Oral Appliance Therapy

What is an Oral Appliance?

Oral appliances are simple in how they function as sleep treatments. An oral appliance keeps the airway open by keeping the lower jaw and tongue from falling back and blocking the airway. This is similar to the “head tilt, chin lift” procedure taught in CPR classes. While there are many appliances on the market, they all basically do the same thing, keep the airway open by preventing the jaw from falling back.


Oral appliances are made out of a variety of materials, most being adjustable. The sleep treatment appliance being adjustable is important so that an effective jaw position can be found. In our offices, patients are routinely scheduled for follow-up sleep studies, during which the appliance can be adjusted by the sleep technician to ensure that the appliance is working as well as possible.

Types of Oral Appliances

ELASTIC MANDIBULAR ADVANCEMENT (EMA)


One of the most comfortable of the oral appliances for sleep treatments of sleep apnea and snoring. It is made with a very thin and comfortable material, along with elastic bands that allow for a good range of motion; with the ability to easily speak and drink while the appliance is in place.


The EMA can be adjusted by using different lengths of bands. The bands also come in different densities, which allows for a custom, comfortable fit.

MEDICAL DENTAL SLEEP APPLIANCE (MDSA)


A safe and effective treatment for snoring, and mild to moderate sleep apnea. The laboratory made MDSA holds the jaw and tongue forward and prevents the throat from collapsing during sleep.


The MDSA is scientifically proven as an effective method for treating snoring and mild to moderate sleep apnea. The MDSA is an alternative therapy when other treatments that involve nasal CPAP or surgery are not accepted.

SOMNOMED (DORSAL)


A relatively new appliance on the market. Its strong point is the fact that it is very smooth and comfortable. It is unique in that the upper and lower component of the appliance are not connected, as with other appliances. This allows for full opening of the mouth. The SomnoMed can also be adjusted.

Sleep Apnea is a serious medical concern. Find out how we can help!

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Frequently Asked Questions

  • If I snore, do I have sleep apnea?

    Snoring frequently accompanies sleep apnea but it is not always an indicator of whether this sleep condition is present. However, snoring can indicate that bulky throat tissue could potentially obstruct airways – especially if patients have certain lifestyle factors that contribute to sleep apnea. Fortunately, the treatment we offer for sleep apnea and snoring is the same. By prescribing a custom oral appliance, the diameter of the airway can be widened to prevent the sounds of snoring as well as episodes of apnea. These oral appliances are soft and comfortable to wear. They work by positioning the lower jaw slightly forward so that the airway is no longer obstructed.

  • Is it possible that I have sleep apnea even if I don't snore?

    Anyone of any age can have sleep apnea. Even though snoring can accompany sleep apnea, it is not always a symptom of this sleep disorder. For this reason, it is important to have a sleep study conducted to determine if apnea is occurring. Our practice provides take-home sleep study machinery to detect episodes of apnea during sleep. After usage, the device will be returned to our practice and we will analyze the data collected. If we find that sleep apnea is present or determine if snoring is obstructing one’s quality of life, we will provide treatment recommendations.

  • What causes sleep apnea?

    The exact cause of obstructive sleep apnea (OSA) is different for each person. Anyone can develop it, regardless of age or gender. The most common risk factors include:

    • Being over age 40
    • Having a large neck (over 17 inches in men, 16 inches for women)
    • Being overweight – approximately half of OSA sufferers are overweight
    • Being male – more men than women suffer from OSA
    • Having a large tongue or small jaw
    • Enlarged tonsils and adenoids (particularly in children)
    • Using alcohol or sedatives which relax the muscles in the airway
    • Nasal obstruction due to a deviated septum or sinus and allergy problems

  • What is the difference between a CPAP and an oral appliance?

    While CPAP is very effective in treating sleep apnea, many people cannot tolerate the discomfort of  the mask and the inconvenience and noise of the machine. Therefore a high percentage of users have difficulty or will not wear them.  


    An oral appliance is a popular alternative to the CPAP. This device is small, portable, fits more comfortably and can provide similar treatment benefits.

  • How do you confirm the effectiveness of the oral appliance?

    You will have a follow-up sleep study while using your oral appliance to confirm the effectiveness of the device. A consultation with the sleep medicine physician will be necessary to interpret the results.

  • Does insurance cover sleep apnea treatment?

    Because insurance plans vary widely, our experienced team will work with you to see if your insurance company will cover the oral appliance. If for any reason it isn’t covered, we will let you know and work with you to develop a financial plan if needed.


    If coverage is available for oral appliances, it will come from your medical insurance carrier. Most dental insurance companies do not cover treatment of obstructive sleep apnea.  


    Our patients tell us it is well worth the investment of their time and money to treat their sleep apnea because of the improved quality of life they experience.

  • How long will it take to adapt to the oral appliance? Will it hurt my teeth?

    The majority of patients will adapt to the appliance within 5-10 days. It will take a few days to get used to having a device in your mouth while you sleep. The appliance will not hurt your teeth. If your teeth are sore after initial use, we can easily adjust it for your comfort.

  • How often will the appliance need to be replaced?

    They are made of hard acrylic, which is very durable. They are typically replaced every 3-5 years depending on wear and tear. If you grind your teeth, you may have a more frequent rate of repair or replacement.

  • Will the appliance change my bite?

    A change in your bite is possible. Depending on the position of your teeth and the status of your bone, your teeth may shift. Whith our experience we've minimized the risk of tooth movement dramatically, and the risk can be minimized further with the use of a morning re-positioning device.

  • Are there any side effects of the appliance?

    The most common side effect is morning muscle soreness that usually goes away after a short time. Some patients may experience either dry mouth or excessive salivation. As mentioned above, minor tooth movement occurs in some patients but is rare when the treatment plan and instructions are followed.

  • How long will I have to use the oral appliance?

    Obstructive sleep apnea is unlikely to decrease with age; therefore your oral appliance will probably be a lifelong therapy. However, certain wellness factors such as significant weight loss may improve your symptoms.

  • Can’t I just order a boil and bite device off the internet?

    While there are over-the-counter appliances you can order, keep in mind these are not FDA approved for treating sleep apnea. Additionally, when not fitted properly they may cause unwanted side effects such as jaw problems or excessive tooth movement.