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Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus
Online ISSN 1827-1723
AN UPDATE ON OBSTRUCTIVE SLEEP APNEA SYNDROME
Fleetham J. A.
The Lung Centre, Vancouver, BC, Canada
Oral appliances (OA) are commonly used for the treatment of snoring and obstructive sleep apnea-hypopnea (OSAH). OA increase the size of the upper airway by either advancing the mandible or the tongue. Mandibular advancement OA are the most widely used type of OA. These require at least 8 teeth in each of the maxillary and mandibular arches and the degree of mandibular advancement can adjusted. There is increasing evidence that OA improve sleepiness, blood pressure and indices of sleep disordered breathing. However, continuous positive airway pressure (CPAP) has been shown to be more effective than OA in improving sleepiness, health status and indices of sleep disordered breathing and remains the primary treatment for OSAH. Current guidelines recommend OA for selected patients with mild-moderate OSAH . Furthermore, OA are the best alternative treatment for patients with OSAH who are unwilling or unable to comply with CPAP therapy. OA therapy may also be indicated as an adjuvant to CPAP when the patient is away from home or electrical power. OA therapy should be supervised by both medical and dental specialists with a major interest in the management of sleep disordered breathing. Patients should not have major periodontal disease and all dental restorations should be complete prior to OA therapy. Follow-up sleep monitoring is needed to verify the efficacy of OA therapy. Patients treated with OA require long-term dental follow-up