What are oral appliances for sleep apnea?
Sleep apnea appliances are custom-made devices you wear in your mouth while you sleep to help reduce obstruction. They offer an alternative to CPAP machines, which work well but aren’t ideal for everyone. Oral appliances can be a good choice for people with mild to moderate obstructive sleep apnea or for those who have trouble using CPAP therapy.
Types of oral appliances for sleep apnea
There are two main types of dental appliances for sleep apnea. One type moves the lower jaw forward. The other focuses on supporting the tongue.
Mandibular advancement devices
Mandibular Advancement Devices, often called MADs, are the most commonly prescribed oral appliances for sleep apnea. They fit over your upper and lower teeth, similar to a mouthguard, and are custom-made for a secure, comfortable fit.
These sleep apnea appliances are adjustable, allowing your dentist to gradually shift your lower jaw into the ideal position. MADs are typically recommended for people with mild to moderate obstructive sleep apnea and for those who prefer a small, wearable alternative to CPAP.
Tongue-retaining devices
Tongue-retaining devices, or TRDs, are another type of oral appliance. Instead of repositioning the jaw, they use a soft suction mechanism to hold the tongue forward during sleep.
TRDs are less common than mandibular advancement devices, but they can be helpful for patients who cannot tolerate jaw repositioning or who have fewer natural teeth to support traditional dental appliances.
Commonly used appliances
Within these main categories, there are specific types of sleep apnea appliances you might come across when talking about treatment or looking up options.
Herbst appliance
The Herbst appliance is a dental device for sleep apnea that uses a special hinge design. It connects the upper and lower parts with small metal bars, letting your jaw move naturally while keeping it slightly forward. This helps reduce airway blockage without limiting jaw movement too much.
One advantage of the Herbst appliance is that it keeps the jaw forward all night, which can help people with mild to moderate sleep apnea.
EMA® appliance
The Elastic Mandibular Advancement (EMA) oral appliance is another popular type of mandibular advancement device. It uses elastic bands and adjustable parts to move the lower jaw forward, while still allowing some flexibility as you sleep.
Because the EMA can be adjusted, it’s easier to set the right amount of jaw movement, making it comfortable and effective for many people.
Aligner Sleep Appliance®
The Aligner Sleep Appliance (ASA) fits comfortably over your teeth, much like a clear aligner. It gently moves your lower jaw forward to prevent airway collapse. This device is slim, comfortable, and often preferred by people who prefer non-bulky designs.
How oral appliances work
Although oral appliances for sleep apnea come in different designs, they all aim to prevent the airway from narrowing or collapsing during sleep.
Mandibular advancement
In obstructive sleep apnea, the muscles in the throat relax during sleep. This can allow the tongue and soft tissues at the back of the mouth to fall backward, narrowing the airway and interrupting breathing.
When a mandibular advancement device gently shifts the lower jaw forward, it also pulls the tongue and surrounding tissues forward. This increases the space behind the tongue and reduces airway resistance. With more room for air to pass through, breathing becomes steadier and nighttime interruptions decrease.
Tongue stabilization
Tongue-retaining devices work differently but target the same problem. Instead of moving the jaw, they hold the tongue in a forward position so it cannot collapse back into the airway.
By preventing the tongue from blocking the throat, these appliances help maintain more consistent airflow throughout the night.
No matter which type is used, sleep apnea appliances are designed to support uninterrupted breathing in a way that feels natural and comfortable.
Custom vs OTC / boil-and-bite appliances
When looking at sleep apnea appliances, you’ll find some that are custom-made by a dentist and others that are sold over the counter or as “boil-and-bite” devices.
Custom oral appliances
Custom oral appliances for sleep apnea are made just for you by your dentist. We take digital impressions of your teeth and jaw during the fitting process. These impressions help us create a device that fits your mouth exactly.
Because they are designed just for you, custom appliances typically:
- Fit more comfortably
- Are more effective at reducing airway obstruction
- Cause fewer side effects like jaw soreness or biting irritation
- Last longer with proper care
Custom devices are especially recommended for people with moderate sleep apnea or for those who haven’t had success with over-the-counter options.
Over-the-counter and boil-and-bite devices
OTC and “boil-and-bite” devices usually cost less and are easy to find. You heat them in hot water and bite down to shape them. While they can be more comfortable and may help with snoring, they aren’t as precise or effective as custom dental appliances for sleep apnea.
For some people with mild sleep apnea, an OTC device might help. But for the best and most reliable results, custom appliances made and fitted by a dentist are the top choice.
The fitting process and what to expect
Many people wonder what the process of getting an oral appliance for sleep apnea involves from start to finish.
Step 1: Consultation and sleep evaluation
Your first step is a consultation to talk about your symptoms and concerns. At Tend, we work with SleepArchitects who offer a sleep study to diagnose obstructive sleep apnea and assess its severity.
Step 2: Digital impressions
If oral appliance therapy is right for you, we take digital impressions or scans of your mouth. This helps us make a custom device that fits you securely and comfortably.
Step 3: Appliance fabrication
Your custom appliance is made in a dental lab with high-quality materials. This process usually takes a few weeks.
Step 4: Fitting and adjustment
When your device is ready, you’ll come back to the office for a fitting. We’ll adjust it as needed so it feels comfortable and works well for you.
Step 5: Follow-up
After you start using your oral appliance, we’ll schedule follow-up visits to make sure it still fits well and gives you the best results. We’ll check your symptoms and make changes if needed.
Many people notice less snoring and better sleep within just a few nights of using their dental appliance for sleep apnea.
Effectiveness of sleep apnea appliances
Oral appliances for sleep apnea work best for people with mild to moderate obstructive sleep apnea. They can lower the number of breathing interruptions and help you sleep better. Research shows that mandibular advancement devices can greatly reduce sleep apnea severity for many people compared to no treatment.
For severe sleep apnea, CPAP therapy is still the most effective treatment. However, some people can’t use CPAP and may still benefit from a dental device, especially when combined with other treatments. Talk with your dentist or sleep specialist to find out what’s best for you.
Caring for your device
Taking good care of your sleep apnea appliance helps it last longer and work better:
- Rinse your device each morning with water
- Brush gently with a soft toothbrush (no toothpaste)
- Soak regularly in a denture cleanser or appliance cleaner
- Keep it in its protective case when not in use
Regular cleaning also helps prevent bacteria buildup and keeps your device comfortable to use.
Insurance coverage and costs
Many medical insurance plans cover at least part of the diagnosis and treatment for sleep apnea, including the sleep study. Coverage for oral appliance therapy can differ. Some plans pay for part of a custom oral appliance if it’s prescribed by a professional. At Tend, we check your benefits ahead of time and can help you understand what your insurance covers.
Final thoughts
Oral appliances for sleep apnea are a comfortable and effective alternative to CPAP therapy for many people. If you have mild sleep apnea, loud snoring, or can’t use other treatments, dental appliances can help you breathe better and sleep more soundly.
At Tend, we work with you and your sleep doctor to find the best solution for you. With custom care, expert fitting, and ongoing support, you can feel confident in your treatment and enjoy deeper, more restful sleep.
Sleep better. Feel healthier.
If you’re wondering if a dental appliance for sleep apnea could help you, schedule a consultation at Tend today. Your path to better sleep begins here.