sleep apnea treatment

Sleep Apnea Treatment at the Dentist’s Office

Oral appliances for sleep apnea treatment are a proven alternative to conventional CPAP therapy — at least for people with obstructive types of sleeping disorders. The problem is you can’t get an FDA approved oral appliance made by a licensed sleep specialist. Why? Because it’s technically a dental device. Even though dental sleep appliances are made by a dentist, they’re covered by your medical insurance instead of your traditional dental benefits.


If all of this sounds confusing, it doesn’t have to be. The most important takeaway is that you can get sleep apnea treatment delivered by our Raleigh dentist. And the biggest perk is that your appliance will work in a holistic, machine-free manner. There are no tubes or nosepieces involved!



Step One: Self-Assessment Before Sleep Apnea Treatment


The first step in treating sleep apnea is pre-screening yourself for the warning signs. The important part is to be completely honest with yourself. If necessary, ask for the help of a family member to get their input (especially if you share a bedroom.)


Some of the most obvious warning signs of a sleeping disorder include underlying or co-existing medical conditions like:


  • Depression or mood changes
  • Fatigue
  • Weight gain or large neck circumference
  • High blood pressure
  • Stress
  • Earaches
  • Headaches or migraines
  • Cardiovascular disease


Plus, you might show intra-oral physical symptoms, including:


  • Enlarged tongue
  • Scalloped ridges along the sides of your tongue
  • Large tonsils
  • Restricted airway opening
  • Flat, worn, or chipped teeth
  • Broken dental work


Plus, there are the traditional symptoms to be on the lookout for. Like snoring, waking frequently throughout the night, or if your body stops breathing when you’re asleep. You might not even realize any of these warning signs are present unless you sleep next to someone who witnesses them every night. Ask them if it sounds as if you choke or gasp for air during your sleep. If you’re already having to sleep in separate bedrooms because of how bad your snoring is, then you’ll know it’s crucial to move right onto step two.



Step Two: Screening with a Sleep Dentistry Provider


Now that you’ve self-screened yourself for sleep apnea symptoms, it’s time to talk to a sleep dentistry provider. No, you won’t need a referral from a physician’s office. You can call a sleep dentistry practitioner directly to request an appointment. Just be sure to ask them ahead of time if they a) offer screenings and treatment for sleep apnea, and b) accept medical insurance for sleep appliance treatments.


Once you arrive at the office — in this case, Raleigh Dental Arts — our dentist will review your medical history, existing health conditions, and discuss the types of symptoms you’re experiencing. From there, we’ll also evaluate the inside of your mouth and overall oral-facial structures. Some of the things we’ll look for are worn areas on specific teeth, the contour of your soft palate, anatomy of your tongue, and the general size of your upper airway.


If you’ve already been diagnosed with a sleeping disorder in the past, please let us know. You can also call our Raleigh Dentist if you’re already using a CPAP appliance but find that it’s difficult (or impossible) to sleep with it. Alternatives like an oral appliance may be easier and more effective, depending on your unique circumstances.



Step Three: Take-Home Sleep Study


Depending on if you fit the criteria for obstructive sleep apnea (OSA), our Raleigh dentist can then order a home sleep study. This medical procedure is prescribed the same way other types of lab tests are. We partner with appropriate medical personnel to be able to offer this service to our patients, without having to refer you to a separate office or medical clinic. That way if a home sleep study is prescribed, you can pick it up and drop it off at our office.


Home sleep studies are ideal for getting a clinical diagnosis for sleep disordered breathing. Depending on the type of disorder that we think you have, it can monitor your vitals to record data for a firm diagnosis by a licensed medical provider.


When you take your sleep study kit home, you’ll attach the device as directed and set the small machine on your nightstand. Usually there’s a small sensor that goes on your upper chest (to record your snoring and breathing rates) as well as a wrist and/or finger sensor to record blood oxygen levels. The next day you’ll bring the machine back to our office. It’s that easy! You won’t even have to schedule a trip to stay overnight in a sleep clinic somewhere.



Step Four: Interpretation of Your Sleep Study


All of the data that was recorded from your bedroom the night of your test is stored inside of the small bedside machine. Sometimes it’s in a wrist device and no separate machine at all! Everything from your breathing and sleep patterns to just how hard you snored is tracked inside of the equipment.


Our partnering medical provider will then download the sleep data and evaluate it. Once they’re able to read the specifics about your particular sleep patterns and the physical symptoms you’re experiencing, a clinical diagnosis can be made. Obstructive sleep apnea is just one of the possible conditions, but it’s the type of sleep disordered breathing that can be treated with a dental device. And even if you don’t have a full-fledged case of sleep apnea but you struggle with snoring, a snore guard may still be an option.



Step Five: Prescription of an Appliance (Sleep Apnea Treatment)


Now that you have a clinical diagnosis on your specific type of sleeping disorder, it’s time to prescribe an oral sleep appliance (assuming you have OSA). Although dental sleep appliances are fitted and delivered by our Raleigh dentist, they’re still technically an FDA-approved medical device. That means they have to be prescribed as such and applied to your medical insurance, if applicable. That’s why you’ll want to work with a Raleigh sleep dentistry provider who accepts medical benefits and can file claims on your behalf. Most dentists only work with dental insurance.


Side note: If you’re already working with a sleep specialist and have been diagnosed with OSA, but you’re CPAP intolerant, you can always ask them to prescribe an oral sleep appliance. The only problem is they won’t be able to fill the prescription for you. Simply bring it to Raleigh Dental Arts and our sleep dentistry providers the same way you would a prescription to a pharmacy, and we’ll schedule an appointment to have the device made.



Step Six: Fitting You for an Oral Sleep Appliance


Although it’s a medical device, your oral sleep appliance must be made by a dentist. Why? Because it’s a custom dental device that could potentially impact your oral health and tooth integrity if it fits improperly.


To get started, we’ll take a series of scans or impressions of your upper and lower teeth. From there a model is poured to replicate your oral anatomy. Then our sleep appliance lab will fit the device to the model so that it positions your mouth in a particular manner. For instance, it might guide your lower jaw slightly forward in a way that prevents your tongue from resting against your tonsils, soft palate, or back of your throat. Within a couple of weeks, the custom appliance is ready to wear. We’ll have you return to our Raleigh dentist’s office to try the device in and make adjustments as needed. It’s not uncommon to see us a few times for fine-tuning over the first several weeks.


If you still have a CPAP machine, an oral appliance can be used alongside of it or potentially replace the device altogether.



Step Seven: Regular Maintenance as Needed


Now that you’re wearing your oral sleep appliance, plan to keep a diary to record your quality of sleep, co-existing symptoms, and document any changes you see. If for any reason you experience soreness or think your appliance needs to be adjusted, simply bring it back to our office to have it evaluated. Occasionally oral appliances need to be re-programed or adjusted for optimal performance. Changes as small as 1-2 millimeters can have a significant impact on your day-to-day sleep quality. Especially when it comes to something inside of your mouth.


At the very least, plan to bring your oral appliance with you to your six-month dental checkups.



Dental Sleep Apnea Treatment in Raleigh


Raleigh Dental Arts is a licensed sleep dentistry provider for people with obstructive sleeping disorder. Our services help patients better their quality of life through attentive, individualized treatments that work in a holistic manner. With improved airway positioning, you can potentially boost your sleep quality as early as the first night of treatment.


If you’re struggling with poor quality sleep, are CPAP-intolerant, or suspect that you have some type of a sleeping disorder, please feel free to contact us. We’ll guide you through a simple screening and request a home sleep study if you’re at risk.


Call our Raleigh sleep dentistry providers today to reserve an exam.



Tarun Agarwal

Dr. Tarun Agarwal, DDS is considered one of the top dentists in the country. He is a recognized speaker, author, and dental leader. He has been featured on CBS, NBC, ABC, FOX, and News 14 Carolina. Dr. Agarwal has been awarded '40 under 40' Business Leaders by the Triangle Business Journal. He is regularly invited to teach other dentists around the world and recently built a training center within the practice dedicated to sharing his expertise. Most importantly he is a loving husband and dedicated father of three wonderful children. His biggest accolade was being voted 'Best Dad in the World' by 2 of his 3 kids.