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.
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.
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.