What Is Oral Appliance Therapy?
Oral appliance therapy treats obstructive sleep apnea. In obstructive sleep apnea, your airway collapses during sleep. That’s because the muscles that support the airway relax at night, and gravity pulls your airway closed.
Oral appliance therapy uses a device in your mouth to keep the airway open during sleep. They are typically prescription appliances that are custom-made for you. Because they hold your airway open at night, they can also reduce or eliminate snoring while treating sleep apnea.
Who Is a Candidate for Oral Appliance Therapy?
Oral appliance therapy is recommended for people who:
- Have obstructive sleep apnea, and
- Their sleep apnea is mild to moderate, or
- Their sleep apnea is severe, but they cannot adapt to CPAP
People with mild to moderate obstructive sleep apnea can get insurance to cover their oral appliance as a frontline treatment. If you have severe sleep apnea, your insurance company will want you to try CPAP first.
Types of Oral Appliances
There are several styles of oral appliances that Dr. Berry can use to treat your sleep apnea. He will help you find the appliance that works best for you. It’s important to understand that not all oral appliances have been proven equally effective. In addition, insurance companies generally only pay for oral appliances with highly documented effectiveness.
Mandibular Advancement Devices (MADs)
The mandibular advancement device (MAD), sometimes called a mandibular repositioning appliance (MRA) or a mandibular advancement splint (MAS), has the best-proven success rate. This dental splint works by moving your jaw forward. Since your jaw is the primary bony support for your airway, this keeps your airway from collapsing. This is the only type of oral appliance covered by most medical insurance. The MADs Dr. Berry offers include the SomnoMed, the Herbst, and the TAP 3 appliances.
Epigenetic Devices
Poor jaw and airway development contribute to sleep apnea risk for many people. Some devices use principles similar to orthodontic treatment to attempt to reshape the jaw and airway. The goal is to reduce or eliminate sleep apnea to effectively “cure” obstructive sleep apnea.
Although there are a few promising studies, there needs to be more evidence that these devices work as intended. Insurance does not generally cover them, and Dr. Berry does not offer them.
Tongue Retaining Devices
The tongue is often the culprit in airway collapse, so some oral appliances target it. Called a tongue retention device (TRD) or tongue stabilizing device (TSD), this device tries to keep the tongue from falling backward. The devices use several strategies to hold the tongue, including suction bulbs, prongs, bars, or other structures to control the tongue’s position.
Dr. Berry offers a TRD, but in our experience, the device is not well tolerated because it creates a strange sensation that makes it hard to sleep. In addition, insurance only generally covers this type of device because it has limited proof of effectiveness.
Hybrid Devices
A hybrid device is both an oral appliance and a CPAP mask. By repositioning your jaw, this appliance lets you get effective treatment with a lower CPAP pressure, which can reduce side effects like swallowing air. Plus, the oral appliance provides stability with no need for straps to hold a mask in place. Dr. Berry offers the TAP-PAP hybrid appliance.
Benefits of Oral Appliance Therapy
Although most people are prescribed CPAP for their sleep apnea, many find oral appliance therapy is the best treatment option. That’s because oral appliance therapy offers many benefits:
- Highly effective: Studies conclude that oral appliance therapy is as effective as CPAP for most people with sleep apnea.
- Greater comfort: CPAP masks can be very uncomfortable. The mask and its securing straps can lead to skin irritation, breakouts, rashes, and more. In addition, some people find that wearing a CPAP mask can feel smothering, especially if it is set to high pressure.
- Easy to use: Oral appliances are very easy to use. Simply put the appliance into your mouth before going to bed. If you’ve worn a sports mouthguard, orthodontic aligners, or teeth whitening trays, it’s very similar. CPAP machines must be assembled each night and may have special reservoirs to fill and equipment to adjust nightly.
- Easy to care for: Oral appliances require little care. A daily rinse, occasional brushing, and an occasional soak are all required. CPAP requires daily disassembly and cleaning.
- Low cost: Like CPAP, oral appliance therapy is covered by most insurance. In addition, based on insurance reimbursement schedules, oral appliance therapy costs less over time than CPAP. This can make a big difference if you pay out of pocket or have a high deductible.
Because of these benefits, most people who have tried both treatments prefer oral appliance therapy to CPAP.
Get Relief with Oral Appliance Therapy in Denver
Getting a sleep apnea treatment that works for you is literally a matter of life and death. If CPAP is not right for you, seek an effective alternative: oral appliance therapy. Denver sleep dentist Dr. Kevin Berry can help. Please call (303) 691-0267 or use our online form to request an appointment at the TMJ Therapy & Sleep Center of Colorado.
