Sleep Apnea Mouthpieces as a CPAP-Free Oral Appliance Therapy
Oral Appliance Therapies present useful alternatives to sleep apnea machines (CPAPs), especially for patients with simple snoring and patients with obstructive sleep apnea that cannot tolerate CPAP therapy.
A Mandibular Advancement Device (MAD) is an oral appliance for sleep apnea that treats snoring and other sleep apnea related symptoms by moving the lower jaw forward slightly, tightening the soft tissue and muscles of the upper airway to prevent obstruction of the airway during sleep. The tightening created by the device also prevents the tissues of the upper airway from vibrating as air passes over them – the most common cause of loud snoring.
There are three functional classifications of oral appliances: tongue-retaining appliances, mandibular repositioning appliances and combination oral appliance with CPAP. Additionally, there are several design variations including the method of retention, flexibility of material, adjustability, vertical opening, freedom of jaw movement, and construction in the laboratory or office.
Considerations of Non-DNA Oral Appliances for Sleep Apnea
• Occlusal changes can occur with mandibular repositioning appliances.
• Most changes appear to be of a minor nature, and of little concern to patients, but some
patients can exhibit changes that are detrimental to their occlusion
• Changes do not appear to be directly correlated to the degree of protrusion, age, gender or
• Regular dental reviews are recommended with on-going treatment
The American Academy of Sleep Medicine indicates oral appliances for sleep apnea when patients have mild to moderate obstructive sleep apnea and prefer oral appliances over CPAPs. The American Academy of Sleep Medicine also recommends oral appliances for those patients who do not respond to, are not appropriate candidates for or who fail treatment attempts with CPAP.