Becker Ear, Nose & Throat Center offers many Oral Treatments for snoring and sleep apnea. Our team of Doctors can help you with deciding on the right type of treatments and services. If you have any questions, feel free to contact us. We are always here to assist to help you with your oral treatments for snoring and sleep apnea symptoms.
In some cases of snoring and obstructive sleep apnea, oral appliances may be used for treatment. An oral appliance is an artificial (often plastic or acrylic) device similar in appearance to a mouth-guard. The device is intended to be worn at night during sleep. By moving the lower jaw (mandible) forward, the appliance decreases the likelihood of the oral soft tissues collapsing and obstructing the airway. It is this obstruction that may contribute to snoring and OSA.
For patients with an oral component to their snoring and/or sleep apnea, an oral appliance may be a reasonable treatment option. While patient compliance can be challenging, oral appliances can be very effective for patients who do not mind wearing them. The use of oral appliances can have associated complications, and so should be fitted and worn under the supervision of a trained health care provider. Complications/ adverse events include TMJ (temporomandibular joint) pain, myofascial pain, dental/tooth pain, tongue pain, dry mouth, gum irritation, severe gagging, excessive salivation, occlusal/bite changes, and TM joint sounds.
In cases where the palate contributes to snoring and sleep apnea symptoms, a wide-range of palate treatments are available. Simple, minimally-invasive, office-based treatments include RadioFrequency Ablation (RFA) of the palate, uvula, and/or tongue base. Another minimally-invasive treatment option for many patients with palatal contributions to their symptoms is the Pillar Procedure, discussed in detail on other sections of this site.
Other, more traditional palate treatments for sleep apnea, such as the “Uvulapalatopharyngoplasty” or “UPPP,” are typically associated with uninspiring success rates and significant levels of post-operative pain, as well as lengthy patient recovery times. UPPP is also associated with some significant complications including respiratory complications, pneumonia, cardiovascular complications, hemorrhage, and death. For these reasons, many patients choose less-invasive interventions to manage their snoring and sleep apnea. On occasion, these more invasive procedures may be indicated but typically they are not chosen as a first-line treatment.
Radiofrequency Ablation of the Soft Palate
In the Pillar Procedure, small implants are placed in the soft palate to induce scarring and create a more rigid, less floppy soft palate [FIGURE 1]. This increased rigidity counters the floppiness that often contributes to snoring and obstructive sleep apnea. The Pillar Procedure is well-tolerated, and is performed under local anesthesia.
The procedure takes around 20 minutes to perform in the clinic setting with most patients. Several studies have shown a significant decrease in patient snoring intensity with associated decreases in daytime sleepiness and significant improvements in lifestyle after patients underwent the Pillar Procedure. Other studies have demonstrated patient and bed partner satisfaction with the reduction in snoring after the procedure at 80% or higher. Studies of patients with OSA demonstrate approximately 80% of patients with a reduction in their AHI (sleep index), and results were sustained at one year after palatal implants. Another study has documented significant improvement in snoring and sleep apnea with insertion of palatal implants in patients who had failed surgical intervention with prior uvulapalatopharyngoplasty.
Tongue Base Reduction
In some patients, an enlarged tongue base which relaxes during sleep may fall back in the oral airway (“hypopharynx”) and contribute to obstruction, turbulence and, ultimately, snoring and sleep apnea which could make a Tongue Base Reduction necessary. Surgeries to treat tongue base enlargement area include a Midline glossectomy and, more recently, Radiofrequency ablation (RFA) of the tongue base. Midline glossectomy is less commonly performed given the significant post-operative complications of bleeding, difficulty swallowing, and dangerous airway swelling. RFA of the tongue base can be a reasonably effective option in appropriate snoring and sleep apnea patients. It is best to have your physician evaluate your anatomy to decide if this could be an effective treatment for you.
Radiofrequency Ablation of the Base of Tongue
In some patients, the tonsils – located in the back of your throat – may “hypertrophy” or enlarge and lead to blockage and obstruction of the oral airway, making a Tonsil Treatment necessary.
The consequent blockage and turbulent airflow may contribute to snoring and/or sleep apnea. More common in children, tonsillar hypertrophy may also be present in adults. If found to be a significant source of obstruction, removal of the tonsils via tonsillectomy may be indicated. Techniques to remove the tonsils vary widely. The past decade has seen the rise of “sub-capsular,” and partial tonsillectomies as less invasive treatments for patients with tonsillar hypertrophy. These newer procedures seem to be associated with decreased post-operative pain; however, there appears to be insufficient data at this time to support their efficacy.
Tonsil treatment procedures are typically associated with significant post-operative pain, particularly in adult patients. Some have described the “worse sore throat of my life.” Complications vary and include bleeding and hemorrhage (most common complication occurs in 2-3% of patients), change in voice, dehydration, mouth and lip burns, and – on rare occasion – death. In some cases, the problem (snoring, sleep apnea) may persist after tonsil treatment.
The uvula – the “punching bag” in the back of your throat – is comprised of a series of intertwined muscles with a mucosal lining.
On occasion, an enlarged uvula may contribute to snoring and /or OSA. In these instances the uvula may be surgically resected or removed. Usually, the uvula alone is not a significant enough source of snoring/obstruction that removal of just the uvula will solve the patients’ problem. It is for this reason that uvula treatment is usually performed as an adjunct to other procedures (e.g., Pillar Procedure, tonsillectomy, etc).
Patients have noted significant pain after this procedure.