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How Can We Help You?
How Can We Help You?
T. (503) 729-6662
Dr. Tom Walker
Dr. Tom Walker
Oregon Dental Sleep Medicine Associates
T. (503) 729-6662
How Can We
Help You?
Besides Lifestyle changes, such as improving sleep hygiene, exercise and weight loss, there are three main ways to treat snoring and Obstructive Sleep Apnea (OSA): CPAP, Oral Appliance Therapy (OAT) and Surgery.
We always encourage our patients to make Lifestyle changes if appropriate. Exercising on a regular basis and losing weight if needed are two examples; weight loss of just 10% can dramatically improve your ability to breathe. On the other hand these are two areas that are very easy to talk about and unfortunately often unsuccessful. Sleep hygiene is always an area that we spend time discussing as not everyone just falls and stays asleep for the night. Many times there are simple remedies that can be implemented to improve your night’s sleep.
Oral Appliance Therapy is indicated for patients with primary snoring or mild to moderate OSA who do not respond to, or are not appropriate candidates for treatment involving lifestyle changes. Patients with severe OSA should have an initial trial of CPAP, due to greater effectiveness than with an oral appliance. But patients with intolerance to CPAP or refuse treatment with CPAP no matter what the severity level should use OAT (Oral Appliance Therapy). Oral appliances are also indicated for patients who are not candidates for tonsillectomy, adenoidectomy, craniofacial operations or tracheotomy.
Oral appliances treat Snoring and OSA. They are small devices that are worn in the mouth, similar to an orthodontic retainer or sports mouth guards. They help prevent the collapse of the tongue and soft tissues in the back of the throat, keeping the airway open during sleep which provides adequate air intake. Currently there are over 100 different oral appliances. These appliances may be used alone or in conjunction with other means of treating OSA, which includes “life-style” changes, CPAP or surgery.
Most appliances fall into one of two categories; the variety is simply a variation of a few major themes. They can be classified by their mode of action or design variation:
•Tongue Retaining Device (TRD) or Tongue Stabilizing Device (TSD)
These function by holding the tongue in a forward position using a suction bulb. When the tongue is kept forward the back of the throat is kept clear of obstructions during sleep.
•Mandibular Repositioning Appliances (MRD)
These function to reposition the lower jaw forward during sleep, which brings the tongue forward. This also stimulates activity of the muscles in the tongue and other structures making them more rigid over time. It also holds the lower jaw and other structures in a stable position; depending on the type of appliance you can either open the mouth or not while wearing. They are generally more comfortable to wear long term than either a TRD or TSD.
Oral appliance Therapy involves proper diagnosis, selection, fitting, testing during sleep, consultation with your physician and maintenance. Dr. Walker has been trained in oral appliance therapy and is familiar with the various designs of appliances. He can help you determine which one is best suited for your specific needs. He will work with your physician as part of the medical team in your diagnosis, treatment and on-going care. Determination of effective treatment can only be made by joint consultation; Dr. Walker and your physician. The initial evaluation phase of oral appliance therapy can take from several weeks to several months to complete. This includes examination, evaluation to determine the most appropriate oral appliance, fitting, testing the appliance with a “home” (ambulatory) sleep study maximizing adaptation of the appliance and function.
Dr. Walker will focus on working with you and your oral appliance to achieve comfort, function and safety. Compliance depends on all of these things … the bottom line is Dr. Walker wants to see your health improve. He can help you by:
•Taking the time to listen to your concerns and what you want.
•Taking the time to gather your medical / dental information from you and your physician, putting it together to derive an appropriate plan of action.
•Spending the additional time with you to achieve appliance comfort … teeth, joint and soft tissues of your mouth. It all starts with appliance selection and Dr. Walker has used many of the appliances he has to offer with personal experience in the treatment of his own OSA.
•You may report feeling “much better”, “rested”, “no-snoring”, “more alert” and so on but the true measure of success is by the numbers. We provide a medical “device” to take home and actually test you to prove that treatment is successful. Often this test is repeated until the appliance is performing correctly for you.
•Your airway is the “king” when managing OSA, but making sure there is room for the “queen” (your tongue) is also extremely important.
•The national average of compliance with oral appliance therapy is 77%. Our average is over 90%! Our goal is 100%.
•Your initial therapy may take 5 – 6 months and once completed Dr. Walker remains available to you for support and service.
•Dr. Walker’s follow-up protocol follows the American Academy of Dental Sleep Medicines guidelines. He will want to see you 6 months after initial therapy and then yearly to ensure the appliance is functioning properly and in good repair.
• The goal is better health. If that means the best treatment for you is sticking with CPAP or combination treatment (CPAP & Oral Appliance Therapy) Dr. Walker will so advise.
•We work with and bill most insurance plans and we will make every effort to insure that you receive the most benefit possible from your insurance carrier. Did you know that Kaiser Plans do offer Oral Appliance Therapy as part of their Medical benefit? If you have Kaiser Medical Insurance and OSA, you should contact them.
This briefly describes what we do at Oregon Dental Sleep Medicine Associates (ODSMA). We are here to help you get a good night’s sleep which will in-turn improve your health.
HOW CAN WE HELP YOU?
