Sleep Apnea Oral Appliance

If you have been diagnosed with obstructive sleep apnea — a condition in which relaxation of the muscles around the tongue and throat causes the tissues to block airflow to the lungs while you sleep — there are a number of treatment options to discuss with your doctor. Two of the most widely used and most effective are continuous positive airway pressure (CPAP) and dental sleep apnea appliances.

If you have mild to moderate obstructive sleep apnea and can’t tolerate or haven’t been helped by CPAP, oral appliances may be an effective treatment option. These devices, which must be fitted by a dentist, and worn in the mouth at night include:

Mandibular advancement device (MAD). The most widely used mouth device for sleep apnea, MADs look much like a mouth guard used in sports. The devices snap over the upper and lower dental arches and have metal hinges that make it possible for the lower jaw to be eased forward. Some, such as the Thornton Adjustable Positioner (TAP), allow you to control the degree of advancement.

Tongue retaining device. Used less commonly than MAD, this device is a splint that holds the tongue in place to keep the airway open.

For people with mild to moderate sleep apnea, dental devices may improve sleep and reduce the frequency and loudness of snoring. Also, people who can’t tolerate the CPAP machine, usually do better with the oral appliance.

Dental devices have also been shown to control sleep apnea long term compared to uvulopalatopharyngoplasty (UPPP), the standard surgical procedure for apnea, in which the surgeon removes soft tissue from the back of the throat. However, dental devices do have some potential drawbacks, including altered bite, dry lips, and excessive salivation.

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