Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.
Thursday, June 9, 2016
Bite Changes From Somnodent Appliance. Experience with TMJ disorders is important in Sleep Apnea Treatment
I have obstructive sleep apnea and I wear a Somnomed appliance at night. As a result, my bottom teeth and top teeth are meeting on top of each other and the bottom teeth are off to the side. I would to be able to straighten my bite and wear the sleep appliance at night. Is this possible? Please let me know if you have additional questions. I have consulted a prosthodontist who told me he needs to confer with my dentist and sleep appliance doctor. But they are busy and I want to know if my situation is something I must accept.
Dr Shapira's Response:
There are many ways to "make you whole" and possibly offer long term cure to sleep apnea. A side effect of wearing a Somnomed Appliance or other sleep appliance is bite changes. These are usually mild but can be more severe. These are discussed at the start of treatment. The bite changes can be favorable or unfavorable. The are he result of the jaw heling to a position with a better airway.
I have been utilizing sleep appliances since 1982 and bite changes are common. Ideally aggressive morning exercise prevents most changes but after they occur they are hard to reverse. I have followed some patients for approximately 30 years and many never have issues.
Sometimes the bite changes can be reversed if you use CPAP instead of an oral appliance to treat your sleep apnea. The changes actually are healing of the retrodiscal ligaments and muscles. They improve your daytime and night-time breathing, posture and actually make your face look younger and healthier but when everything is healed your bite looks wrong.
I teach all my patients how to prevent changes before giving them an appliance. I often have patients who want permanent orthopedic change and this is accomplished with a plan rather than as an accident.
The changes you see in essence explain why you originally had seep apnea. It is possible to orthodontically or prosthetically correct the bite but my preferred method is the RNA version of the DNA Appliance that orthopedically grows your maxilla to a proper size. Additional work may be required to finish case after the DNA Appliance.
I frequently see long distance patients with difficult problems and the DNA Appliance lends itself to long distance treatment.
The beauty of the DNA Appliance is that it has been shown in clinical studies to cure sleep apnea in some patients. Long term prospective studies are underway.
The first video is a physician who is using DNA Appliance to grow larger airway.
This patient is a young girl whose DNA Appliance is growing a larger airway after orthodontics constricted her airway
This is a month by month explanation of a long term patient utilizing DNA Appliance.
It is also possible to do a full mouth reconstruction to a neuromuscular position.
I currently wear the Summoned sleep appliance which I believe the only appliance my doctor makes. I would like to continue to wear this appliance because it helps my OSA without tearing up the inside of my mouth. I would like to correct my bite as my jaw pops and it is difficult to chew. Is my situation futile or can I do the bite correction and keep my current appliance?
Dr Shapira's response:
I see many patients who we treat for both TMJ and bite issues who also wear sleep appliances. I will usually make a daytime orthotic to treat the jaw issues that is worn when the sleep appliance is out.
Treatment is usually divided into phases, the first phase is a diagnostic that can be adjusted over time during initial treatment. A second phase of long term stabilization is then done. This can be done with long term removable orthotic that would allow you to use your current Somnomed appliance.
There are other options for long time stabilization but they would require replacement of Somnomed appliance.
Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Chair, Alliance of TMD Organizations
Diplomat, American Academy of Pain Management
Diplomat, American Board of Dental Sleep Medicine
Regent & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal
Member, American Equilibration Society
Member, Academy of Applied Myofunctional Sciences
posted by Dr Shapira at 7:19 AM
Wednesday, April 13, 2016
WALL STREET NEWS.... Sleep Apnea Treatment: CPAP and Oral Appliances are Equivalent
Sleep Apnea Treatment: CPAP and Oral Appliances are Equivalent According to Outcome Studies. Patients Prefer Comfortable Oral Appliance to CPAP Chicago Dentist Leader in Oral Appliance Therapy
Oral Appliances are preferred over by 95% of patients with Sleep Apnea yet CPAP is usually prescribed even in mild and moderate sleep apnea when outcomes are equal. Patient Testimonials say it all! Do CPAP Companies Pay Kickbacks to promote CPAP?
CHICAGO, IL, April 09, 2016 /24-7PressRelease/ -- Treatment of sleep apnea is essential. CPAP was once considered the Gold Standard of Care but today Oral Appliances are considered a First Line Approach equal to CPAP for mild to moderate Sleep Apnea and an alternative for severe apnea when the patient does not tolerate or prefers oral appliance therapy.
Patients generally don't like CPAP, in fact only 25% use CPAP as recommended but 60% abandon it completely. The number one reason patients give why they discontinue CPAP use "I Hate CPAP!"
Millions of patients have visited www.IHateCPAP.com looking for comfortable alternatives to CPAP. Marketing of this site at AASM and AADSM meetings was banned even though it was acknowledged it would save lives of non-compliant CPAP patients.
Dr Ira Shapira is a Chicago area dentist who has been treating sleep apnea with oral appliances since 1982. The American Academy of Dental Sleep Medicine is celebrating it's 25th Anniversary in June in Denver. Dr Shapira was one of 20 dentists worldwide who started the Sleep Disorder Dental Society 25 years ago that became today's American Academy of Sleep Medicine. Dr Shapira created the I Hate CPAP website that brought oral appliances into the mainstream and was featured on numerous Television and Radio news stations as well as publications like Bottomline.
The Science of Sleep Medicine has given it's verdict: Oral Appliances are safe and effective for mild, moderate and severe sleep apnea.
Outcome studies for cardiac, blood pressure and cognitive measures are equal and sometimes oral appliances rate higher than CPAP.
A new article in JAMA states that outcome studies of CPAP and Oral Appliances are similar. Another article in Sleep and Breathing Comparison of effects of OSA treatment by MAD and by CPAP on cardiac autonomic function during daytime. This article concluded that "that both MAD and CPAP result in similar beneficial changes in cardiac autonomic function during daytime, especially in blood pressure."
Oral Appliances continually prove to be equal to CPAP in OUTCOME STUDIES. This is in spite of the fact that the majority of research money funds studies to show value of CPAP and that CPAP companies expect a return on their investment.
The conclusions of this study are enormous, Among patients with obstructive sleep apnea, both CPAP and MADs (mandibular advancement devices) were associated with reductions in BP. Network meta-analysis did not identify a statistically significant difference between the BP outcomes associated with these therapies.
Another article in Respirology, "Cardiovascular mortality in obstructive sleep apnoea treated with continuous positive airway pressure or oral appliance: an observational study" concluded "Both CPAP and MAD may be equally effective therapy in reducing the risk of fatal cardiovascular events in patients with severe OSA."
The Sleep and Breathing article also stated that "CPAP is more effective than MAD in eliminating respiratory events." While this is true other studies have shown that the frequency and length of use of oral appliances actually makes total effectiveness higher. Most CPAP users only utilize CPAP 30-40% of the time.
A 2-year mean follow-up of oral appliance therapy for severe obstructive sleep apnea: a cohort study. (Oral Dis. 2015 Apr;21(3):386-92.) concluded that "Oral appliances were found to be successful for treating for severe OSA after first-line treatment had failed."
The DNA Appliance (an oral appliance) has been shown to orthopedically grow the airway in a process called Pneumopedics and has been shown in clinical cases to "Cure" Sleep Apnea. Long term prospective studies are beginning.
CPAP continues to be prescribed far more than oral appliances. Much of this is due to doctors who are ignorant of newest studies or who like CPAP and ignore the research. There is also a problem with billions of dollars in Revenue allowing CPAP companies to push their product, often using unethical practices.
A recent lawsuit found " Philips Respironics has agreed to pay $34.8 million to resolve alleged False Claims Act violations for paying kickbacks to DME providers that bought its CPAP masks, the Department of Justice has announced."
There are many in the field of sleep medicine who feel this is only the tip of the iceberg and that illegal or unethical marketing may be widespread.
"The payment of illegal remuneration in any form to induce patient referrals threatens public confidence in the healthcare system," said Principal Deputy Assistant Attorney General Benjamin Mizer, head of the Justice Departments' Civil Division. "Americans deserve to know that when they are prescribed a device to treat a serious healthcare problem, they supplier's judgment has not been compromised by illegal payments from equipment manufacturers."
The Anti-Kickback Statute prohibits the knowing and willful payment of any remuneration to induce the referral of services or items that are paid for by a federal healthcare program, such as Medicare, Medicaid or Tricare. Claims submitted to these programs in violation of the Anti-Kickback Statute are also false claims under the False Claims Act.
Respironics will pay roughly $34.14 million to the federal government and roughly $660,00 to various state governments based on their participation in the Medicare program.
The field of Dental Sleep Medicine grew based on patient referrals and testimonials not by illegal kickbacks. In the following youtube testimonials patients clearly explain why they prefer oral appliances to other treatments.
Think Better Life - Dr. Ira Shapira
35 YEARS OF SLEEP APNEA TREATMENT. VIEW THIS VIDEO OF A PATIENT WEARING AN ORAL APPLIANCE FOR 9 YEARS.
ANOTHER PATIENT WITH 9 YEARS EXPERIENCE
A FEMALE PATIENT USING ORAL APPLIANCE
USED TO FALL ASLEEP DRIVING
ORAL APPLIANCE FOR INTERNATIONAL TRAVEL
PHYSICIAN REVIEWS SLEEP APNEA APPLIANCE.
RESPIRATORY THERAPIST REVIEWS APPLIANCE
Dentist helps with sleep apnea, snoring, and fibromyalgia
ADNA Appliance Testimonial...Life Changing results!!!
ADDITIONAL VIDEOS ON SLEEP, TMJ TREATMENT, MIGRAINE TREATMENT , CHRONIC DAILY HEADACHES AND MORE
Learn More at www.IHateCPAP.com
In Highland Park and surrounding suburbs Visit:
In Gurnee and Far North Suburbs:
North Shore visit:
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Dr Ira L Shapira created the I HATE CPAP (www.ihatecpap.com) and I HATE HEADACHE (www.ihateheadaches.org) websites to help patients find help with these difficult medical disorders that medicine can frequently not treat adequately without a dental collaboration. Dr Shapira did research in the 1980's as a visiting assistant professor at Rush Medical School where he worked with Rosalind Cartwright PhD who is primarily responsible for the entire field of Dental Sleep Medicine. He also studied with Dr Barney Jankelson who created the initial concepts that neuromuscular dentistry still uses today and created a company Myotronics that is the leading manufacturer of instrumentation used by Neuromuscular Dentistry.
Dr Shapira is a Diplomate of The American Board of Dental Sleep Medicine, a Diplomate of the American Academy of Pain Management, and a Fellow of the International College of CranioMandibular Orthopedics (ICCMO). He is a former national and International Regent of ICCMO, its current Secretary and the representative to the Alliance of TMD organizations or the TMD ALLIANCE has a general dental practice (http://www.delanydentalcare.com) in Gurnee, Il and has recently started Chicagoland Dental Sleep Medicine Associates with offices in Vernon Hills and Highland Park. Patients in Northern Illinois or southern Wisconsin can contact Dr Shapira thru his office websites or thru http://www.ihateheadaches.org or http://www.chicagoland.ihatecpap.comwww.ThinkBetterLife.com, NorthShoreSleepDentist.com SleepandHealth.com
Dr Ira L Shapira is President of I HATE CPAP LLC, President Dato-TECH, and has a Dental Practice, Delany Dental Care with his partner Dr Mark Amidei. He has recently formed Chicagoland Dental Sleep Medicine Associates. He is a Regent of ICCMO and its representative and the current Chair of the American Alliance of TMD Organizatins (www.TMDAlliance.com), He was a founding and certified member of the Sleep Disorder Dental Society which became the American Academy of Dental Sleep Medicine, A founding member of DOSA the Dental Organization for Sleep Apnea. He is a Diplomate of the American Board of Dental Sleep Medicine, A Diplomat of the American Academy of Pain Management, a graduate of LVI. He is a former assistant professor at Rush Medical School's Sleep Service where he worked with Dr Rosalind Cartwright who is a founder of the fields of Sleep Medicine and Dental Sleep Medicine. Dr Shapira is a consultant to numerous sleep centers and teaches courses in Dental Sleep Medicine in his office to doctors from around the U.S. He is the Founder of I HATE CPAP LLC and http://www.ihatecpap.com
Dr Shapira also holds several patents on methods and devices for the prophylactic minimally invasive early removal of wisdom teeth and collection of bone marrow and stem cells. He is currently working with Dr Tom Diekwisch at the Baylor in Texas to prove these stem cells can change peoples lives for the better. Dr Shapira is a licensed general dentist in Illinois and Wisconsin.
Dr Shapira is currently working on patents he hope will drastically improve the field of pain management.
posted by Dr Shapira at 3:15 PM
Thursday, April 7, 2016
North Shore Sleep Apnea Treatment: Oral Appliances are The Comfortable CPAP Alternative!
Chicago Sleep Apnea Treatment: Patient Testimonials Praise Oral Appliance Therapy
95% OF PATIENTS PREFER ORAL APPLIANCES OVER CPAP IF OFFERED A CHOICE!
35 YEARS PROVIDING SLEEP APNEA TREATMENT.
posted by Dr Shapira at 8:54 AM
Wednesday, March 23, 2016
Sleep Problems and Chronic Migraines. New Study At Rush Medical School Looking For Participants
posted by Dr Shapira at 2:44 PM
Sunday, March 20, 2016
Chicago Sleep Apnea Treatment: Oral Appliances, A Better Alternative. Patient Testimonials Tell All!!!
95% OF PATIENTS PREFER ORAL APPLIANCES OVER CPAP IF OFFERED A CHOICE!
35 YEARS PROVIDING SLEEP APNEA TREATMENT. VIEW THIS VIDEO OF A PATIENT WEARING AN ORAL APPLIANCE FOR 9 YEARS.
Labels: aadsm chicago, ABDSM Chicago, Best sleep apnea treatment chicago, cpap alternative chicago, dental sleep medicine chicago, Mandibular Advancement Appliances Chicago, Oral Appliance Therapy Chicago
posted by Dr Shapira at 12:30 PM
Tuesday, March 15, 2016
Oral Appliance Therapy in Sleep Apnea Patients Improve Cognitive and Psychomotor Performance
Other recent outcome studies have shown improvement in Blood Pressure and Cardiac Function.
Review these abstracts and you will understand why more and more sleep physicians consider oral appliances to be a first line treatment for moderate obstructive sleep apnea and an alternative for severe sleep apnea.
Find oral Appliance Therapy in Chicago:
www.IHateCPAP.com find a dentist section
Improvement of Cognitive and Psychomotor Performance in Patients with Mild to Moderate Obstructive Sleep Apnea Treated with Mandibular Advancement Device: A Prospective 1-Year Study.
CPAP vs Mandibular Advancement Devices and Blood Pressure in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis.
DATA EXTRACTION AND SYNTHESIS:
MAIN OUTCOMES AND MEASURES:
CONCLUSIONS AND RELEVANCE:
- [PubMed - as supplied by publisher]
Comparison of effects of OSA treatment by MAD and by CPAP on cardiac autonomic function during daytime.
posted by Dr Shapira at 11:07 AM