Discovering that your child has sleep apnea can be really unsettling. You probably have a big list of questions, one of which is about treatment options. You wonder if surgery is the only sure treatment or if non-surgical options are available. While it's possible that surgically removing tonsils and adenoids might be recommended, it isn't always the best choice. In some cases children can't have surgery and in others the surgery doesn't eliminate sleep apnea. If you are hesitant to surgically treat your child's sleep apnea, a pediatric dentist or orthodontist could offer an alternative solution.
What Types of Oral Appliances Help with Sleep Apnea?
There are two main types of oral appliances dentists use to treat sleep apnea: the mandibular advancement devices and the tongue retaining mouthpieces. These appliances effectively keep air passageways open and promote breathing, but in 2 different ways. Here's how they work:
- Mandibular Advancement Devices: This device is sometimes referred to as a double retainer because it works in a similar way to retainers. One piece fits over the lower teeth and the other fits over the upper teeth. It repositions the jaw – or mandibular – by pulling it slightly forward. Your child's tongue will naturally lift as the jaw is adjusted for sleep.
- Tongue Retaining Mouthpiece: This mouthpiece fits over the teeth, but it doesn't adjust the jaw position. Instead, a separate part of the appliance holds the tongue forward using a suction. This style of mouthpiece may be better for young children whose jaws are continually growing and changing, because they don't reposition the jaw in any way (which could change the way your child's jaw develops).
What About an Air Mask?
Many adults successfully treat sleep apnea with an air mask worn at night. This mask keeps air passageways open and promotes air circulation. However, it isn't always the best choice for young children. Many children don't tolerate the mask because they:
- Fear It: Something over your child's face could cause them to panic at night. Your child might get more restless and have difficulty falling asleep with the mask on.
- Are Uncomfortable: The mask may make it difficult to maneuver at night, and a lot of children roll in their sleep. If your child rolls from side to side at night, the mask will shift and be both uncomfortable and ineffective.
- Get Dry Mouth: The continuous flow of air into the oral cavity can dry out your child's mouth. This can cause them to wake up in the night or feel more groggy and irritable first thing in the morning.
Which Treatment is Best for Your Child?
Determining which treatment option is best for your child depends on many factors – what your child's doctor and dentist (or orthodontist) recommend, the cause of sleep apnea, and what your child can tolerate. However, oral appliances are a good option because they:
- Are Small: Oral appliances are small enough that your child can travel, attend sleepovers, and camp easily while still treating the condition. The air masks aren't designed for portability. They can also call unwanted attention to your child when with friends.
- Are Comfortable: Most people find oral appliances comfortable to wear and sleep in. They are custom-fit to your child's mouth for comfort and effectiveness. They are also stable enough that they don't shift if your child moves in their sleep.
Oral appliances are a non-surgical alternative to treat sleep apnea. They are a good option to consider for children because they are more comfortable than other non-surgical methods. Before determining a course of action, however, it's best to consult with both a doctor and a dentist about treatment to decide which treatment will be most effective. Depending on the severity of sleep apnea, a combination of treatments may even be recommended.