Using a Mouthguard to Treat Sleep Apnea (Podcast)

John Maher: Hi, I am John Maher, and I’m here today with Dr. Nammy Patel, founder of Green Dentistry in San Francisco, California, helping patients recognize the vital connection between dental health and whole-body health and author of the bestselling books, Age with Style: Guide to a Youthful Smile and Healthy Living, and Total Wellness: Understanding the Link Between your Teeth and your Health. Today, our topic is using a mouth guard to treat sleep apnea. Welcome, Dr. Nammy.

Dr. Nammy Patel: Hi, John. Thank you for having me.

Can a Mouthguard Replace a CPAP Machine?

John: Sure. Dr. Nammy, a lot of people struggle with CPAP machines, which are often prescribed for sleep apnea problems. How can a mouth guard maybe be a viable alternative to treating sleep apnea?

Dr. Nammy: So, a mouth guard is going to be a static appliance, and what it does, it creates some space in between the teeth so it creates more space for the tongue. So that’s a basic place to start. Now, there’s different appliances that are out there as far as mouth guards. There’s appliance that move the jaw forward, kind of like the MAD appliances. There’s appliances that make space in between the tongue a little bit more, and there’s, they call the Oasis.

There’s a lot of different appliances that are out there, and they’re a good start. The problem with those things is that they don’t really encourage nose breathing. We really want to have nose breathing. So the reasons why I recommend products like Homeoblock or the Vivos is because we actually increase the 3D nasal volume. We want to have everyone breathing through their nose. When we’re breathing through the nose, we’re actually healing ourselves and preventing disease and dysfunction, and that is my main reason for always recommending the Vivos and the Homeoblock.

Well, what it actually does is it activates your bone making cells to make your bone. Now, if you have an appliance like the MAD appliance or the Oasis, what it’s going to do, it’s going to be like a mouth guard, it’s going to stay in your mouth, and it’s going to be static. Now, it doesn’t do anything for you. It’ll stop you from being apnea, which means that you’ll breathe through the night. Now, the only problem is you’re just going to be mouth breathing all day long or all night long, excuse me.

When you’re mouth breathing all night long, what happens is that the mouth becomes super dry. When it becomes really dry, it makes certain bacteria grow that cause heart attack, diabetes, cancer, and it kind of defeats the purpose. So that’s the only reason. Yes, it’s cost-effective, but it’s not the best product for you, mainly because we always want you nose breathing, and anytime there’s an appliance in between the teeth, it’s hard to keep your mouth closed. And so that’s my challenge with the Oasis and the MAD appliances and night guards is that they don’t really allow the nose breathing to actually occur.

How Do Mouth Guards Work?

John: How do the mouth guards actually work to open up your airways and treat the sleep apnea?

Dr. Nammy: Sure. So, sometimes what happens is that our tongue… So, our oral cavity is 3D, right? So we can either increase the height, we can either increase the width or we can increase the height and the width. Right? And the depth, excuse me.

So when it comes to the actual Oasis appliance, what it’s going to do is increase the vertical height so there’s more space for the tongue so that the tongue has enough space. That’s great. Now the MAD appliance moves the jaw forward. That creates the depth, which also stops sleep apnea.

Now we actually need to have height, width and depth, and that’s what the Homeoblock and the Vivos does is that we have a 3D change, physiological change, structural change in the body in order for you to be able to have more space for the tongue, get breathing through the nose, and you’re also not dependent on an appliance once you’re done. So-

John: So patients have- I’m sorry. Go ahead.

Dr. Nammy: …the MAD appliance you have to wear forever. Yes, the MAD Appliance you have to wear forever. Same thing with the Oasis. You have to wear it forever. With the Homeoblock and the Vivos, once we get the increase in the 3D volume, the tongue is actually going to keep everything in place because now the tongue has enough space, it’s been strengthened, it knows where it needs to go, it’ll be supporting the sinuses, it’ll be opening the airway, it’ll be closing your lips closed.

Do You Have to Wear Mouth Guards the Rest of Your Life?

John: So, when you say forever, you mean for the rest of the patient’s life, they would have to wear one of these mouth guards just when they sleep at night or all the time?

Dr. Nammy: Yes, when they sleep at night, mainly. It’s mainly when they sleep at night. Yes.

John: But having to do that for the rest of your life is daunting, certainly. Whereas like you said, with something like the Homeoblock or the Vivos appliance, you can just maybe do that for a couple of years or something like that and be done with it.

Dr. Nammy: Exactly, and that’s really our goal and really training your body to know what’s normal. When you have an appliance, it’s not normal. So what we’re really doing is training the body to know what’s in harmony. Basically, our ancestors 500 years ago or 500,000 years ago actually had really good airways, and sleep apnea wasn’t really around, and the main reason for that is because our sinus cavities were huge.

But as evolution has occurred and time has passed, our heads have gotten bigger, our sinus cavities have gone smaller, and there’s not as enough space for the tongue. And that further got worse as we started putting braces on individuals when they’re growing. So their skeleton’s not allowed to grow, but their musculature or your tongue keeps growing, and so there’s no space for the tongue, and that’s what causes the sleep apnea.

Are Homeoblock or Vivos Appliances Comfortable?

John: Are mouth guards uncomfortable as well, and are they more uncomfortable than something like the Homeoblock or the Vivos?

Dr. Nammy: The mouth guards are a lot more uncomfortable than the Homeoblock or Vivos because they’re also active. They’re not a passive appliance, and so it’s a big hard product that’s in between, and it’s not designed to be in harmony, especially like this. I don’t know about you, but I feel very uncomfortable talking like this. Right?

John: Right.

Dr. Nammy: And so, the appliances that change a physiological or just move the jaw forward are very uncomfortable. The appliances like the Oasis is more comfortable than the MAD appliance, but it still takes a little bit of getting used to for sure.

Does Wearing a Mouth Guard Have an Impact on Dental Health?

John: Does wearing a mouth guard have any impact on your dental health as well?

Dr. Nammy: Well, wearing the mouth guard if your mouth is open is going to be disastrous because you’re going to be keeping the mouth open, creating a dry environment, which makes specific bacteria grow that are not good for the body. So number one.

Number two, it’s also going to cause maybe a lot of stones in the throat. Your tonsils get inflamed. Those are very common things we hear from patients, or like rocks in the back of the throat, or they feel like they get infections quite often. That’s also another thing we hear from patients who are actually wearing a night guard or a appliance that keeps the mouth open. So those are common things that we hear.

Thoughts on Wearing a Mouth Guard to Treat Sleep Apnea

John: So just to sort of sum this up for us in terms of your thoughts on wearing a mouth guard to treat sleep apnea versus other types of appliances that somebody could use.

Dr. Nammy: My favorite thing to do, honestly, if somebody has sleep apnea, the first thing I would start is called myofunctional therapy. So training the tongue to become stronger. Exercises like this. So what that does is start strengthening the base of the tongue. I would much rather see somebody do myofunctional therapy than be in an appliance where they’re breathing through the mouth.

I want to encourage as much nose breathing as I can because it creates a molecule called nitric oxide, which is like your BFF. It helps by cancer, heart attacks, diabetes, what have you. It’s a scavenger for cancer. So nitric oxide is really the wonder drug that our body naturally makes, and I really want to support your body in making that. A night guard isn’t really going to help us with that. Myofunctional therapy, on the other hand, will, so I’d much rather look at myofunctional therapy as the most cost-effective way to get started than like a MAD appliance or a night guard or an oasis.

John: All right, that’s great advice, Dr. Nammy. Thanks again for speaking with me today.

Dr. Nammy: You’re welcome.

Information About Green Dentistry

John: And for more information about Green Dentistry, visit the website at sfgreendentist.com or call 415-433-0119.