The Department of Dental Surgery of the Division of Human Medicine at the University of Göttingen has achieved success against snoring with a novel therapeutic approach. Using a so-called oral vestibule plate with a pressure indicator, patients can train to keep their lips closed and thus create negative pressure in the oral cavity by swallowing. This “parks” the tongue in a special position and reduces snoring. So far, several hundred patients have been treated with the method in different treatment centers. “About 80 percent showed an improvement in snoring symptoms,” said Prof. Dr. Wilfried Engelke of the Department of Dental Surgery.
Train to keep lips closed
With each swallowing process, the base of the tongue is brought into firm contact with the soft palate; this interrupts snoring and expands the pharynx, making voluntary snoring impossible. The contact between the soft palate and the base of the tongue acts as a kind of valve, so that the tongue adheres to the hard palate in a similar way to wearing a full prosthesis. This process is repeated reflexively with every swallow, even unconsciously during the night.
The oral cavity represents a hydraulic system during swallowing. Only when the lips are closed can a negative pressure be created that stabilizes the tongue and the soft palate. How long the valve mechanism acts after swallowing, only a few seconds or many minutes, depends on whether the hydraulic system oral cavity is closed or open.
The new and simple therapy principle involves patients training to keep their lips closed and create negative pressure in the oral cavity by swallowing through an oral vestibule plate with a pressure indicator. In this way, the naturally existing swallowing reflex can be used to achieve the desired stabilization of the tongue and soft palate. With each swallow, the tongue and soft palate are stabilized again with the exercise treatment not just for a few seconds, but for several minutes until the next swallow.
Surgery unnecessary
In many cases, the concept eliminates the need for surgical treatment, such as shortening the soft palate or removing mucosa from the throat. Before treatment begins, it is possible to check what effect is achieved by changing the position of the tongue during swallowing. During the therapy, an X-ray or an endoscopic examination can be used to determine whether sufficient widening of the airway can be achieved. In the positive case, the patient receives a device for home exercises.
The exercise treatment lasts several weeks and is performed at home. It consists in wearing a soft plastic splint with pressure indicator in the oral vestibule for two hours. The aim is to train a physiological tongue rest position, the “tongue park position” after swallowing, and to stop any mouth breathing that may be present.
The splint is also worn at night after a familiarization phase. Once the patient has trained the “tongue park position” after about six to eight weeks, nighttime wearing is often no longer necessary. A custom splint can support longer-term nighttime therapy, which is sometimes necessary.
