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.
How oral appliances work
Oral appliances for sleep apnea are designed to help keep the airway open during sleep. In obstructive sleep apnea, the muscles in the throat relax, allowing the tongue and soft tissues at the back of the mouth to fall backward. When this happens, the airway narrows or becomes blocked, interrupting breathing and lowering oxygen levels during the night.
Oral appliances help reduce these breathing interruptions by gently repositioning parts of the mouth and jaw so air can move more freely through the airway.
Mandibular advancement
One way oral appliances improve airflow is by moving the lower jaw slightly forward during sleep. When the lower jaw shifts forward, it also brings the tongue and surrounding soft tissues forward. This increases the space behind the tongue and reduces the likelihood of airway collapse.
By creating more room for airflow, mandibular advancement helps stabilize breathing and reduce nighttime breathing interruptions.
Tongue stabilization
Another approach focuses on the tongue itself. Tongue-retaining devices hold the tongue in a forward position so it cannot fall backward during sleep.
These appliances typically use gentle suction to maintain the tongue’s position throughout the night. By preventing the tongue from obstructing the airway, they help support steady breathing while you sleep.
Types of oral appliances for sleep apnea
Oral appliances for sleep apnea generally fall into two main categories: mandibular advancement devices and tongue-retaining devices. Both are designed to be worn during sleep and are typically custom-fitted by a dentist to ensure comfort and stability.
Mandibular advancement devices
Mandibular advancement devices (MADs) are the most commonly prescribed oral appliances for sleep apnea. They fit over the upper and lower teeth, similar to a mouthguard, and are custom-made to provide a secure and comfortable fit.
These appliances are adjustable, allowing dentists to gradually modify the jaw position over time to improve comfort and treatment effectiveness. MADs are commonly recommended for people with mild to moderate obstructive sleep apnea and for patients seeking a small, wearable alternative to CPAP therapy.
Several well-known appliances fall into this category, including:
Herbst appliance
The Herbst appliance uses a small hinge system that connects the upper and lower portions of the device. This design allows natural jaw movement while maintaining a stable fit throughout the night.
EMA® appliance
The Elastic Mandibular Advancement (EMA) appliance uses small elastic bands that connect the upper and lower trays. These bands can be adjusted gradually as treatment progresses.
Aligner Sleep Appliance®
The Aligner Sleep Appliance fits over the teeth similarly to a clear aligner. Its slim profile makes it a comfortable option for patients who prefer a less bulky oral appliance.
Tongue-retaining devices
Tongue-retaining devices (TRDs), sometimes called tongue stabilizing devices (TSDs), are another category of oral appliance used to treat sleep apnea. These devices typically sit outside the lips and include a small bulb-shaped chamber that holds the tongue in place during sleep.
TRDs are used less often than mandibular advancement devices but may be appropriate for patients who cannot tolerate jaw-positioning appliances or who have fewer natural teeth to support traditional dental devices.
Examples of tongue-retaining devices include:
Tongue stabilizing devices (TSDs)
These appliances resemble a small, soft bulb or pacifier-like device. The tongue rests inside the bulb while the appliance remains positioned outside the mouth.
Custom tongue-retaining appliances
Some tongue-retaining devices can be custom-fitted by a dentist to improve comfort and stability. These appliances are designed to better match the patient’s oral anatomy.
Hybrid oral appliances
In some cases, appliances may combine elements of both tongue-retaining devices and mandibular advancement devices. These designs aim to support the tongue while also gently moving the lower jaw forward to help keep the airway open.
Custom vs over-the-counter / 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.