Dental Sleep Appliances Work… When made Properly

Throughout the medical and dental professions there are numerous courses given by suppliers of various devices for treatment of many medical problems, including Obstructive Sleep Apnea. After a two day course the doctor is assured he or she is qualified to deliver the device to their patients with great expectations of increased practice income.

Over the last five years, my office at Advanced Oral Diagnosis and Treatment Center, has delivered close to 600 dental sleep appliances with overwhelming records of success. This success did not come as a result of a two day course; it came from years of study and practice, plus a sizable investment in the purchase and continued training in the use of the Acoustic Pharyngometer and Rhinometer.

With this device, a visual reproduction of the airway is produced so that both the patient and I can see the obstructions and watch them be reduced when the jaw is properly placed. It can also show me if a dental device will not work and when the obstruction may require other treatment options, including surgical intervention. This demonstration (that an oral appliance wouldn’t be effective) has only occurred three times in my office, and the surgical results were great with the side effect of making the patient more attractive by bringing the chin forward.

The Rhinometer test results can prove the need for clearing of the nasal passages. Recent research in physiology has clearly proven that nasal respiration is very important to one’s health, to the extent that some of the researchers began taping their mouths closed to break the habit of sleeping with their mouth open. I merely refer the patient to an ENT with the print out of the rhinometry report and have them discuss treatment options to open up those airways.

Without the use of an echopharyngometer, the practitioner can only guess if the oral appliance would be effective, and the results are by chance. Every patient is asked to do a follow up sleep study once the patient is happy with the appliance. Our results have been incredible in many cases. One severe case went from 78 sleep disturbances per hour to only three.

It has taken years for the dental sleep appliance to become accepted by the medical profession. Originally, the CPAP, which stands for continuous positive airway pressure, was the only acceptable method of treatment. One big problem with this method is patient compliance. In my own case, the mask and the air flow greatly interfered with my sleep. I heard about oral appliance therapy and tried seven different types of appliances, some of which were downright painful. I finally settled on the SomnoDent appliance. Half of my practice is the treatment of TMJ disorders and I found this appliance to be the most friendly to patients with TMJ.

If you or someone you know would like to look into this method of treating OSA, a complimentary appointment may be made by calling 925-837-8048.


Natural Treatment for Rotator Cuff Injuries

The Rotator Cuff muscles (four muscles in total) are the primary support structures for the shoulder. Therefore, even minor dysfunction associated with these muscles can create pain and decreased performance of everyday tasks. A Rotator Cuff injury can be caused by many everyday activities. These activities include traumatic events (e.g. fall on an outstretched arm, “yanking” of the arm), repetitive motion (e.g. throwing a ball, carrying children) and chronic improper posture (e.g. operating a computer, driving).

There are three major types of Rotator Cuff injuries that we treat successfully:

1. Rotator Cuff Muscle Tears: This is a partial tear of one or more of the four Rotator Cuff muscles. Rotator Cuff muscle tears are often accompanied by deep achy pain in the shoulder and arm weakness.
2. Tendonitis: Tendons are at the ends of each muscle and attach the muscles to the bones they move. When there is inflammation of these tendons it is called Tendonitis. The symptoms of Rotator Cuff Tendonitis are often trigger point pain over the tendon accompanied by deep, achy pain in the shoulder and arm weakness.
3. Rotator Cuff Impingement Syndrome: Chronic injury of the Rotator Cuff can lead to a “pinching” of the nerves passing through the shoulder. This is commonly referred to as a Shoulder Impingement or Rotator Cuff Impingement. Symptoms often include numbness, tingling or sharp, shooting pain into the arm or hand.


The most common forms of medical treatment for Rotator Cuff injuries are anti-inflammatory medications, cortisone injections and surgery. Although meds and injections may reduce the severity of pain associated with rotator cuff dysfunction, they are not a long-term solution and may do more bodily harm than good in the long run. Surgery is a last resort and should only be used if there is irreparable damage to the shoulder that cannot be handled with proper rehabilitation.


First: Heal the Damaged Tissue
Ending the pain caused by a Rotator Cuff injury requires stopping the cycle of inflammation that is creating the pain. Class IV laser therapy is an excellent method for this, because it is presently the only modality that can both reduce inflammation and heal tissue simultaneously. During Laser Therapy, the infrared laser light interacts with tissues at the cellular level, increasing metabolic activity and improving the transport of nutrients across the cell membrane. This creates an optimal healing environment that reduces inflammation, swelling, muscle spasms, stiffness and pain. As the injured area returns to normal, pain is relieved and function is restored.

Second: Correct the Shoulder and Postural Mechanics
Long-term pain relief of shoulder injuries involves rehabilitation of the shoulder, neck, and thoracic spine. Shoulder rehabilitation is achieved by utilizing specific postural adjustments, exercises and specific posture stabilizing methods in order to re-establish proper motion and strength of the shoulder joint. Ongoing strengthening and stretching exercises are used to rehabilitate the musculature of the shoulder to ensure lasting results.

If you suffer from chronic pain, it is worth your while to spend some time figuring out which of any number of factors are contributing to your pain — we will help you explore which combination of therapies will help you heal it. The good news is — you can do it without drugs, and you can get back to the activities you love!

Dr. Niele Maimone, DC is the owner and founder of Align Healing Center in Danville, California. For more information or to set up a consult call 925.362.8283 or visit

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