We’re very lucky because there’s several alternative treatments, the first one is mandibular advance splints, which basically change the position of the mandible, which is the lower jaw to the layperson. And how that works is it pulls the jaw forward. And here’s one I prepared earlier. So this is a picture of a face. This is the bottom jaw here, the mandible. This represents a fat pad that runs down the back of your airway, which is very important to get rid of if you want to help your sleep apnoea.
Now, the tongue believe it or not, has been shown to be like wagu e beef. So I don’t know if you are familiar with wagu beef, but that’s marbled beef, it’s got lots of fat in it and your tongue is no different. So it’s not rocket science to realize if you had a fat pad to your airway , you have a tongue that’s like wagu beef then infact you end up with a small airway. It’s not rocket science.
That’s why we want to lose weight. But given you’ve done all that and you’ve BMI’s down to under 25, which is sort of a nice, arbitrary figure, we can then pull the bottom jaw forward, which then opens the airway further, plus stabilizes the soft tissue in that airway. So what we do there is that we use a little splint to allow that. So it’s sort of like a mouth guard, but to mouth guards, one for the top and one for the bottom, and they sit together and hold the bottom jaw forward.
The next option would be surgery. And with surgery, they tend to cut off this part here. This is the uvula, which is like, you know, in cartoons. When you see that dangling between the cartoon characters open their mouth and you see it’s all punching bag up the back. Well, that’s the uvula. So there’s a few surgical procedures around. But generally they fall into the category are the soft tissue, which means that dangly bit or hard tissue, which means to actually move the mandible and the Maxilla, or one or the other forward.
So sort of a permanent splint in a way. It’s what we call morbid, which means it’s not very comfortable. And, , I only ever recommend that treatment if you need it for orthognathic purposes, meaning that you need it to give you a better bite or occlusion or if you’re grossly malformed and you’ve got a very receded bottom jaw and you actually want to look better. So there’s more to it than just primarily treating it for the sleep apnea, although that procedure is done quite regularly.
So that’s an alternative. And another alternative is that we can just work on the tongue by itself. So we leave the bottom jaw alone. We don’t do anything more, but we simply put a little suction cup on on our tongue. The one we use is called a tongue stabilizing device. People are not as compliant, meaning they don’t adhere to the treatment as well as they do on mandibular advancement splints.
But they’re still very effective if you can get used to wearing it.