Comprehensive Oral Appliance Treatment For Sleep Apnea

Obstructive sleep apnea occurs when people choke on their tongue and soft palate during sleep. Dentists make a variety of different oral appliances to treat obstructive sleep apnea by advancing the mandible (the lower jawbone) to create more space in front of the tongue, and they are well tolerated by patients; but they can't pull the tongue base into the space created or pull the soft palate away from the obstruction, because the mandible is only attached to the tongue base by muscles and not at all attached to the soft palate. As a result, mandibular advancement appliances only cure the problem in about half of the patients treated.

To relieve sleep apnea in the other half and in people who wear dentures, Dr. Summer has developed new technologies that can be added to oral appliances or denture base plates to control the soft tissues that produce the actual obstruction. A tongue holding device holds the tongue and tongue base forward together with the mandible so it cannot drop back into the pharynx, while a soft palate elevator draws the end of the soft palate forward and upward away from obstruction in the nasopharynx. These components are described further in, MULTI-LEVEL TREAMENT OF OBSTRUCTIVE SLEEP APNEA under the tab FOR DOCTORS. 

THE TONGUE HOLDING DEVICE holds the tongue in a comfortable target treatment position between an upper and lower tongue gripping plate containing thousands of tiny forward slanted bristles that prevent it from dropping back into the pharynx. A light spring beneath one of the plates produces a cushioned grip which ensures comfort and prevents accidental tongue release during small jaw movements, including nocturnal bruxism. Bite stops ensure that biting down cannot hurt the tongue. 

The first pilot study for the FDA submission used patients with a normal healthy set of teeth (dentate patients).  The 2025-2026 study will involve only full denture patients who have obstructive sleep apnea. They will receive a new denture baseplate (no teeth) containing a tongue holding device and also a soft palate elevator if needed.  Multi-night home sleep testing will be used to guide treatment.  

THE SOFT PALATE ELEVATOR, which has already been cleared by the FDA, uses a soft silicone bulb on the end of a thin flat sheet metal arm to raise the center of the soft palate, where there are no gag reflexes, in order to draw forward the back end of the soft palate, which is so full of gag reflexes that it cannot be contacted directly. The flexible arm allows it to move up and down with the normal action of the soft palate during swallowing, when breathing stops anyway. Most people can't even feel it. A soft palate elevator can be added to most upper oral appliances to eliminate snoring, because the soft palate is the area that usually vibrates. It also can help prevent sleep apnea by pulling the back end of the soft palate out of the narrow space between the tongue base and the pharyngeal wall, where it acts like a gasket to stop the airway flow.