Most patients experience movements of the teeth, with continued movement over time.By making various measurements of the teeth from these casts, including in the same patients over time, they were able to measure the tooth movements that occur over time. Because they are such a busy center, they had a group of 77 patients with an average length of followup of 11 years. ![]() When their patients wear out their oral appliance and needs a new one, they take impressions of the teeth and have saved them. Alan Lowe, DMD, PhD and Fernanda Almeida, DDS, MSc, PhD at the University of British Columbia in Vancouver, Canada, are some of the world’s true experts in the use of oral appliances to treat snoring and sleep apnea. This study shows that the tooth movements continue far beyond the first 2 years of use. Based on limited studies, it has been felt that most of these occur in the first 2 years and then never worsen. The December 2014 issue of the Journal of Clinical Sleep Medicine included what is now the most thorough study of the long-term risks of tooth movements with oral appliances. Tooth movements occur with oral appliances because the forces applied to the teeth, while not excessive, are applied for long periods of time while patients sleep. The most likely side effects of oral appliances are drooling, temporomandibular disturbances (muscular or related to the joint–also known as the TMJ), tooth pain, and movements of the teeth that can change a person’s bite. Before referring my patients, I discuss the potential risks of oral appliances that are not life-threatening but that can be problematic. In fact, I refer a number of patients to my dental colleagues, whether based on my office examination or drug-induced sleep endoscopy. Studies have shown that they can work well for some patients. Oral appliances are a possible treatment for snoring and obstructive sleep apnea that work by holding the lower jaw in a forward position during sleep. ![]() ![]() Oral appliances for snoring or sleep apnea have risks too A key part of that discussion is having quality knowledge of surgical risks so that a discussion can be based on accurate information. The goal of a surgeon and their team is to minimize those risks and discuss them with patients, who can weigh the benefits and risks of surgery. In fact, my previous blog post cited the research I have done showing that the risk of serious medical complication after sleep apnea surgery is 1.6%, mainly in those with major medical problems before surgery. As a surgeon writing this post, I feel like I have to emphasize that I know that these risks and side effects exist. Surgery for snoring and sleep apnea has potential risks and side effects.
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