Choosing Apnea Mouth Guard

[newtothis1]

Hi. I saw 2 Sleep Apnea dentists for mouth guards and one of them recommended Panthera Classic mouthguard and the other recommended SomnoMed Avant Mouthguard. Anyone has any feedback or comments on which appliance is better? Or can you recommend another mouthguard for sleep apnea?

By the way I recently purchased a mouth guard from Amazon and my biggest problem that did not allow me to fall asleep is very excessive salivation. Any recommendation how to avoid this? I am afraid to purchase a several thousand dollar mouthguard to not be able to use it due to salivation discomfort...

Also is this a bit strange that every dentist seems to only recommend a single mouth guard?

[Deborah K.]

Have you gone to a regular doctor and had a sleep study done?  That's the best way to deal with apnea.  Dentists are going to suggest mouthguards to make money.  Most folks don't benefit from a mouthguard.  CPAP is the gold standard for treating apnea and is usually cheaper than dental mouthguards.

[FrankFuss]

I had difficulty getting use to CPAP at first.  A custom made mouth guard cut my AHI in half, down to under 10.  I made a descsion to try CPAP again.  Now with CPAP my AHI is consistently under 1.

[newtothis1]

The problem with CPAP is that when I sleep on my right side my right nose is congested and when I sleep on my left side my left nose is congested. So this tossing and turning makes it more difficult to get used to the CPAP. I think CPAP is not intended for people that toss and turn due to stuffy nose.

By the way. Do you know why some apnea dentists charge much less than others. Are the ones that charge more really better?

[Sleeprider]

The effectiveness of dental appliances in sleep disordered breathing is really poor, with 50% or less efficacy, high costs, and often result in TMJ pain. A MAD or other appliance will do nothing to resolve your nasal blockage. You are visiting the wrong specialist, and need to see an ENT (ear nose throat). Using a nasal pillows mask in conjunction with an anti-inflammatory nasal treatment like Flonase may net better results.

[WakeUpTime]

Exactly all what SleepRider mentioned above.  I wish it weren't so, but that's the credible truth at this time.

Having said that, they just recently announced the first dental appliance approved for severe sleep apnea (I think).  I'm sure it comes with many footnotes about the category of people that it's supposed to treat.  Although an expert dentist is the way to go, there are a lot of costs that go along with it, with results that are not guaranteed, with limits on their effectiveness, and an early ceiling in terms of the need for more effective therapy.  Those dental appliances need to be adjusted ($$$) and periodically replaced ($$$$) - and they still don't have the effectiveness of CPAP.  CPAP is such a mature market now and there are so many treatment options and combinations.  

Although you're asking in a place that's filled with such a substantial amount of expertise and experience, this is not the place where you're going to find much of any commentary on dental appliances or mouth guards - and that's not because of any kind of restriction.  Most issues with CPAP can be resolved through persistence and the supportive advice of this extremely valuable board of contributors.

I hope that you're not thinking that I like CPAP.  I hate it.  But there are some things I like a lot more, like a functioning brain, a healthier body ecosystem, the ability to effectively accomplish tasks each day, a longer life expectancy, a nicer personality, etc.  Going off CPAP to any other solution would severely degrade all of those things.  CPAP just needs a lot of tweaking in the early days.  I know people that haven't had their settings changed in 5, 10 or 15 years.  They don't see their routines as complex or a burden after a while.  They're so grateful for CPAP's effectiveness.

There was a documentary on TV the other day about workers on a mega project from years ago.  They had to go into a pressure chamber afterwards for a couple hours because of its depth and the pressure change.  A few chose other solutions or just skipped it.  Those people weren't able to work the next day, or any more days. Choose any therapy that leads to 100% effectiveness.

[FrankFuss]

The problem with CPAP is that when I sleep on my right side my right nose is congested and when I sleep on my left side my left nose is congested. So this tossing and turning makes it more difficult to get used to the CPAP. I think CPAP is not intended for people that toss and turn due to stuffy nose.

I had a similar problem, but now I use both Azelastine and Nasacort Nasal Sprays.  Occasionally on really bad days I will use Sudafed or Afrin, but not often.  Use a nasal type mask to make it easy to sleep on your side.  I use a ResMed AirFit N30 mask.  I also had difficulty getting use to CPAP.  To make it easier, use the CPAP during the day, like when watching TV.  Good Luck.

[G. Szabo]

Many years ago, when I presented my symptoms to my family physician, he arranged an appointment with a Sleep Apnea dentist. I knew nothing about CPAP at that time.

When I showed up in his office, in the first step, his secretary presented a declaration that I would cover the cost of the entire procedure. I signed it, hoping to see the doctor who would decide my suitability for the procedure. Instead, his nurse delivered a 15-minute introductory talk about the dental insert and showed a mockup. Then she declared that I would need a second appointment with the doctor, but I needed to pay $120 for her "training". 

I never went back.

These dentists are only for a money grab.

[BoxcarPete]

Been there, done that, got the T-Shirt. If you want to skip experiencing the same three years of struggling that I did, take Sleeprider's advice and use a CPAP with nasal pillows mask and/or get your airway evaluated by an ENT. Single nostril congestion isn't uncommon and it will swap itself around depending on your position. Usually a theraputic pressure from CPAP is enough to keep it open, and if it isn't then you have a problem an ENT can help you solve.

[stevew168]

A properly made dental guard is very helpful reducing obstructive apnea. Dentists can make the best ones. Just make sure to tell your dentist you have obstructive sleep apnea.