Oral Appliance Therapy (CPAP Alternatives) For Snoring & Sleep Apnea


Oral appliances (OA) that treat snoring, obstructive sleep apnea, and upper airway resistance syndrome are devices worn in the mouth similar to sports mouth guards or orthodontic retainers. They are made of plastic and fit partially or completely within the mouth. Currently there are over 40 different professional types of oral appliances available. Oral appliances may be used alone or in combination with other means of treating sleep apnea, such as weight management, surgery and CPAP. There is no one particular appliance that will work for every patient. Our dental providers here at the Center for Sleep Medicine have specialty training in this area. Both Dr. Sosenko and Dr. Schwarz are Diplomates of the American Academy of Dental Sleep Medicine, one of the most highly respected dental organizations dedicated to improving quality of lives of those suffering with snoring and obstructive sleep apnea issues.

Indications for use of an OA

  • Primary snoring/Mild OSA
  • Moderate / Severe OSA who are intolerant or refuse CPAP ( as set forth by the American Sleep Disorders Association)
  • Poor tolerance of nasal CPAP
  • Poor surgical risks
  • Non-successful UPPP surgery
  • Use of appliance during travel

Which appliance is best for me?

As specially trained dentists in the treatment of obstructive sleep apnea and oral appliance therapy, our team considers many factors before choosing which appliance maybe best suited for each individual. After your primary care physician or sleep physician confirms your diagnosis and decides that you are a candidate for oral appliance therapy, our team begins with a very comprehensive examination of your oral cavity. Along with evaluating your sleep test results and oral examination, we discuss your oral cavity anatomy, your specific lifestyle factors and your sleeping habits to help decide which device would be best suited for you.

The most common category of oral appliances include:

MRD - Mandibular Repositioning Device

  • A more commonly prescribed appliance.
  • It repositions and stabilizes the lower jaw, tongue, soft palate, and uvula.
  • It increases the muscle tone of the tongue.

A second type of oral appliance:

TRD - Tongue Retaining Device

  • This device advances the tongue and actively holds the tongue forward to open airway and preventing it from falling backward and blocking the airway.
  • These devices are most useful in patients with large tongues, Poor dental health, no teeth, and chronic joint pain.
Over-the-counter night mouth guards for snoring and apnea are not recommended.

Most importantly, many who try boil and bite devices may be masking obstructive sleep apnea (OSA), a life threatening condition in which a person stops breathing repeatedly through the night. Unsupervised wearing of these devices can lead to permanent side effects including: permanent dental damage, tooth movement, and jaw problems. Due to its non-professionally supervived process, the potential for failure is high, discouraging treatment with professionally fitted and custom-made Oral Appliances. Please be cautious of such brands as: Pure sleep, snore guard, zsleep, snore eliminator.

Samples of FDA approved Professional Oral Appliances for Snoring and Obstructive Sleep Apnea

SomnoDent Appliance

The SomnoDent features medical grade stainless steel screws on the side of the appliance to provide incremental levels of jaw advancement. This optimizes the effectiveness and comfort-level of treatment, as the jaw is moved only as far as is required to alleviate snoring and OSA.

SUAD Appliance

The SUAD appliance is similar to the Herbst, but has an internal metal framework which prevents fracture of the acrylic. It is well suited for those that grind often at night or who have other devices that have broken.

Thornton Adjustable Positioner (TAP® 3 appliance)

The TAP®3 fits over the teeth similar to a mouth guard and advances the jaw forward during sleep. The TAP3 is similar to the TAP appliance without the adjustment device extension.

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