Sleep apnea is a serious, sometimes fatal medical disorder that affects around 10% of American men over the age of 40, and 6% of American women of the same age. Sleep apnea sufferers completely stop breathing during sleep, sometimes hundreds of times in a single night. Normal breathing ceases because the airway becomes obstructed, causing a serious reduction of airflow to the lungs.
There are a number of dental devices that can be used to help alleviate this condition. The goal of most of these devices is to move the mandible (lower jaw) forward, opening the airway. Wearers of sleep apnea dental devices report that they stop loud snoring, feel more rested in the daytime, and are much more comfortable going to sleep. Sleep apnea appliances work best on patients who are not significantly overweight. They offer a viable alternative to Continuous Positive Airway Pressure (CPAP) for the "Mild" and "Moderate" patients and can potentially offer a reduction in the severity of all types. The true test of the effectiveness of the oral device is that of having an "after" overnight sleep study done in the sleep laboratory that would be compared to the "before" sleep study.
Dr. Turner uses two types of oral positioners: The Tap 3 and the Somnodent devices. Both accomplish approximately the same end goal -- that of opening the airway by moving the base of the tongue forward by moving the mandible (lower jaw) forward.
TAP® 3 (Thornton Adjustable Positioner)
The TAP® 3 is the smallest, most comfortable member of the TAP family. It is a two-part custom-created sleep apnea appliance that fits over the teeth in much the same way as a sports mouthguard. The TAP® 3 projects the jaw forward to prevent the tongue and soft tissues from impeding the airway. The lower jaw positioner is adjustable, which means that it can be altered to suit the comfort level of the wearer. The TAP® 3 appliance can accommodate the three main types of malocclusion, and allows the lips to fully close.
Somnodent
The SOMNODENT is similar in its size to the Tap 3. Its biggest difference is that there are two adjustment screws (right and left). Dr. Turner would tend to use this appliance for a patient who has a history of TMJ problems, only because it offers some extra adjustment of the midline of the teeth as compared with the midline of the skull.
The final position of either of these devices would be approximately the same. The Somnodent has more adjustment capability for the patient who already has a history of TMJ problems. The Tap 3 would be the appliance least likely to cause TMJ problems for the patient who has never experienced any TMJ symptoms. So there are advantages and disadvantages of each device. The TMJ history dictates the design of the device.
The biggest difference in Dr. Turner's technique is that it involves starting from a three dimensional position that is created using an electronic "tensing" device (similar to those used by orthopedic surgeons to stimulate muscle activity after joint surgeries) that places the jaw in its most relaxed position for the starting position. The device is then advanced over a three to four month series of visits that moves the mandible to open the airway SLOWLY. Can the treatment be done without the tensing or the slow repositioning? Probably sometimes. My training tells me that using the tensing and the slow movement gives a more comfortable appliance and results in better sleep numbers, less snoring, and better daytime alertness and higher energy levels. The numbers at the "after" overnight sleep study is the scientific proof of the device's effectiveness.