My patients often ask me,
“When should I get a new sleep apnea device or oral sleep appliance?” This is a great question, and I am glad to answer it!
In answering their question, I often relate it to a pair of glasses – strange, right?
Well, not really. Each person who wears glasses has a varying degree of dependence on them. Some wear them for close reading, while others need them for distance and then others are nearly blind if they do not wear their glasses.
This scenario holds true for my sleep dentistry patients too!
Some of my patients experience relief of just one symptom like snoring, while others might have a lot of symptoms that the apnea oral device controls.
The amount of symptoms an untreated apnea patient may experience is often independent of the severity of the diagnosis. In other words, some mild apnea patients may experience a lot of symptoms, while a person with severe apnea may experience very little symptoms when left untreated.
For those who have experienced many apnea related symptoms, an oral appliance can help reduce mental fogginess and increase daily productivity. Without their oral device, my patients feel exhausted and often find themselves in a mental fog throughout the day due to a lack of oxygen and interrupted sleep patterns during their sleep.
And for these patients, they’re miserable when they go just one night without using their oral sleep appliance. They can’t fathom going a few nights, much less several weeks without their device.
For severe apnea patients who use oral devices successfully, the danger of going without treatment lies far more than dealing with snoring issues. Dangerous levels of breathing ‘blockages’ may occur.
Almost all sleep dental devices will break somewhere along the way after an extended amount of use.
Many forces are put on these devices influencing longevity. Device warranties often can range 1-3 years. And even though the manufacturer would cover the repairs, many patients will still need to go without their oral appliance device for a period of time.
Factors that influence sleep apnea oral devices to break:
- Heavy, persistent tooth grinding
- Incorrect ‘adjustments’ (advancements)
- May lead to unevenly loaded forces on to the device.
- Inadequate daily care routine of the device
- Shape of the dental arches
- Narrow arched mouths can contribute to more weaknesses in particular areas of the device.
- Materials and design of the device
- How many teeth support the device
These are just some of the factors that will influence how long your oral device lasts. Some of my patient’s mouthguards will last as little as 2 years, while others may last 7 years.
The issue is not “if” your dental appliance will break, it’s more about “when” will your appliance break! This will be determined by the wear and tear that your oral mouthguard experiences.
Other common reasons for leaving a patient without the use of their device include:
- Pets chewing or destroying the device
- Loss of the device especially during travel
- Patients with multiple homes often leave the device behind mistakenly.
- Dropping the device onto a hard surface
So, what’s the solution to my patient’s dilemmas?
Need a Plan B and maybe a C
Just like when the optometrist recommends keeping your old eyeglasses, I too suggest keeping your previous mandibular advancement device on hand just in case disaster would strike. If you don’t have a backup, read on to find out what you can do to get a spare.
Your CPAP machine could be Plan C in a worst-case scenario. I know you aren’t fond of this route, but if your machine is in working order and you can tolerate it, it might be your saving grace while your oral sleep appliance goes to the repair ‘shop.’
Better safe than sorry!
Most medical insurances cover a new oral sleep device within a 2-5 year range, with the majority closer to the 3-5 year mark. Upon occasion, a new sleep apnea mouthguard may be approved sooner.
It’s all in the follow-up!
For your insurance to cover your oral appliance reboot, it’s essential to go to your sleep apnea dentist for regular checkups, even if everything is going well and you are getting great results with your oral device.
Your sleep dentist can evaluate your custom mouthguard to determine if there are any weak areas or spots where they feel a break may occur. In many circumstances, a device with a small crack starting can be sent to the lab for a repair. And if the timing is right to consider a new device, the patient can start the necessary insurance approval process.
The sooner, the better!
Oral appliances will break somewhere along the way, and it’s unfortunate when it is at an inopportune time, such as before a vacation or before a work meeting where my patients need to be at the top of their game.
I can’t stress enough how important it is for a patient to take the time to come in for a yearly visit to make sure their oral appliance is functioning at its best!
My recommendations for apnea dental device use: I like to get patients fitted with a new device before their other appliance completely breaks.
Then they wear their newer device regularly and use their older one as a backup one weekend a month to make sure that they both fit well.
By having a backup, this gives my clients more leeway and reduces their stress level with thoughts of going without their oral appliance.
Once disaster strikes, then you are working against the clock – trying to get seen, get it fixed, and get insurance to approve a new one to be made. This process is often longer than shorter.
Bottom line … see your sleep dentist regularly! It could save you a lot of heartache down the road and even save you money!
Case in point!
I had a patient who recently broke his device and is awaiting a repair. He commented that he hoped “he didn’t die without his oral appliance.”
In his case the device was found to not only work on reversing his symptoms, but through follow-up sleep testing it was proven to control his apnea events. Luckily, he survived the couple weeks that it took for his device to be repaired. At that time, long term success points were discussed, including the importance of having back-up therapy.
I like to make it very clear for my patients who have received profound positive relief from their symptoms due to using an oral appliance device how important it is to have a backup oral device or a CPAP device to be used in case of emergency.
Your oral sleep device appliance will break at some time in the future! We want to put time on our side and here’s how we can do that:
- Don’t wait until it breaks – act proactively
- Have a back-up appliance to wear if needed
- Wear your back-up device one weekend a month
- If you own a CPAP keep it in good working order and have it available as a back-up treatment if needed
- Clean and care for your oral device properly
- See your sleep dentist annually or sooner if a weak area is detected in your mouthguard
When you take care of your oral appliance and make regular visits to your sleep dentist, you can discuss the necessary steps in having an alternative treatment plan available if your current custom-made oral device breaks.
Need more help? Want to learn more?
Let me help you learn more about how your custom made dental device can help you have better control over your snoring, sleep apnea, daytime tiredness and improve your overall health.
Take a quick look at my sleep guide to learn more!