Airway Orthotics—The Evolution of a Name

Airway Orthotics; what are they, where did the name originate and what does it mean?

First, there was the name, Dental Appliance; since these appliances are fabricated by a Dentist, this name seemed appropriate. However, the common consensus was, how can a Dental Appliance treat a Sleep Problem?

Then came the name, Oral Appliance; this eliminated the misleading Dental term; however, it still did little to explain the function of the appliance.

Next in the evolutionary chain was the name, Airway Dilator; this name was introduced with much excitement. Finally, a name that accurately described the function of the appliance. But even this name fell short.

To accurately describe the function of these appliances, we must first agree on what this function is. Dilation of the airway is undoubtedly one of their functions, this has been demonstrated with MRI’s in the literature. However, to be successful, they must also fulfill another function, that of airway splinting. The name Airway Dilator provides no indication that it works by splinting the airway thus preventing it from collapsing.

Although the mechanism by which these appliances work clearly involves both dilation and splinting of the airway. We still do not know what other mechanisms may underlie successful therapy with an appliance. Clearly then, the best name should not be tied to a particular mechanism.

If we put aside specific mechanisms, these appliances work by normalizing pathological airway behaviour. Thus the name Airway Orthotic. This name is not tied to a particular mechanism that may only partially describe how the appliance works, but rather, it concisely describes exactly what the appliance does; It makes the airway behave “Ortho” or correctly.

Through the use of Acoustic Pharyngometry, we can access exactly how an airway behaves in the awake patient. The most current thinking in this area, involves determining if manipulating mandibular posture with an Airway Orthotic can make a pathological airway behave like a healthy airway, and how success in the awake state relates to successful Orthotic therapy in the sleep state. Research in this area has demonstrated a link between behavior of the awake orthotic manipulated airway and ultimate orthotic success. Currently, we are continuing to conduct research to further validate this relationship.

Airway Orthotic most accurately represents what these appliances actually do. No matter what we learn about the mechanism by which they work, they will most certainly still be making the airway behave “Ortho”

History of Airway Orthotics

Methods of treating snoring and sleep apnea include nCPAP, Surgery and Airway Orthotic Therapy.  However, appropriate lifestyle changes should always be attempted prior to initiating these therapies and in milder cases, a lifestyle change may be all the therapy necessary to eliminate the problem in milder cases. 

Medications are rarely prescribed, but under certain circumstances, may prove beneficial; homeopathic remedies alone rarely eliminate the problem.  Any procedure, or medication (homeopathic or otherwise) that helps clear the upper respiratory tract may help reduce the severity of the problem and in mild cases may eliminate it completely.

Airway Orthotics, often referred to as Oral Appliances, first appeared in the literature in 1980, and were officially accepted by the American Academy of Sleep Medicine ion 1995. Today, they are considered mainstream therapy for the treatment of snoring, sleep apnea and other breathing related sleep disorders.

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Last modified: October 17, 2007