Oral Appliances for Obstructive Sleep Apnea: The Complete Guide for 2024

Due to the serious health implications of untreated Obstructive Sleep Apnea (OSA), it’s important to find an effective treatment plan that works for your individual needs. While Continuous Positive Airway Pressure (CPAP) therapy is often the most effective OSA treatment option, some find it difficult to tolerate because of the air pressure that is necessary to keep your airway from collapsing while you sleep. If you are diagnosed with mild to moderate OSA and are having a hard time with CPAP therapy, talk to your sleep specialist or sleep medicine dentist about CPAP alternatives like oral appliances.

Mostly confined to those who have mild to moderate OSA, oral appliances for sleep apnea adjust and reposition your jaw or your tongue to help prevent airway blockages and obstructions.

Are you now left wondering, “do dental appliances work for sleep apnea?” In this article, we will dive deeper into what oral dental appliances for Obstructive Sleep Apnea are, the different types of oral appliances, how effective they are, and the benefits and drawbacks. We will also answer some frequently asked questions (FAQs) to equip you with the information you need to talk to your doctor about alternative treatment options.

If you are living with untreated Obstructive Sleep Apnea (OSA), you will likely experience a blockage in your airway due to the muscles in your mouth and throat relaxing while you sleep. The blockage causes a temporary stoppage of breathing, which may result in waking up gasping for air and experiencing poor sleep. If you are living with untreated OSA, you may experience symptoms that affect your day-to-day life, such as daytime sleepiness, difficulty concentrating, headaches, irritability, etc. Untreated OSA can also increase your likelihood of experiencing other serious health conditions like a stroke, high blood pressure, type 2 diabetes, liver problems, and even falling asleep while driving or completing daily tasks.

As an alternative treatment, oral appliances for sleep apnea, which are also referred to as sleep apnea dental appliances, either change your jaw position to create more room in your mouth or stabilize your tongue to help your airway remain open and clear of the obstructions that could lead to stoppages in your breathing.

Sleep apnea dental appliances aim to improve your sleep apnea symptoms by bringing your lower jaw or tongue forward during sleep. This action increases the space in the airway, making it less likely for obstructions to occur.

Mouth appliances for sleep apnea are broken up into three main categories for adults: Mandibular Advancement Devices (MADs), Tongue-Retaining Devices (TRDs), and mouth guards. A Mandibular Advancement Device is a splint that rests over your teeth and slightly slides your jaw forward to create extra space in the back of your throat, keeping your airway open in the process. A Tongue-Retaining Device is an oral appliance that keeps your tongue from falling back and causing a blockage in your airway. Comparable to MADs that move your lower jaw to a forward position, mouth guards don’t move your jaw as far, which does make them the least effective oral appliance.

Your doctor or dentist may recommend a Mandibular Advancement Device if you have mild to moderate sleep apnea. Using molded hard plastics, MADs work by holding your lower jaw in a forward position during sleep.

MADs are often custom-made to fit your mouth. The plastic base typically covers your lower teeth, upper teeth, and gum line and can be tightened to push your jaw farther forward if needed. The device is attached to metal hinges or springs, which allows the lower jaw to move forward slightly.

Related Reading: MyTAP Oral Appliance Review - a Cost-Effective Treatment Option

Your dentist may recommend a Tongue-Retaining Device if you have moderate sleep apnea. TRDs hold your tongue in place through the use of a soft, plastic or silicone device that rests around your tongue. This mechanism prevents your tongue from collapsing and blocking your airway.

Mouth guards go over your teeth and gums while you sleep. They work by holding your lower jaw forward, which prevents your tongue and soft palate from collapsing and blocking your airway.

Mouth guards are less effective than MADs and TRDs, but they may be an option if you can't tolerate a MAD or TRD.

For children with OSA, your dentist or sleep doctor may recommend a Rapid Maxillary Expansion (RME), which is an orthodontic device that expands the roof of your child’s mouth in order to open their airway. With an RME, your provider will fit a custom expander over the back of your child’s teeth, pushing the upper molars outward. Unlike the oral appliances for sleep apnea in adults that are only worn at night, your child will wear the RME at all times to permanently adjust their narrow or arched hard palate. Through RMEs, the hope is to rid your child of sleep apnea in the future by adjusting their mouth anatomy while they are young.

Oral appliances are best for those that have mild to moderate sleep apnea that are struggling with CPAP therapy. The most important aspect of your treatment to remember is that sleep apnea therapy is not one-size-fits-all. Compliance is key, so work with your doctor to test out alternatives for your mild to moderate OSA that will work for you.

Additionally, if you wear dentures or don’t have many teeth, tongue-retaining devices would be the better option for you in comparison to a Mandibular Advancement Device.

Conversely, oral appliances are not a suitable treatment option for those with Central Sleep Apnea (CSA) because those with CSA don’t experience a blockage but instead stop breathing as a result of their brain not telling their lungs to breathe.

Yes, dental appliances do work for treating sleep apnea if you are the ideal candidate, which would be determined by your sleep provider. For those with milder to moderate forms of OSA, oral appliances can treat your sleep apnea by repositioning your jaw and tongue to open up your airway or to ensure your upper airway isn’t obstructed. However, it is often not the most successful sleep apnea treatment option, especially when compared to CPAP therapy.

If you can’t tolerate your CPAP therapy, there are sleep apnea alternatives, like oral appliances, that you can discuss with your doctor, so you can reap the benefits of sleep apnea therapy.

While there are several pros and cons of using oral appliances to treat sleep apnea, these devices boast many benefits for those with mild OSA that would normally benefit from CPAP therapy but are having trouble adjusting to the air pressure. These benefits include:

An oral appliance can be a great option when traveling because it is small and portable. You can easily take it with you when you travel and use it wherever life takes you. For example, if you have a business trip, you can pack your oral appliance in your carry-on bag.

Oral appliances are easy-to-use. You put the device in your mouth and wear it during sleep. There are no cords or tubing, so you don't have to worry about setting up a machine.

Oral appliances are typically custom-made to fit your mouth so that they will be secure and molded to your unique mouth shape. You may experience some soreness when you first start wearing the appliance, but this usually goes away after a few nights.

Oral appliances are basically silent. Therefore, you can wear them without disturbing your partner.

Of course, anything with an upside has some potential downsides, and oral appliance therapy is no different. Here are some possible side effects of using an oral appliance for sleep apnea.

If you use an oral appliance, you may experience dry mouth. To minimize dry mouth, drink plenty of fluids throughout the day and use a humidifier at night. You can also ask your dentist about special oral rinses to help reduce dry mouth.

Alternatively to dry mouth, when you first start using the appliance, your body may produce more saliva than usual. The good news is that this side effect usually goes away after a few nights.

When you first start using an oral appliance, you may experience soreness in your jaw, teeth, or gums. The soreness occurs because the appliance holds your jaw in a new position.

However, it usually goes away after a few nights. However, if the soreness persists, contact your dentist or sleep specialist.

Some people may have difficulty speaking clearly when they first start using oral appliances because it causes their tongues to move differently.

The good news is that this side effect usually goes away after you get used to the appliance.

Here are some frequently asked questions to better understand oral dental appliances for sleep apnea.

The answer to this question is yes, however, it depends on your specific diagnosis, severity, and your doctor’s treatment recommendation. Oral appliance therapy can be an effective treatment for sleep apnea if you have a mild case of sleep apnea.

However, the results of oral appliance therapy can vary from person to person. Some people may experience a significant reduction in their sleep apnea symptoms, while others may only experience a mild improvement. The secret is to work with your doctor to find an appliance that fits well and is comfortable to wear.

Again, the most effective solution differs; one device may work well for one individual but not work well for the other. MADs are often the most effective and are frequently recommended for mild cases of sleep apnea.

The cost varies from one appliance to the next. On average, oral appliance costs between $1,800 and $2,000. However, a range of factors may dictate the price, such as the type of appliance, the complexity of the device, and whether you have insurance coverage.

Therefore, before purchasing an appliance, check with your insurance provider to see if they cover the cost of oral appliance therapy.

If you are looking for an alternative to CPAP therapy, oral appliance therapy may be a good option, depending on your health situation. As we mentioned earlier, oral appliances can be an effective treatment option.

If you are experiencing sleep apnea therapy troubles, consult your doctor to determine which treatment is best for you.

Living with untreated OSA can impact your daily life and lead to other serious health conditions, like high blood pressure, type 2 diabetes, daytime sleepiness, or a stroke. If you are struggling with your CPAP therapy, talk to your doctor about alternative treatment options, like oral appliances.

Oral appliances like Mandibular Advancement Devices, Tongue-Retaining Devices, or sleep apnea mouth guards serve as a potential alternative to CPAP therapy for those with mild to moderate sleep apnea by repositioning your jaw or tongue to keep your airway clear.

Talk to your sleep specialist or sleep medicine dentist about alternatives to customize your sleep apnea therapy to your needs.