How often were you forced to sleep in another room?

Can you relate to any of these questions?

Snoring is a common problem, affecting persons of all ages, but particularly middle-aged and elderly men and women who are overweight.

The medical profession has identified snoring as a risk indicator of an upper airway abnormality associated with significant sleep disturbance and sleepiness. Although not all snorers have sleep apnea, snoring is a cardinal symptom of Obstructive Sleep Apnea (OSA).

OSA syndrome is a common, chronic disorder of sleep and breathing related to upper airway obstruction that develops during sleep. Obstruction of the airway results in many repeated involuntary breathing pauses during the sleep cycle.
Snoring and OSA, disorders that result from upper-airway obstruction, have been associated with:

• hypertension (high blood pressure)
• ischaemic heart disease (reduced blood supply to the heart muscle)
• cardiac arrhythmia (abnormal heartbeat rhythm)
• stroke

Other more apparent symptoms include:

• Fatigue
• Irritability
• Depression
• personality changes
• difficulty concentrating
• morning headaches
• choking or gasping during sleep
• sore, dry throat on waking
• decreased sex drive or impotence
• memory and judgment problems
• Falling asleep at work or while driving, which may cause life threatening accidents.

You may be wondering, “What is my dentist doing talking about snoring and this thing called OSA?”

Well the answer is simple. The Standards of Practice Committee of the American Sleep Disorders Association (ASDA) appointed a task force to review the current role of oral appliances (snoring mouthguards) in the treatment of snoring and OSA. From this task force their recommendations are;

a. Oral appliances (snoring mouthguard) are indicated for the use of patients with primary snoring or mild OSA.
b. Patients with moderate to severe OSA should have an initial trial of nasal CPAP.
c. Oral appliances are indicated for patients with moderate to severe OSA who are intolerant of or refuse treatment with nasal CPAP or surgery.

We as dental practitioners don’t expect you to understand these guidelines, but, by discussing the situation with us, we can guide you.

Treatments for Snoring and OSA

a. Behavioural Therapy; This is extremely important to the overall plan. It is important to identify and manage health or lifestyle conditions such as obesity, alcohol or benzodiazepine consumption, body position/sleep posture, and nasal congestion. Weight reduction is an important adjunct to treatment.

b. Pharmacological Therapy; I only include this for completeness. Articles reveal conflicting opinions. Most authors believe there is no real effectiveness to pharmacological therapy without undue side effects.

c. Nasal Continuous Positive Airway Pressure (nCPAP); the most effective treatment for moderate to severe OSA. It employs a tight fitting mask that is attached to a blower that will blow room air under pressure through the nasal passage.

d. Surgical Treatment; Designed to correct anatomical abnormalities that lead to airway obstruction. There are a number of techniques available, depending on the site of obstruction.

e. Snoring mouthguard therapy; (Oral Appliance Therapy) Based on the clinical research and clinical experience of the practitioners using oral appliances. It is clear that these devices have a positive effect on upper airway patency.

Snoring mouthguard therapy is useful for patients who suffer from snoring and or with mild sleep apnea.

Snoring mouthguards are also useful for patients who do not wish to have surgery or have poor compliance with the nCPAP treatment. Patients have been shown to have a higher compliance and fewer side effects from treatment with an oral appliance than with nCPAP.

Snoring mouthguard therapy has been shown to be 50-80% effective in reducing OSA.
What are the side effects of the oral appliance?
• mucosal dryness or hyper salivation
• transient tooth or jaw pain
• masticatory muscle stiffness

The above are quite common and occurred in 36% to 86% of patients. However, according to the patients’ own judgment’s, the subjective benefits experienced from Snoring Mouthguard therapy outweighed these minor inconveniences by far and did not lead to discontinuation of treatment.

A team approach facilitating the skills and knowledge of an Ear, Nose and Throat Surgeon and a Dental Professional is important in treating Snoring and OSA. Please approach your Dental Practitioner about these issues if any of the above symptoms sound like you or you are interested for someone else. OSA is a very important health issue.

How much does a snoring mouthguard cost?

The cost for a snoring mouthguard appliance for snoring and Obstructive Sleep Apnea is $980, your health fund may contribute towards the cost of this mouthguard. We recommend MDSA appliances. These have shown to be the most effective at reducing jaw pain and muscular stiffness.

Call us on 02 92323866 for an appointment with Dr Adam Alford to get a professional opinion and get on the right track for a good night’s sleep.

Dr Adam Alford BDS Sydney (hons) is a professional dentist and the author of this article. He is located in Sydney City’s Martin Place. Dr Alford has been treating patients with sleep disorders for over 10 years; he has a special interest in preventative dental and treating the cause of the symptoms. Email him for further information or an appointment adam@adamalford.com.au