The following article with the clinical director of SleepWise Clinic, Dr Harry Ball, was recently featured in The Age newspaper.

Custom-made oral appliances are recognised as being one of two main treatments for people who have problems with snoring and sleep apnoea.

Oral appliances can bring welcome relief to people who are unable or unwilling to use the other recommended treatment – continuous positive airway pressure, or CPAP, a machine that keeps airways open by gently forcing air through the nose or mouth.

Oral appliances work by placing the lower jaw slightly forward, stopping the soft tissues from flopping down into the back of the throat and blocking the airway.

A myriad of appliances are available, however Dr Harry Ball, one of the founders of Melbourne’s SleepWise Clinic, says it’s worth making the effort to get the right appliance.

‘‘After all, this is something you’ll wear for a third of your life and it needs to be both comfortable and effective.’’

Asking some simple questions can help you choose the right practitioner.

First, is the dentist trained to provide this service? Training is provided through the Australasian Sleep Association (ASA). ‘‘The ASA is the peak body of everyone in the field, including sleep physicians, dentists, technicians, psychologists and ear, nose and throat specialists,’’ says Ball, who is co-chairperson of the association’s Dental Sleep Medicine Council.

‘‘We have regular meetings, training programs and newsletters, and the ASA holds an annual three-day training event for dentists.

‘‘I think it’s very important that every dentist interested in providing oral appliances should be a member and attend the training programs.’’

Second comes experience. Are oral appliances a major part of the dentist’s practice?

The more often a dentist provides an appliance, the more likely they are to have developed the skills required.

The third issue is the range of appliances offered.

‘‘There are more than 100 appliances on the market, but only a handful have evidence, published in journals, that they are both effective and comfortable,’’ Ball says.

There is also concern that some dentists are being trained by a particular maker of oral appliances and are being influenced by the manufacturer to offer only that brand.

Ball says SleepWise has committed itself wholly to the field of oral appliances.

‘‘We are the only clinic that focuses solely on appliances,’’ he says. ‘‘It’s not an add-on, so patients know they are seeing someone who does this all the time.’’

The dentists at SleepWise are some of the most experienced in the world, having treated more than 7000 patients.

The clinic is not aligned with any brands and has selected appliance designs that are backed by a solid body of evidence.

‘‘At SleepWise we select from four appliances, choosing the one that’s best suited for each patient,’’ Ball says.

‘‘We make our own appliances using 3D printing technology, so they are much thinner, more comfortable and stronger than the alternatives.’’

SleepWise offers a satisfaction guarantee, so that if a patient is not fully satisfied, 80 per cent of the fee will be returned.

‘‘We are happy to offer this because it takes the financial risk out of getting an appliance and is on a par with trialling a CPAP machine.’’

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