Treating obstructive sleep apnea: the case for oral appliances.

A Obstructive sleep apnea (OSA) is a chronic, progressive, and potentially life-threatening disorder that can be effectively treated with surgery. It is also a condition that orthodontists see in their offices every day; thus, they are ideally suited to diagnose and treat it. OSA is related to an anatomic obstruction of the upper airway; surgical correction of the obstruction is effective and definitive, and should be considered for appropriate patients with mild, moderate, or severe OSA. OSA is a multifactorial condition, and diagnosis and treatment must be individualized, with multidisciplinary management. The definitive diagnosis and treatment plan is formulated after a comprehensive medical and dental history and examination. Adjunctive diagnostic studies such as cone-beam computerized tomographic imaging for airway analysis, fiber-optic nasopharyngoscopy, polysomnography, and 3-dimensional cephalometrics are included in the workup. OSA occurs during sleep as a result of an obstruction or partial collapse of the upper airway. Signs and symptoms include tiredness or sleepiness during the day, memory loss, irritability, depression, decreased libido, and headache. If OSA is not treated, it can cause diabetes, hypertension, heart disease, and sudden death while asleep. Exacerbating factors include a high body mass index (.34). Continuous positive airway pressure (CPAP) is currently considered the gold standard for the treatment of OSA. Positive airway pressure can be divided into continuous (CPAP), bilevel, and auto titrating modes, through a nasal, oral, or oronasal interface during sleep. Unfortunately, compliance with CPAP is variable for numerous reasons including social stigma, feelings of claustrophobia, and