Obstructive Sleep Apnea (OSA) occurs when your muscles relax during sleep, allowing the soft tissue to collapse and block the airway. As a result, sleep apnea can cause you to stop breathing for anywhere from a few seconds to more than a minute -- as many as hundreds of times per night. Snoring, excessive daytime sleepiness, memory problems, irritability, fatigue, and insomnia are all signs that you could be losing valuable rest to sleep apnea. If left untreated, sleep apnea can be a potentially life threatening condition. It can increase the risk for other serious health problems including high blood pressure, stroke, heart disease, diabetes, obesity, depression, anxiety, dementia, and impotence. Untreated severe OSA has been shown to reduce life expectancy and increase mortality.
The traditionally prescribed treatment for obstructive sleep apnea is continuous positive airway pressure (CPAP) therapy. CPAP has been shown to be an effective treatment for OSA. However, as many as 50 percent of patients don't stick with the treatment. For patients who do not tolerate CPAP, or for patients with mild to moderate OSA and who do not prefer CPAP, Dr. Boucher can provide an alternative with oral appliance therapy.
Oral Appliance Therapy (OAT) is an effective, non-invasive treatment option for snoring and obstructive sleep apnea that fits easily into your daily routine. A dental oral appliance looks like a sports mouth guard or orthodontic retainer and is worn only when you are sleeping. The dental oral appliance supports the jaw in a forward position to help maintain an open upper airway, preventing sleep apnea and snoring.
Once you have been diagnosed with obstructive sleep apnea by a sleep physician, Dr. Boucher can make a custom-fitted oral appliance using impressions and models of your teeth. Oral appliance therapy is covered by many medical insurance plans. We can help you verify if coverage is available through your insurance plan. Patients like it because the dental oral appliances are comfortable, easy to wear, quiet, portable, convenient for travel and easy to clean.
Treating snoring or sleep apnea with oral appliance therapy can help you feel like a new person. You will find that your symptoms, and your quality of life, can improve dramatically when you remain committed to your treatment and use the appliance nightly. Custom-fit oral appliances from University Hills Dental can improve your sleep, restore your alertness and revitalize your health.
If you have problems with snoring or concerns about sleep apnea, it may be time to make an appointment. If you suspect you may have sleep apnea, we can recommend a sleep physician to help get you started on your path to treatment. If you have already been diagnosed with sleep apnea, Dr. Boucher can fit you with an oral appliance. Our team at University Hills Dental is ready to answer your questions about obstructive sleep apnea, dental sleep medicine and oral appliance therapy.
Dr. Liberty Boucher is a Diplomate of the American Board of Dental Sleep Medicine (ABDSM). The ABDSM is the leading national testing organization for dentists who treat snoring and obstructive sleep apnea with oral appliance therapy. Earning Diplomate status from the ABDSM is a unique honor that recognizes special competency in dental sleep medicine, and Dr. Boucher is the only provider in Dane County and surrounding areas to have earned this distinction.
Dr. Boucher is a member of the American Academy of Dental Sleep Medicine (AADSM), the only non-profit professional association dedicated exclusively to the practice of dental sleep medicine. She received the designation of "Qualified Dentist" by the AADSM in 2017, and continued her education in dental sleep medicine with the AADSM completing their Mastery Program in January 2020.
Dr. Boucher helps treat snoring and obstructive sleep apnea with oral appliance therapy, an effective treatment that is covered by most insurance plans. AADSM membership provides Dr. Boucher with access to educational resources and practice management tools that help her better serve University Hills Dental patients by providing the highest quality of care in the treatment of snoring and obstructive sleep apnea. For more information about AADSM, visit www.aadsm.org.
Dr. Boucher is also a member of the Wisconsin Sleep Society, which provides educational and scientific resources to Sleep Professionals like Dr. Boucher in the State of Wisconsin. The Wisconsin Sleep Society promotes increased awareness of sleep medicine and sleep disorder treatments and provides education in sleep disorders and sleep medicine.
Q. I don't know if I have OSA, what do I do?
There are many questionnaires that are used as screening tools for OSA. Examples are the STOP-BANG and the Epworth Sleepiness Scale. These are used to predict whether or not you have OSA, but their accuracy (sensitivity and specificity) is questioned in the sleep medicine community. The only way to confirm OSA is with a sleep study. If you are concerned you have OSA it is best to talk with your primary care physician. If you have any more questions, contact us and we can try to help.
Q. I think I might have OSA, what now?
The best place to start is with a conversation with a member of your healthcare team. Talk to your primary care physician or dentist -- they can help. Because treating OSA may require collaboration between several specialists, it is best to start with the doctor who manages your care. If you are having trouble getting the help you need, contact us and we can try to help.
Q. I have a CPAP and I hate it, what do I do?
CPAP is considered to be the 'gold standard' for treatment of OSA. It has been shown to be predictable and effective. However, some patients have problems with mask comfort or leaks, wearing it for the entire night, or simply cannot tolerate it. Discuss this with your sleep medicine physician to see if there are any options to make CPAP more comfortable. If you have already done that and are ready to try something else, speak with your sleep medicine physician about oral appliance therapy or contact us to see if oral appliance therapy is an option for you.
Q. I wear a CPAP and it seems to be fine, but my pressures are so high it's uncomfortable
Some patients with severe OSA may benefit from combination therapy. This is where CPAP and oral appliance therapy are worn together. The goal of combination therapy is to either increase the effectiveness of CPAP, or lower the pressure of CPAP by opening the airway and stabilizing the jaw with an oral appliance.
Q. I had a sleep study that found I snore, but don't have OSA
Some patients find that snoring affects the quality of their sleep (and their bedpartner's sleep!), and contributes to daytime sleepiness, mental fog, and energy levels. Oral appliance therapy has been shown to benefit those with primary snoring as well as patients with OSA.
Q. My CPAP is fine, but I want something else to take with me when I travel
If you camp, backpack, or travel where taking your CPAP machine with you is not a realistic option, oral appliance therapy may be a good alternative or back-up for those situations.
Q. I love my dentist, do I need to switch to be seen for an oral appliance?
Absolutely not! We collaborate and communicate with your entire health team, including your dentist, to make sure your treatment with an oral appliance is appropriate and effective.
Q. Does oral appliance therapy work for everyone?
Unfortunately, no. Patients with certain jaw shapes, patients with unstable periodontal disease, and patients with specific medical conditions are not good candidates for oral appliance therapy. And sometimes we don't know until we try. Oral appliance therapy has been shown to be effective in the treatment OSA for most patients, but not all. The good news is, patients who use OAT are more likely to wear it every night, for the entire night, than patients using CPAP. And because of this, oral appliance therapy has shown similar effectiveness as CPAP in the treatment of mild to moderate OSA. Simply put, a treatment doesn't work if you don't use it, and patients have been shown to be more willing to use OAT consistently than CPAP. However, just like CPAP, OAT it isn't for everyone. After beginning OAT, we will refer you back to your sleep medicine team to evaluate its effectiveness.
Q. What are the side effects or risks?
Oral appliance therapy may cause minor side effects including excessive salivation, dry mouth, tooth and jaw discomfort and temporary bite changes. These symptoms often resolve after a few weeks of treatment. Some patients experience potential complications including permanent bite changes, jaw pain, and TMJ symptoms.
Q. What is the process?
Most often the process consists of three to four appointments. After diagnosis of OSA and referral by your sleep medicine physician, we schedule a consultation to evaluate whether or not oral appliance therapy is a good option for you. At this appointment, we will discuss your sleep study results, your sleep and medical history, go over risks and benefits of treatment, appliance options, take photos and any necessary images, and discuss financial considerations including insurance coverage. At the second appointment, we take records including an oral evaluation and TMJ exam, impressions of your teeth (digital and/or traditional), a special bite registration, and go over the plan for treatment. At the third appointment, we deliver your oral appliance -- we try it in, do any necessary adjustments, practice using it, go over how to use it and take care of it -- and also fabricate a Morning Occlusal Guide. The next appointment is a follow-up appointment about 2-4 weeks later where we check to see how the appliance is functioning and look for changes in your symptoms of OSA. Once we are confident that your OSA is being managed, we refer you back to your sleep medicine physician for confirmation.
Q. How do I get started?
Getting started is easy! Contact us to set up a consultation to see if oral appliance therapy is right for you.
Dr. Liberty Boucher is proud to maintain memberships & foster affiliations with a variety of professional organizations not only in dentistry and oral health, but also with a commitment to the treatment of sleep apnea.
In addition to the above, Dr. Boucher is a member of the Wisconsin Sleep Society, the Chicago Dental Society, and the local Spear Education Study Club.
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