TMJ & Sleep Services
Snoring & Sleep Apnea Devices
For patients who have been diagnosed with mild to moderate obstructive sleep apnea or cannot tolerate CPAP therapy, a custom oral appliance may be an option worth discussing with your care team.
Start with your family doctor
Sleep apnea is diagnosed by a physician or sleep specialist, typically through a sleep study, not by a dentist. If you suspect you may have sleep apnea, the first step is to speak with your family doctor, who can refer you for assessment. Once a diagnosis is in hand, we can discuss whether an oral appliance may be an appropriate option for your situation.
What is sleep apnea?
Sleep apnea is a condition in which breathing repeatedly stops and starts during sleep. There are different types, but obstructive sleep apnea (OSA) is the most common form. In OSA, the muscles at the back of the throat relax during sleep, causing the soft tissues to collapse and partially or fully block the airway. This interrupts breathing, often for seconds at a time, and typically causes the person to rouse briefly, sometimes without being aware of it.
These interruptions can occur many times per hour throughout the night, preventing restful sleep and placing ongoing strain on the cardiovascular system.
Common signs and symptoms
Many people with sleep apnea are unaware they have it, the symptoms are often first noticed by a bed partner. Common signs include:
- Loud, persistent snoring
- Gasping, choking, or pausing in breathing during sleep (observed by a partner)
- Waking unrefreshed despite a full night of sleep
- Excessive daytime sleepiness or difficulty staying awake
- Morning headaches
- Difficulty concentrating or memory problems
- Frequent nighttime awakening or insomnia
- Irritability or mood changes
Snoring alone does not confirm sleep apnea, many people snore without having OSA, but persistent loud snoring combined with daytime fatigue warrants a conversation with your doctor.
The role of dentistry: oral appliance therapy
Dentists can fabricate oral appliances, sometimes called mandibular advancement devices (MADs), for patients who have been diagnosed with sleep apnea. These are custom-fitted devices worn during sleep.
The appliance works by repositioning the lower jaw slightly forward, which in turn keeps the airway more open during sleep. This can reduce the frequency and severity of obstructive events and, in many cases, also reduce snoring.
Who is an oral appliance appropriate for?
Mild to moderate OSA
Oral appliances are most commonly used for patients with mild to moderate obstructive sleep apnea. They can be an effective alternative to CPAP in this group and are often preferred for their simplicity and portability.
CPAP intolerance
CPAP (continuous positive airway pressure) therapy remains the standard of care for moderate to severe OSA. However, some patients find it difficult to tolerate, due to the mask, the noise, or other factors. For those patients, and with their physician's involvement, an oral appliance may be considered as an alternative or adjunct therapy.
Severe OSA
For patients with severe sleep apnea, CPAP is the primary recommended treatment. An oral appliance may be discussed only in consultation with the treating physician if CPAP is genuinely not tolerated and all alternatives have been considered.
The referral pathway
If you suspect you have sleep apnea, the appropriate first step is a conversation with your family doctor. They can refer you for a sleep study, which may be done at a sleep clinic or with a home testing device depending on your situation. A diagnosis, and the severity classification, guides the treatment options available to you.
Once you have a diagnosis, contact us to discuss whether oral appliance therapy may be suitable. We will take impressions and fabricate a custom-fitted device. Follow-up with your physician after starting the appliance is important to confirm it is having the intended effect.
Have questions about your treatment?
Call 306.374.7272 or book an appointment.