Oral Appliances for snoring & sleep apnoea

What are Oral Appliances and how do they work?

Oral appliances or MAS devices are custom made devices that fit accurately over the upper and lower teeth. They are aimed at repositioning the lower jaw, tongue, soft palate and uvula in a forward direction. They help prevent collapse of the tongue and soft tissues in the back of the throat by stabilising the lower jaw and tongue and increasing the muscle tone of the tongue. These keep the airway open during sleep and promote adequate oxygen intake.

Custom made oral appliances are far superior to generic devices that can be bought over the counter or online. These prefabricated appliances can be bulky and more difficult to continue wearing. The custom made oral appliances are far more reliable and successful in treating sleep apnoea and snoring. Further treatment needs to be carefully monitored and usually a repeat sleep study is required to determine the success of the therapy.

This video features an animation that shows how an oral appliance can prevent the tongue from obstructing the airway and describes the different ways these appliances can open the airway.

Who are oral sleep appliances suitable for?

Oral appliances are well suited for

• Those diagnosed with a primary snoring or upper airways resistance syndrome
• Those who have been diagnosed with a mild to moderate Obstructive Sleep Apnoea (OSA) who prefer it to Continuous Positive Airway Pressure (CPAP) or unable to use positional therapy or weight loss to control their apnoea
• Those with a diagnosis of severe OSA if they cannot tolerate CPAP therapy.

NOTE: Patients with severe OSA should always trial CPAP before considering oral appliance therapy. CPAP is the gold standard of treatment as it can reduce apnoeas to 0.

Only a dentist trained in dental sleep medicine can then provide treatment with oral appliance therapy.

The benefits of oral appliance therapy over CPAP include:

• Ease of use – oral appliances are easy to wear and it takes only a few weeks to adjust to it. The comfort encourages patients to continue wearing the appliances for longer periods of time compared to CPAP
• Small and easy to transport – Oral appliances are discreet, quiet and portable so making it easy to travel with. Unlike CPAP, oral appliances are small enough to fit into your purse or carry-on bag, and are suitable for situations like camping when there is no electricity.
• Treatment with oral appliances is reversible and non-invasive

Side effects of oral sleep appliances

• Excessive salivation
• Dry mouth
• Tooth and jaw discomfort
• Temporary bite changes

However, most of these side effects are minor and resolve quickly on their own or with minor adjustment to the appliance.

Some patients experience potential complications such as jaw pain, permanent bite changes and TMJ symptoms. These complications can be recognized and managed by dentists trained in dental sleep medicine.