New Device - SomnoDent

By DebK Latest Activity June 30, 2010 at 11:50 am Views 17,357 Replies 15 Likes 1

DebK

I visited my dentist yesterday to ask about the SomnoDent OSA appliance. My CPAP mask and all that goes with it is on my last raw nerve. This appliance goes in the mouth and holds the jaw forward. I've been to the website and read a bit more about it, but was wondering if anyone has one or has heard the pros and cons of using a SomnoDent? I understand the cost can be prohibitive (~$3K) but if it works and I can eliminate the mask, leaking, rain-out, machine noise and maintenance, then it just may be worth it. Any feedback would be appreciated! Thanks.

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Replies (15 replies)

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  • Flash-Gordon
    Flash-Gordon April 22, 2013 at 5:57 pm   

    Thank-you to SleepDentist, and all below, for sharing their experiences. I am just beginning to investigate the SomnoDent appliance. I have upcoming appointments with two dentists who support it. I will evaluate, to see who has the most experience with sleep disorder management, and the device in particular. It is sooo helpful to have people, who actually use it, share their I sights and recommendations. Your thoughts will be grist for mill in my decision making. Thanks again!

  • SleepDentist
    SleepDentist April 30, 2011 at 11:28 pm   

    Hello Deb K. I admit to being a bit biased here, but I need to clear up some misconceptions I read from Avera.

    1. Many dentists like myself do not charge for follow up visits.

    2. Yes, dentists should tell you that these appliances have a life span. The SomnoDent has the longest warranty on the market (3 years). The SUAD has the second longest (2 years), and the industry standard is 1 year. However, on AVERAGE, we are seeing these last about 5 years, depending on level of bruxism, care by the patient, and any reinforcements that are requested by your dentist when prescribing.

    3. Yes, your dentist should be working with a sleep physician. The American Academy for Dental Sleep Medicine suggests monitoring efficacy of the appliance through home testing during treatment (we have about 10 home monitors, for example), then after maximum clinical effectiveness is achieved, sending the patient back to the sleep physician for a follow up polysomnogram. I'm afraid Avera is painting all dentists with the same broad brush.

    4. Yes, bite changes can occur, and your dentist should always advise you of this possibility prior to ever making one for you. This is not the norm, but can happen. You should be given exercises to help prevent this.

    5. The jury is NOT still out on how effective they are. There are numerous studies on effectiveness that I would be glad to provide - you can also visit the Somnomed site already mentioned, as they have research articles on the site.

    6. If patients are not making it past 6 months due to TMJ problems, the dentist is not monitoring the patient correctly. This can happen if protocols are not properly used.

    7. We know how effective they are by periodically using portable (home) sleep studies, and at least on our office, we do not even charge for these studies.

    8. Lastly, obesity is discussed due to studies that show oral appliance therapy being LESS effective with increasing obesity. However, if someone is not using CPAP, it's the next best thing, so at least an appliance is SOME treatment. We recently treated a female with a BMI of 52, and we have dropped her AHI from 91 to 9. She has also been losing weight with her increased energy.

    One of my Somnodent patients told me about this site, so I got on and realized there was some incorrect information being broadcast, so I felt I needed to respond. I may not check the site often, but if you have specific appliance questions, I can be reached by emailing me at info@SleepDallas.comEmail Small

  • topazhorse
    topazhorse February 8, 2011 at 7:59 am   

    I use a Somnodent after struggling for two years with a CPAP and love it. My snoring stopped completely the first night. My doctor is a dentist whose specialty is the Somnodent device and quite different than just going to my regular dentist. She works with my sleep doctor and used the sleep studies I had done. Insurance covered 100% less the deductible. I think this device is well designed and more appropriate for some cases than others. I would encourage anyone frustrated or giving up on CPAP to consider consulting with a doctor specializing in the Somnodent device. It has been a life changer for my wife and me.

  • Spaz54
    Spaz54 November 29, 2010 at 3:21 pm   

    Ditto on oral appliances messing up your teeth.

  • capbli
    capbli November 23, 2010 at 10:15 am   

    BEWARE!
    I can't tell you about SomnoDent, but I had a similar device when first diagnosed with OSA in mid-90's. While it seemed to work OK (no snoring complaints from sleeping partner) it totally re-arranged my mouth.
    After 2 years my bite was 1/4" to 3/8" off and I had a hard time chewing food.
    Expensive braces cured the problem, but who wants braces at 60?

    CPAP works.

  • Flash-Gordon
    Flash-Gordon April 22, 2013 at 5:45 pm   

    All oral devices are different now, than almost 20 years ago. I am sure bite-shifting is a possibility with any oral device. But from all my research, this is one of the slimmest devices available, and that may minimize the potential for shifting. I don't know…

  • DebK
    DebK July 5, 2010 at 1:30 pm   

    Avera,

    Thank you for the VERY helpful feedback. There's much to consider and I don't want to make this decision hastily. I am having the awful visual of sleeping with a mask for the rest of my life… argh. I've been to the website, but I'm going again now to read more of what you've sent me. Thanks again! (love this board/newsletter) :)

  • Avera
    Avera July 2, 2010 at 12:29 am   

    Hello DebK,

    The device that you mentioned is a very good one according to many dentists. The best thing to do is to visit the SomnoMed home web site for a review of the most recent information concerning the device. Of course, you realize that they will always tell you mostly the good things concerning the device. Their ultimate goal is to sell it.

    Yes it is expensive AND continues to be expensive long after you purchase it. When you wear one, you are required to make regular dentist visits for adjustments and checkups. These appointments cost you each time you go and no matter how good your dental insurance is, the best plans only pay 50% of followup visits at most.

    An important thing many dentists fail to mention is that the device only lasts from one to three years before it has to be replaced.

    It is important to mention here that your dentist and the dentist that treats your sleep apnea with this device is most likely NOT a Sleep Specialist MD but a dentist. You have Sleep Apnea so you already know the dangers of NOT treating it. It is up to you to decide if you feel comfortable having a dentist treating a dangerous disease. A good question to ask your dentist is if they will work with a Sleep Specialist to make sure the device is working as it should for you. When you go for your dental visits, they do not check to see how well the device is treating your Apnea, but treat you as to how it is affecting you dentally. The dentist determines how well it is working by what YOU tell them unless they work directly with a Sleep Specialist. REMEMBER…if they use a Sleep Specialist, you are required to pay for those appointments as well.

    I am going to cut a paste some information below for you. Here is what the Academy of General Dentistry says about oral devices.

    "Bite changes are the most common drawback, says Dr. Bailey. Transient bite issues exist briefly, typically in the first half hour after the device is removed. Dr. Thornton recommends a special oral exercise for patients to do after removing the appliance, in order to reset the joint. Dr. Perkins has modified the TAP to balance the bite in the back. “Most OSA patients clench their teeth,” he explains. “Balancing the device with two posterior pads alleviates some of that stress.”
    Some patients have no problems at all with appliance therapy. If the appliance is balanced, tooth pain, joint pain, and bite changes should be minimal. “Once you’ve worked several cases, when a patient comes in with a problem, you’ll know what it is immediately,” says Dr. Perkins.
    A bite change is a minor issue, however, compared to the morbidity and mortality of sleep apnea, says Dr. Thornton. Patients must understand the follow-up care necessary to manage sleep apnea successfully with an oral appliance. Be sure that patients understand that if the appliance isn’t working, they need to see their physician and get CPAP instead."

    Here are a few important things to remember:

    **Compliance is a lot higher with the use of an oral device but the jury is still out on how effective they are.

    **There are no stats BUT recent reports via Sleep Apnea chat sites have users saying that many people don't make it past six months with oral appliances due to TMJ and jaw pain problems.

    **You have got to remember oral devices work only if your tounge is the only obstruction. Most people have multiple obstructions.

    **One drawback to oral appliances is that they don't monitor data like CPAPs do, so it's very hard to know how effective they are being.

    One more thing…you CANNOT be obese if you want a SomnoDent® MAS. I have no idea why. They didn't say on the web site that I could find. They do provide a formula for checking your size to detrmine if you are considered obese by their standards. They even give you a chart.

    Hope this helps.

  • cathyswoods
    cathyswoods November 23, 2010 at 9:56 am   

    Avera
    I currently use the Somnimed appliance - I love it. I had TMJ BEFORE the appliance and now do not have any pain in my jaw. As far as the expense, it cost me $1800 and my insurance (not dental) paid for most of it. Sleep Apnea should be covered under a health policy. You may have to point it out to your insurance company. Follow up visits for adjustments are no charge. I am still in the process of adjusting. The adjustments are done very slowly, so you don't notice any difference in the position of your jaw. My snoring has not completely stopped, but have gone to a lite muffle.
    Hope this helps.

  • peterpie
    peterpie February 29, 2012 at 7:59 am   

    hello cathyswoods… i am using the somnolent for my 3rd time tonight but i still find that i am snoring . was this same for you in the beginning?

  • cathyswoods
    cathyswoods February 29, 2012 at 9:01 am   

    Give it time, adjustments should be made in small increments so you don't have to change the positition of your jaw too much. At first I went back for adjustments about every 3 days until it leveled off. I would record myself sleeping to know if I snored. Good Luck

  • peterpie
    peterpie February 29, 2012 at 10:22 am   

    you went back for adjustments? he gave me a little tool and told me i could do it myself if i recorded the changes by writing it down. did it stop your snoring after a few days? thanks for the help, peter

  • cathyswoods
    cathyswoods February 29, 2012 at 10:48 am   

    Peter, I'm at the point that I definitely notice the difference in bite at night with the appliance in. But after takng out in the morning, it goes back to normal. It has been adjusted quite a lot. I am about 40 lbs overweight also, which makes a big difference. I had a doctor tell me that 5 lbs can make a differene in snoring. Be patient and don't get discouraged. I also grind my teeth and there is a piece that can be put on the appliance, which I haven't gone there yet.

  • peterpie
    peterpie March 1, 2012 at 4:33 am   

    cathy, i am so tired of being tired. i really hope this mouth piece works so i can discontinue using the cpap mask. taped my sleep last night and snoring was loud as it always was. i made adjustments myself yesterday. i see your pattern of every 3 days so i will wait a bit longer before making another adjustment. thanks, peter

  • pdot
    pdot March 27, 2012 at 6:57 pm   

    peterpie, I'm new to this site. I've had the Somnident appliance for about 3 years now. I was recommended to have and was fit for a cpap. My Dentist suggested trying this appliance. And I am Glad I did. It took a little time to get used to , but is well worth it. My dentist does all the setting on my appliance. I live in a smaller town and my dentist, like most, is very concerned about the health of her patients. The best thing I like about this appliance is that I can visit my family and do not need to be hauling a cpcp machine & mask with me. My appliance fits in with my shaving gear. Don't be afraid to ask questions if you have any. Thanks, Paul

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