Complex Care
Patients with TMJ problems, hypertension, GERD, nocturnal atrial fibrillation, insomnia or headaches, diabetes, erectile dysfunction, depression or anxiety issues can have a compromised airway that affects them during sleep. The challenge of maintaining your ability to breath can contribute to the above conditions.
This narrowing or blockage of the airway can often trigger more pain and discomfort during the night, or first thing in the morning in the jaw joints. Research has shown that approximately 80% of patients with obstructive sleep apnea also clench or grind, therefore, part of the treatment process in this office when patients present with signs of clenching or grinding is to evaluate if you are getting enough oxygen when you are sleeping.
Just because you do not snore, does not mean that you do not have a problem. Typically, an evaluation of your oxygen levels, heart rate and actual flow of air as you breathe is compiled to see if a part of your compromised health is from Obstructive Sleep Apnea.
THIS PROCESS SHOULD BE DONE WITH COMMUNICATION WITH YOUR PRIMARY CARE PROVIDER. They are responsible for your overall health. We are only a part of the team, and are not intending to replace their supervision of your healthcare.
It used to be that the only way you could find out for certain was through a test called a polysomnogram, or PSG. This was done in a hospital or clinical setting. Now you have the ability to have this information gathered right in your own bed.
If you do not already have a known diagnosis, please discuss doing a diagnostic test with your physician. Testing can be done through a hospital setting - polysomnogram(PSG) or at home as a home sleep apnea test (HSAT). The type of testing completed is up to your primary care provider, or the sleep physician you are working with.
Please be aware that if your medical history already includes congestive heart failure, or COPD, or if you have a severe neuromuscular disorder, your insurance may mandate a PSG so that they have a more detailed evaluation of what happens when while you are sleeping.
If your evaluation shows that you have a severe problem, a CPAP, or constant positive air pressure machine will be prescribed by the evaluating physician. It is VERY important that you make an ernest effort to successfully implement the recommended CPAP therapy. It is the gold standard for treatment of OSA.
If your problem is found to be in the range considered to be mild or moderate, an oral appliance can be fabricated by this office using technology proven to provide the best fitting, least irritating appliance for you.
Oral appliances can be implemented as the first line of treatment for mild and moderate cases of sleep apnea. Severe apnea patients who can not tolerate the CPAP or those who refuse to wear it can be fitted with an oral appliance by Dr. Wiggins as well . This decision needs to be discussed and supported by your physician.
Sometimes, both CPAP and an oral appliance are necessary to be successful for you. This is known as combination therapy.
You should never be fitted for an oral appliance for "snoring" without a proper diagnostic test to rule out sleep apnea. Be cautious if someone offers to do so as it really is not a good idea.
Over-the-counter oral appliances that you can get from your local store or off of the internet are NOT approved by the FDA for treatment of sleep apnea. Please realize that just because you are not snoring, which some of them can help with, it does not mean that the apnea has been corrected. A silent apnic is scary!! When you no longer have noise that ecourages your bed partner to make you roll over - you loose your reminder to breathe!!!
Most oral appliance fabricated for treatment of sleep apnea will hold your bottom jaw in a more stable and/or a more forward position. Since the appliance is being used to hold your jaw, your JAW JOINT must be evaluated to make sure it is strong enough to hold in this position for the night. It is not a "no-brainer" process. Our goal to make sure that you do not trade one problem, snoring or apnea, for another, TMJ pain. Short cuts only work for a short amount of time!!
If you are interested in meeting with Dr. Wiggins to see if you are a candidate for an oral appliance, please fill out the link below.
The form will securely download to this office. Once it is completed, please call to schedule an appointment. Please make sure to include your insurance information so that my staff can get a head start with communications with your insurance carrier.
If you already have the diagnosis of OSA, please ask your physician to forward a prescription for an oral appliance for sleep apnea to our office, along with a letter of medical necessity and a copy of your most recent diagnostic apnea test (PSG or HSAT). It can be faxed to 906 225-0889.
1) Prescription: Oral Appliance Therapy for OSA (G47.33)
2) Letter of Medical Necessity from your physician
3) Copy of diagnostic testing (most recent HSAT/PSG)
4) Most recent examination/conversation notes from your physician
This treatment process is done through your medical insurance, not your dental insurance. Most patients get reimbursement from their insurance carriers, including Medicare. Outside financing is available if needed.
I look forward to helping you achieve better health and a higher quality of life.