Dr. Jacques Doueck says that many patients are curious about the difference between the made-to-order dental appliances that he produces and the generic dental appliances sold over the counter or through television ads and on the Internet. He explains in this report.
The two kinds of appliances are similar, says Dr. Doueck, in that the objective of all these appliances is to move the lower jaw forward and open up the airway to permit proper breathing during sleep. “So in that respect, they’re very, very similar.”
However, there are some big—and important—differences. The most important point is that the size and the fit of a custom-made appliance are perfect. As Dr. Doueck points out, an appliance he produces is made to fit exactly over a patient’s teeth. Any appliance sold online or on television won’t have that kind of perfect fit. These appliances are made for the “average size mouth.” The appliances try to adapt to someone’s teeth after being put in boiling water so as to be moldable. “Unfortunately, it’s a big bulky and a bit uncomfortable.”
Another important difference has to do with the treatment of sleep apnea. If a patient who snores has had a sleep study and is found not to have sleep apnea, a generic appliance might be effective in dealing with the snoring problem. The trouble is that an appliance like that may not treat sleep apnea. So someone who suffers from sleep apnea may stop snoring with the generic appliance but get no useful treatment for the sleep apnea problem.
Dr. Doueck points out that the appliances his office produces are precisely calibrated to get the exact amount of forward jaw movement needed to open a patient’s airway during sleep. “At the end of everything, we send you for a sleep study with the appliance so we verify that the appliance is doing what it’s supposed to do.” Dr. Doueck emphasizes that it is important to be certain that an appliance is actually stopping the sleep apnea and not just the snoring. His office is able to help 80% of the patients who seek help for sleep apnea.
What this means, obviously, is that 20% of patients with sleep apnea need combination therapy. That combination, Dr. Doueck explains, can be wearing a custom-made appliance along with wearing a pajama pillow that prevents patients from sleeping on their backs. Sleep study reports often recite that a patient with sleep apnea has much more pronounced problems while sleeping on the back than when sleeping on a side.
Another combination therapy option is to have a patient wear a custom-made appliance along with a CPAP-type device, only without as much pressure as a traditional CPAP device uses. This device does not use the straps and headgear found in a normal CPAP device. This arrangement provides much more comfort for a patient than is found with the usual CPAP devices.
Dr. Jacques Doueck, DDS, practices with Doueck Dental Sleep Medicine, Brooklyn, New York. Dr. Doueck is a diplomate, American Academy of Sleep Medicine. He holds membership in the Academy of Dental Sleep Medicine and the Academy of Minimally Invasive Biomimetic Dentistry. He hosts a 45 minute weekly radio show on various health topics. He is a clinical consultant for the Dental Advisor, a monthly journal that reviews current dental materials and techniques. Dr. Doueck writes a monthly article on state-of-the-art dentistry for “Image” and “Community” magazines. The Legal Broadcast Network is a featured network of the Sequence Media Group.