Dental appliances for sleep apnea: do they work? – Harvard Health Blog


Want to keep your partner (or yourself) up at night with loud snoring? This can be more than a nuisance. Approximately 25% of men and almost 10% of women have obstructive sleep apnea (OSA), a severe sleep disorder characterized by explosive snoring, growling, and blowing. Tissues in the back of the throat temporarily clog the airways, causing respiratory pauses (apneas) throughout the night. OSA not only leaves people tired and dazed, but also puts them at risk for many health problems such as high blood pressure, depression and heart disease.

The most effective and best studied treatment is positive airway pressure (PAP), a small night machine that blows air through a mask to prevent the airways from collapsing. But people with mild to moderate OSA sometimes find PAP difficult and often difficult to use wonder about alternatives. Dental devices (also known as oral appliances) are an option for some people. But do your homework before you go down this path, warns Sogol Javaheri, MD, MPH, MA, a sleep specialist at Harvard-affiliated Brigham and Women’s Hospital.

Who can benefit from a dental device for sleep apnea?

“These devices are supposed to reposition the jaw or tongue to open the upper airway. But they can be really uncomfortable and only work about half the time,” says Dr. Javaheri. It is difficult to predict who may benefit from using an oral device and people with very mild OSA and few symptoms may not notice any difference. As a result, it is generally not recommended except for people with mild to moderate OSA or those with severe OSA who do not tolerate PAP.

Three main categories of dental devices for OSA

Mandibular advance devices. Made of molded hard plastic, these devices fit the lower and upper teeth and also include metal hinges and screws that can be adjusted to push the lower jaw forward. Some dentists make custom mandibular advancement devices, but before you consider buying a custom device, be sure to ask yourself if your dentist has experience with sleep-related respiratory disorders and is certified by the American Academy of Sleep Medicine. Some non-certified dentists simply take a toothpick from you, send it to a company that makes the device, and then sell it to you at a large label, sometimes totaling $ 4,000 or more. Also, it is unlikely to be covered by your dental or medical insurance if used to snore.

Oral protectors. Similar to mandibular advancing devices, these devices also help reposition the lower jaw, albeit to a lesser degree. Some sleep doctors recommend SnoreRx, which you can buy online for less than $ 100. Instead of starting with a tooth impression created by a dentist, use what the company calls the “boil and bite” method. Place the device in a cup of boiling water for one minute, then bite the softened plastic to fit your teeth.

Tongue retention devices. These devices consist of a soft plastic splint placed around the tongue that keeps it forward and out of the mouth throughout the night. They usually make your mouth very dry and can be quite uncomfortable.

Most insurance plans partially cover these devices when used for OSA, but not if used for simple snoring. Don’t be tempted to try a trait that has been formally diagnosed with OSA, says Dr. Javaheri. And even if you have OSA, be sure to call your insurance company to understand how much is covered before you manufacture a device.

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