Snoring, Sleep and the Airway
Your airway and sleep are rated at every examination here, alongside decay, gums and bite. Where snoring is the problem, we make a mandibular advancement device — a custom appliance worn overnight that holds the lower jaw slightly forward. Where the picture points to sleep apnoea, we work alongside an ENT surgeon, because that is a medical diagnosis and it should come first.
- Assessment
- Part of every examination
- Appliance
- Custom, made with our laboratory
- Fee
- S$2,180
- MediSave
- Not claimable
What we look at
Every examination here produces four risk ratings — decay, gums, bite and wear, and airway and sleep — each rated low, moderate or high and rated again at review. The airway rating draws on what you tell us about snoring, how you sleep and whether you wake unrefreshed, together with what the mouth shows: the size and posture of the tongue, the shape of the palate, signs of mouth breathing, and the tooth wear that so often accompanies disturbed sleep.
That rating is a screen. It is good at telling us that something deserves looking into, and it is not a diagnosis of sleep apnoea, which is made from a sleep study read by a physician. What it does is make sure the question gets asked at all, which for most people it never has been.
An appliance for snoring
Where snoring is the main complaint, a mandibular advancement device is usually the most straightforward thing to try. It is a custom appliance worn at night that holds the lower jaw a little forward of its resting position, which opens the space behind the tongue and makes the airway less likely to vibrate and collapse.
Yours is made by our laboratory from scans taken here, so it is built to your own teeth rather than boiled and bitten into shape. It is fitted, and the amount of advancement is adjusted afterwards, because the right position is the smallest one that works and that is found by trying it rather than by predicting it.
How well it works varies between people. We check at review whether it is actually helping, and if it is not, that is worth knowing early rather than persevering.
Where sleep apnoea is likely, we work with an ENT
Snoring and obstructive sleep apnoea sit on the same spectrum, and the difference matters, because apnoea affects the heart, blood pressure and daytime alertness in ways that snoring alone does not. When your history points that way — witnessed pauses in breathing, waking unrefreshed, daytime sleepiness — we refer you to an ENT surgeon for proper assessment and a sleep study.
Once there is a diagnosis, an appliance may well be part of the answer, and we make it in step with the physician managing you. Working that way round means the appliance is prescribed for a condition that has actually been measured, and that someone is checking it is doing the job.
Grinding and snoring often arrive together
Sleep bruxism is linked to disturbed breathing during sleep, so the two frequently turn up in the same mouth. If you have come in about worn or sensitive teeth and the history suggests your sleep is broken, we will say so, because treating the wear without asking about the sleep tends to mean doing it again later.
Who does this at Calm Dental
Fees for this treatment are on our fees page, including GST. A written quotation follows examination.
Questions
Will a mandibular advancement device stop my snoring?
It reduces snoring for a great many people, and for some it stops it. It works by holding the lower jaw slightly forward so there is more room behind the tongue. How much it helps varies, which is why we review it rather than fit it and assume.
Do I need a sleep study first?
For straightforward snoring, no — we can make an appliance for that. Where your history suggests sleep apnoea, yes, and we will arrange the ENT referral. The distinction is not something to guess at from home, so tell us what your nights are actually like and we will say which of the two this looks like.
Is this the same as a nightguard?
No. A nightguard protects teeth from the forces of grinding. A mandibular advancement device is designed to hold the jaw in a particular position to open the airway. They are different appliances, made differently, and they are quoted separately on our fees page.
Is it made here at the clinic?
The scans are taken here and the appliance is made for you by our laboratory, then fitted and adjusted here.
Can I use MediSave for it?
No. MediSave covers a listed set of surgical dental procedures, and an appliance is not a surgical procedure, so it is not claimable. Our MediSave page sets out what is.
Do you diagnose sleep apnoea?
No — that diagnosis comes from a sleep study interpreted by a physician, and we refer you for one where it is warranted. What we do here is notice the signs, raise it, and make the appliance where one is the right answer.
Who does this at Calm Dental?
Dr JD Tan.