Oral Appliance for Sleep Apnea Dental Device Therapy

Sleep Apnea Oral Appliances & Dental Devices

Treatment Options for Sleep Apnea – Oral Appliance Therapy. “Sleep Apnea Mouth Device”

Summary: Oral appliance therapy, also known as mandibular advancement device or splint (MAD, MAS) for the treatment of sleep apnea and snoring. American Sleep Association oral appliance

There are several treatment options for sleep apnea. One of the options is the oral appliance. Also called Jaw Advancing Device (JAD) or Mandibular Advancement Device (MAD), these sleep apnea oral appliances are custom made by dentists using a plastic-like mold to form to the specific shape of the patients teeth and mouth. Not only do they work against sleep apnea, they are also effective to stop snoring.


ASA SOMNODENT FUSION TYPODENT sleep apnea oral appliancesomnodent sleep apnea mouth guard device 2

How Does the Sleep Apnea Oral Appliance Work?

Sleep apnea oral appliances work by moving the jaw forward, which increases the size of the upper airway, thus reducing the air resistance that leads to sleep apnea and snoring.

Oral appliances for sleep apnea are often used as a substitute for CPAP or sleep apnea oral surgery. It is often used in conjunction with weight loss if the individual is overweight. Sleep apnea mouth guards are anti-snoring devices. They reduce airway turbulence and stop snoring.

These custom sleep apnea mouthpieces, often called by the general public, ‘sleep apnea mouth guards’,  are often most effective in sleep apnea patients who have mild or moderate obstructive sleep apnea.

Sleep physicians often recommend a sleep study before a snoring mouthpiece is recommended (to determine the diagnosis), and after the oral appliance is used (to determine if it is effective).

sleep apnea oral appliance dental device
sleep apnea oral appliance dental device

Benefits of Oral Appliance Therapy for Sleep Apnea

  • Improved compliance of therapy compared to other treatments for sleep apnea
  • Compact and portable – device can fit in a pocket
  • Discreet – device is not visible to bed partner when mouth is closed
  • Immediate response – most patients see improvement on the first night
  • Energy conservation – the device does not use any electricity. You don’t have to plug the device into a wall to function.

Consequences of Oral Appliance Therapy

Some sleep apnea patients who use oral appliances experience TMJ or temporal mandibular joint arthritis or arthralgia (pain). Others report an unusual sensation shortly after removing the device in which they have difficulty bring their teeth together in the usual position. Some patients experience teeth shifting after prolonged use. Occasionally orthodontic care is required to normalize the teeth positioning.

Although there are several businesses that sell oral appliances on the internet, it is important that your sleep physician, primary care doctor, and/or dentist approve the appliance, as many of the over-the-internet ‘boil and bite’ mouth pieces for sleep apnea are not effective.

The oral appliance is one of several cpap alternatives.  The mouth guard is sleep apnea treatment without cpap.
There are several alternatives to cpap. These dental appliance for sleep apnea are sleep apnea dental devices. Sleep apnea dental appliance are not suitable for all patients. Sleep apnea dental devices are generally more effective in mild – moderate sleep apnea cases.

Sleep Apnea Devices
Sleep Apnea Devices

How much do sleep apnea oral appliances cost?

This depends on the type of the snore mouthpiece. The average cost for a sleep apnea mouth guard is estimated at $1800 – $2000. This includes the actual mouthpiece, dentist visits, adjustments, follow ups and modifications to the dental device. Most health insurance companies and Medicare cover sleep apnea oral appliances.

Review of snore guards, and anti snoring mouth guards and American Sleep Association oral appliance are found on the related links above.

Do Dental Appliances Work for Sleep Apnea?

Yes, some dental appliances are effective for treating sleep apnea and snoring. Although CPAP is more popular for the treatment of OSA, dental appliances are becoming more common as new research solidifies their efficacy in treating mild-moderate sleep apnea and snoring. It is important to work with your doctor and dentist to find an appropriate device for you. Follow care is imperative to insure that the treatment is working.

Problems with Sleep Apnea Dental Devices

One of complaints with sleep apnea dental devices is that they are difficult to monitor compliance. Most new CPAP machines have tracking software which shows the patient and the healthcare providers the amount of hours of use and the presence of persisting respiratory events. Because of their size, sleep apnea mouthpieces are not able to contain the same amount to technology that a CPAP device contains. There are some new mouth devices that are made with microchips that are able to measure the amount of hours of use.

Another reported problem with sleep apnea oral appliances is that they have a limited life expectancy. They are not designed to last forever. Many are only effective for a year or two before the materials weaken and the appliances loses efficacy.

sleep apnea oral appliances and dental devices
sleep apnea oral appliances and dental devices

How do you get a sleep apnea oral appliance and dental device?

The first step to getting any sleep apnea treatment device is talking to your doctor. Some are candidates for certain sleep therapies while others are excluded because of medical history or anatomy. Discuss your symptoms with your healthcare professional. If warranted, a sleep study might be ordered. If a diagnosis of sleep apnea is made, treatment options for OSA will be discussed. If a dental device is indicated, you will be referred to a dentist who specializes in treatment of sleep disordered breathing. The dentist usually takes an impression (a mold) of the teeth bite – called a bite registration. A reproduction of your teeth is made of plaster. With your teeth model, a sleep apnea oral appliance is designed.

With the increase in supply of manufacturers and qualified dentists, sleep apnea oral appliances (Oral Appliance Therapy) have become a popular treatment for sleep disordered breathing and snoring.

33 Replies to “Oral Appliance for Sleep Apnea Dental Device Therapy”

  1. Andrew Rappaport

    Will these oral appliance’s also take care of grinding one’s teeth? I currently wear retainer to stop this and hopefully these appliance’s can kill two birds with one stone? Also, do these appliances need to be replaced or can one last a lifetime?

    • George Markle DDS

      Yes, most sleep apnea appliances eliminate the need for a nite time grinding mouth guard or splint. The stone does kill two birds. Check with your dentist to confirm.

    • George Markle DDS

      By comparing a pre-appliance sleep study with a post-appliance sleep study. Symptoms of sleep apnea should also decrease if the applianc e is working.

  2. denise sandford

    I have a tough time removing my top portion of my device. It feels like it’s stuck. And as its coming off, it feels like it’s going to rip my teeth out with it. Is this how it’s sposed to be.

    • carolyn CAMPBELL

      I have had my device for only three weeks. I must say I did not have much confidence in it at all. We did the impressions dr. answered all my questions and concerns I ask. Took about 3 weeks to receive. Dr. had me put the OSA in my mouth and I thought how will I keep this in my mouth all night. (first night)I must say it was so easy and it did just what the Dr. said it would do. My husband said I did not snore, I slept all night , no tossing and turning and waking each turn, no dreaming, that was great because some were not good dreams. I want to tell you I tried about (6) different mouth pieces with the apna machine you have to wear on your face. I gave up and took the machine back and told them I was getting less sleep with it than I was without wearing it. Could not keep it on more than 4 hours . You have to try to become a believer and I am now a believer, sleeping, no snoring , no waking every time I move and no dreaming. This works.
      Carolyn Campbell

      • Jane Chisholm

        Hi Carolyn, Does your jaw hurt and have you noticed any moving of your teeth? Please contact me as I really don’t want to use a CPAP!

  3. Tom Merten

    Denise Sandford: I had the same problem with the top part of my telescopic Herbst. I now pry down hard on the front of the top part. When it slides down, I then pry down on the back part. The top piece is now free and the bottom component pops out easily.

  4. Kathy Craig

    My sleep apnea is there I stopped reading 70 to 80 times an hour. I have done to overnight sleep studies but have difficulty tolerating the quantity of air necessary to help me. I’m looking for an oral appliance that is useful for severe sleep apnea is there one? My medical coverage through Kaiser says there is not

    • Julia T.

      The air pressure I must use to be in compliance is high. I found that working with my sleep center through my doctor allowed me to try different masks and headgear to find what worked for me. It took a little trial and error, but with the help of my RT, found the perfect combination of headgear, mask and heated humidity that allows me to sleep a full night and be comfortable. Also, the newer machines have ramping that allows the pressure to slowly increase and let your respiratory system slowly get used to the pressure over a period of time. I personally don’t need to use but it is very helpful for some patients. If it is still uncomfortable, make another appt with your dr. Hope this helps you.

  5. Jim Fisher

    I suffer from acute sleep apnea and will stop breathing for up to 90 seconds at a time. I have the c pap machine gave me a runny nose all the time so I had a mandibular splint fitted. I have been using the mandibular splint for almost 20 years now and it is very successful.

  6. Amy Bennett

    I already have issues with slight TMJ. Is it wise for to consider get an oral appliance for snoring if this will only aggravate the problem?

  7. JoAnn Stewart

    I had a mouth guard–after almost a year no matter what I cleaned it with it still had a offensive taste and smell. I would like to get another one that medicare will pay for. info please



    • Peggy S.

      Hi Bobbie,

      I have a Herbst Adjustable mouthpiece and love it. I tried a number (quite a few) cpap masks and just could not get used to them. I could fall asleep, but after about 4 hours I would rip them off in my sleep.

      Medicare and my co-insurance covered my entire charge. It was wonderful. But my sleep is what is wonderful. My oral appliance has really made a difference and for that, I am thankful.

  9. E Hubble

    I have had the Moses dental device for sleep apnea. I am seeing a dentist that specializes in sleep apnea. She said my tongue is too large for my mouth & I have a narrow trachea so a c-pap wouldn’t help me. It has cost me over $4,000 & it doesn’t work in spite of numerous adjustments. My teeth “pop” apart during the night & it wakes me up. I was told Medicare didn’t pay for dental devices nor does my secondary insurance, Tricare. I found out they sent the bill to Medicare without a billing code since they knew Medicare wouldn’t pay. I feel I have been scammed by the billing dept & they wouldn’t have accepted the amount they would have been paid. Has anyone else dealt with this?

    • cristy

      Medicare and Tricare both cover Oral Appliance therapy. However Medicare specifies which appliances have been approved to issue to their members. They will only pay for those type of appliances. The secondary normally follows suit with primary insurance. The office that made your appliance should have instructed you on which appliance is covered by your insurance, and given you the option to choose to upgrade to a different device (the Moses) appliance and then had you to sign a form called an ABN. You are correct in that your insurance would cover portions of the cost. The office you chose may not be a participating provider with Medicare as well an so does not accept the amount Medicare allows. In this case they are able to bill you for the remaining portion. I would contact the office to see if they show that you signed an ABN, and exactly what they billed to your insurance to see if they can correct the issue. I do know that the last time I checked the Moses is not a covered appliance with Medicare. There are several types of appliance that are covered by medicare and tricare. Narvall, Herbst and Somnomed have appliance that are covered and would most likely work better for you since you are having the issue of popping out of the appliance you currently have. I hope this was helpful sorry you were taken advantage of.

      • John Halpern, DDS

        $4000 for an acrylic sleep appliance? I’m in NYC and charged $800 for one I made recently. The Moses locks you into one position and many people don’t care for that. The two piece design with elastic hinges offers movement and adjustment. There are many similar designs of these. The Silent Night and EMA are examples.

  10. harris ammerman

    I need the name of a dentist in the Washington DC area who will charge the recommended fee of $1800 to $2000 for a replacement somnomed device

    • Frank Kaulback

      I live in Northern Virginia (Fairfax County) – any luck finding a dental practice that is a Medicare provider for oral appliances?

  11. Cassie OConnell

    What if I have sleep apnea, but am a mouth breather, because of sinus and perhaps some seasonal allergies. If my mouth is locked down with the appliance, will this still be an option for me?

  12. Jessica Johnson

    I too am like a previous person who commented… A mouth breather due to sinus and allergy issues… Is there a recommended appliance?

  13. Kirk

    The single biggest issue that I’m experiencing with the Herbst sleep apnea appliance is all my lower teeth are moving forward. The am aligner does nothing to bring back the lower teeth back to original position. Its also a problem with crowned teeth. I had to have an implant placed on a lower moler that moved enough to crack it causing an infection which required removal. I really don’t think some dentists are privy to this. I’m actually considering an attorney to make my point to the manufacturer and dentist. My dentist said the sacrifice of good sleep is moving teeth. We ‘ll see about that. The association’s affiliated with the aforementioned issues better step up otherwise they ‘ll find themselves in suit as well.

  14. julia kaplan

    when you have a sleep study (wheter its through an app or at a lab) once you’ve been wearing your mouthgard piece, then how do you test with or without piece on?

  15. Jane

    I have overbite and cannot protrude bottom jaw outside top jaw. Also have fixed upper plate (4 front teeth) over 35 years old and don’t want to mess this up, as extremely expensive to replace. And severe periodontal disease kept in check through 4 annual visits to periodontist. I’ve had sleep study. One sleep doctor said I had severe obstructive sleep apnea, needed CPAP machine & took me to CPAP sales office in clinic to pay my $1000. I couldn’t breathe through any of the masks, which doctor attributed to nervousness and me to blocked sinuses (he had left by then). Second opinion doctor to read results said he would call it moderate apnea not severe, suggested oral appliance (non-custom as cheaper). Do you think such an appliances would work without damaging my upper plate?

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