How Do Oral Appliances Work for Obstructive Sleep Apnea?

Obstructive sleep apnea (OSA) is an increasingly common sleep disorder. OSA is caused by collapsed soft tissue in the back of your throat. When this tissue collapses, it blocks your airway and causes symptoms of OSA.¹

Doctors treat moderate to severe OSA with machines that give continuous positive airway pressure (CPAP) to you while you sleep. These machines can be hard to wear. Many people have trouble tolerating them. Oral appliance therapy may be another option for those with mild to moderate OSA who cannot wear a CPAP machine.¹

What is oral appliance therapy?

This type of therapy uses a dental appliance to keep your airway open. Oral appliances keep your airway open by repositioning your tongue or pushing your lower jaw forward. There are different types of oral appliances.^2-3

Mandibular advancement devices (MADs)

MADs are the most popular type of dental appliance for OSA. They are made of hard plastic. They are fitted to your teeth and push your jaw forward. They can be custom-made by a dentist or ready-made from a manufacturer.²

For a custom-made MAD, a dentist makes a mold of your teeth so the MAD specifically fits your mouth. You may have several visits to make sure the MAD fits correctly. You can also buy a ready-made version called a “boil and bite” MAD. You boil the plastic mold to soften the plastic then bite down on it so it molds to your teeth.^2-3

Tongue-retaining devices

These oral appliances hold your tongue out of your mouth while sleeping. It stops the tongue from falling into a position that blocks your airway. It looks like a splint for the tongue.²

Do oral appliances for OSA work?

These devices can lessen symptoms for some people with mild or moderate OSA. Custom-made MADs tend to be more effective than other types of dental appliances. They can lessen snoring and lower your apnea-hypopnea index (AHI). Your AHI is used to rate how severe your OSA is.⁴

Compared to CPAP machines, dental appliances are not as useful in treating OSA. However, if you cannot use a CPAP machine, using a dental appliance may be a good option.²

Oral appliances do have some advantages. They are small, easy to travel with, and do not need electricity like CPAP machines do.¹

Are there any side effects?

Oral appliances may cause the following side effects:^1,2

• Drooling
• Jaw, tooth, gum, or temporomandibular joint (TMJ) pain
• Loose teeth
• Dry mouth

These side effects often cause people to stop using their dental appliances.²

How do I get an oral appliance for OSA?

If you are interested in a dental appliance for sleep apnea, talk to your doctor. You will be referred to a dentist with special training in OSA. The dentist will evaluate you to decide if you are a good candidate. If so, you will begin the process of making a dental mold for your oral appliance. Expect several visits to make sure the appliance fits you.¹

Oral appliance therapy is only recommended for the following:²

• People with mild to moderate OSA
• Those who cannot tolerate a CPAP machine or do not respond well to it
• Those who prefer oral appliance therapy

Will my insurance cover the cost?

Many health insurance plans will cover at least part of the cost of an oral appliance for OSA. However, you must have an OSA diagnosis. Check with your insurance plan if you are thinking about using a dental appliance for OSA.³