Our Dentist, Lyall, has recently undergone further training and is now able to provide treatment for snoring and mild to moderate Obstructive Sleep Apnoea.
What We Offer
At Belhaven, we offer a free consultation to see if you are suitable for our anti- snoring treatment. This consultation includes a screening to see if you are at risk of Obstructive Sleep Apnoea (OSA). We will also check that your mouth and teeth are healthy prior to any treatment.
If you are suitable for treatment, we will make your custom mandibular advancement device by taking some impressions and measurements of your jaw.
We will fit the appliance and give you instructions on how to take care of it.
In addition, we will review your treatment and the appliance every 6 months for 2 years. Regular reviews are required to assess the success of the appliance and to ensure that the appliance is in good order and that there are no negative effects on the teeth, gums, bite and jaw joint. A new snoring/sleep apnoea history will be retaken. The attendance for reviews is a vital part of the process and patients are reminded that if they do not attend for reviews they increase the risk of problems.
The average lifespan of an intra-oral mandibular advancement device is 2 years. The full treatment cost is £350.
Background to Snoring
During sleep the throat narrows due to a reduction in muscle tone. Snoring is the vibratory noise produced as air passes through the narrower airway. Further narrowing of the airway produces a louder snoring noise but it also causes breathing to become more difficult. Extreme narrowing can cause complete airflow obstruction; this is known as obstructive sleep apnoea.
Eventually, the increased breathing effort is sensed by the brain and your brain wakes you up. If this happens a few times a night, it is usually not an issue. However, in some people, this can happen several times (sometimes hundreds) in one night. This result is severely disturbed sleep which results in excessive daytime tiredness.
Snoring and sleep apnoea are a spectrum of disorders ranging from “simple” or “benign” snoring with no sleep disturbance to severe obstructive sleep apnoea with severe daytime sleepiness and possible physiological side effects of recurrent periods with insufficient oxygen.
Is Treatment Necessary?
Benign snoring is more of a social problem rather than a medical issue. Even though it is described as benign it can cause distressing social consequences such as banishment from the bedroom, marital problems, fear of travelling and sharing hotel rooms and sheer embarrassment. Therefore, we feel treatment of snoring may not be essential but is appropriate.
Obstructive Sleep Apnoea (OSA) is a medical condition that needs treated. Obstructive sleep apnoea, resulting in serious sleep disruption, can produce greatly impaired performance at work, at home, and on the road. The response to appropriate therapy can be extraordinarily dramatic with commonly, a return to a state of alertness and vitality often not previously experienced for years or even decades. OSA needs diagnosed by a medical practitioner after appropriate investigations such as a sleep study.
We will carry out a screening test for all patient’s who attend for a snoring device and if we suspect you could suffer from OSA we advise referral to your General Medical Practitioner.
Please note DVLA guidelines on those who have or are being investigated for obstructive sleep apnoea. (https://www.gov.uk/obstructive-sleep-apnoea-and-driving)
The following are risk factors for snoring and sleep apnoea. Simple lifestyle changes can improve your condition. We will provide advice on lifestyle changes at your assessment appointment.
- Nasal Stuffiness
- Late evening alcohol
- Use of night-time sedatives
- Large tonsils
- Sleeping on your back
At Belhaven, we offer treatment of benign snoring through lifestyle advice and the provision of Mandibular Advancement Devices (MAD).
If you have been diagnosed with Obstructive Sleep Apnoea by a Doctor, they may recommend having a mandibular advancement device made. A referral from your medical practitioner would be necessary.
Any patient with uncontrolled epilepsy is not suitable for treatment with an intra-oral appliance.
There has been good evidence to show that intra-oral mandibular advancement devices can reduce snoring at night. The appliance works by altering the position of the lower jaw such that the tongue is lifted forward and this increases the area available for airflow, thus reducing snoring by improving muscle tone.
MADs consist of close fitting, custom made ‘rims’ that fit around the upper and lower teeth. These rims are connected in various ways to allow the lower jaw to be postured and held in a forward position. Many of these appliances will allow some horizontal and vertical lower jaw movement
You must be able to maintain a good standard of oral hygiene – that is being able to keep your teeth spotlessly clean. When teeth are not kept clean when an anti-snoring appliance is worn overnight an increased risk of tooth decay and gum disease is seen.
Side effects of treatment may include excess salivation (sometimes a dry mouth), jaw joint ache and tooth sensitivity. These are short-term side effects and usually disappear once you become accustomed to the appliance. Evidence of long-term side effects include minor tooth movements and bite changes. These side effects must be balanced against the benefits of treatment. Most patients do not find these side effects sufficiently intrusive to discontinue treatment. Some time may be required for the device to work and it is important that you are aware of this, in some instances no improvement will be achieved – it is impossible to predict in whom this will occur and so it is vital that you are prepared to accept this risk before embarking on treatment.
It is important to note that other options are available for the management of snoring and sleep apnoea; these include:
- no treatment
- ‘boil and bite’ devices which are often available commercially. It is important to note that there is no evidence base for the effectiveness of these devices in the management of snoring and sleep apnoea.
- CPAP treatment
- Surgical options – via an Ear Nose and Throat Surgeon