Are Oral Appliances a Solution for Obstructive Sleep Apnea?

If you are one of many people who suffer from obstructive sleep apnea, then you are probably familiar with Continuous Positive Airway Pressure (CPAP). In fact, many of you say that CPAP has improved your quality of health and life so much that you would never sleep without it. This is not surprising, because research continues to prove that CPAP is still the most effective treatment for moderate to severe obstructive sleep apnea. Unfortunately, studies also show that about half of all people who have CPAP don’t or can’t wear it. If you have worked with your healthcare team but still can’t tolerate your CPAP, what can you do?

CPAP-Intolerance continues to motivate the health care industry to try to find effective alternatives. One treatment gaining attention lately is custom-fitted oral appliances (these are not the same as mouthpieces that can purchased at your local drugstore). To be considered for this therapy, you must schedule a visit with a dentist specializing in treating obstructive sleep apnea. According to the American Academy of Sleep Medicine, oral appliance therapy offers many of the same health benefits as CPAP for people who have mild to moderate sleep apnea.

What is an oral appliance?

There are many different types of oral appliances. They vary in appearance but fall into two main categories:

  1. Mandibular Advancement Devices (MAD):  These devices work because they hold your lower jaw in a protruding (forward) position during sleep. This creates more space at the back of the throat so air can flow freely through.
  2. Tongue Retaining Devices: These devices hold your tongue in a forward position during sleep. This keeps the tongue from falling back into and blocking your airway.

Mandibular advancement devices are oral appliances that are custom-made by a dentist who specializes in dental sleep medicine.  The American Academy of Dental Sleep Medicine compares the fit of an oral appliance to a sports mouth guard or an orthodontic retainer and states that research shows that oral appliance therapy is an effective treatment option for snoring and obstructive sleep apnea.

Can an oral appliance be used in place of a CPAP machine to treat obstructive sleep apnea?

Treatment with oral appliances is more effective in people who have mild to moderate obstructive sleep apnea.  For people with severe sleep apnea or who already wear a CPAP unit, wearing an oral appliance may help you be able to decrease your CPAP pressure level.

What are the advantages and disadvantages of an oral appliance?

Oral appliances are convenient, portable, easy to use and often covered by your medical insurance.  On the other hand, the devices can cause minor side effects such as excessive salivation, dry mouth, and temporary tooth and jaw discomfort.  These complications can be managed by a dentist who is trained in dental sleep medicine.

Are there any people who shouldn’t consider an oral appliance?

While oral appliances are a good option for many people, your dental and medical history will be considered. These appliances may not be the best therapy for people with complex sleep apnea or those with sleep apnea who also have severe lung or heart problems.  People who wear dentures are not a candidate for oral appliances unless they decide to have implants placed to hold their dentures in place.

Next steps

If you are interested in exploring the option of oral appliances and have a diagnosis of obstructive sleep apnea, you should begin a discussion with your physician.  For more information or to find a dentist who specializes in dental sleep medicine, visit the American Academy of Dental Sleep Medicine at http://aadsm.org/.