Treating Sleep Apnea without CPAP

by Roberta Bolduc

Obstructive sleep apnea syndrome (OSA) is a life-threatening disorder affecting over 18 million Americans. 40 percent of Americans (2 out of 5) snore and 40 percent of snorers have OSA with no signs or symptoms of the disease.

An oral appliance, similar in appearance to a dental retainer, called a mandibular advancement device (MAD) is now available at Palmer Distinctive Dentistry as an alternative to the traditional CPAP machine. Dr. John J. Palmer, owner of Palmer Distinctive Dentistry, is well known in the Upstate as a provider of biological dentistry.

CPAP, which stands for “continuous positive airway pressure”, was developed in the 1980s and was the first viable solution for OSA. It is an effective therapy when it is used; however, some individuals have difficulty in adjusting to the CPAP therapy which consists of a pump that delivers positive air pressure to a mask that is fitted over the nose and/or mouth. The air pressure is adjusted until the airway is forced open, much like blowing up a balloon. Many people wearing a mask complain about the discomfort of having air pushed down their throats.

Other complaints include interrupted sleep experienced when wearing the device, the inability to get the mask to fit properly, pressure on the upper lip causing tooth-related problems, and restricted movement during sleep, just to name a few.

It is interesting to note that humans are the only mammals to have this problem. Researchers have speculated that our faces have become more flat in relation to other mammals and primates in order to develop the necessary facial structure for speech. Although sleep-disordered breathing and OSA have been recognized for many years by the medical establishment, until recently proper diagnosis and treatment has been limited.

Mandibular advancement devices open the airway by moving the mandible (lower jaw) forward. The tongue is attached to the lower jaw behind the chin. As the jaw is moved forward, the collapsible part of the airway is held open by the forward movement of the tongue and other airway muscles. MADs also improve the strength and rigidity of the airway by increasing the muscle activity of the tongue and other muscles of the airway.

Celia Bridges, office manager at Palmer Distinctive Dentistry, notes that an MAD may not be appropriate for severe cases of OSA. For low- or mid-risk OSA, the device can be a positive solution, particularly for individuals who find adjusting to CPAP therapy a challenge. She adds that the device is custom fitted to the patient and can be easily adjusted if needed.

Before being fitted for the device, a sleep evaluation is performed. The resulting paperwork is shared with a medical doctor that is well versed in OSA. A webinar between the doctor and the patient is then scheduled. A decision to recommend the device is made by the doctor, based on the sleep evaluation and the conversation with the patient.

Palmer Distinctive Dentistry is located at 134 Milestone Way, Greenville. For more information, visit or call 844-326-4420.