What sleep apnea is: and why a dentist is involved
Obstructive sleep apnea (OSA) happens when the muscles of the throat relax during sleep to the point where the airway partially or fully collapses. Breathing pauses (sometimes dozens or hundreds of times a night) disrupting sleep and reducing oxygen levels. The most common symptoms are loud snoring, waking unrefreshed, daytime fatigue, and morning headaches.
Dentists don't diagnose sleep apnea, that requires a sleep study and a physician. But once a diagnosis is in place, a dentist trained in dental sleep medicine can play a meaningful role in treatment by fitting a custom oral appliance.
What a mandibular advancement device does
A mandibular advancement device (MAD) looks a bit like a sports mouthguard, but it's custom-made from detailed impressions of your teeth and designed to hold your lower jaw in a slightly forward position while you sleep. That forward posture keeps the tongue and soft tissues away from the airway wall, reducing the collapse that causes apnea events.
Modern MADs are adjustable. Once fitted, we can advance or retract the jaw position incrementally until we find the point that provides the best balance of comfort and effectiveness. Most devices are durable, discreet, and easy to travel with.
Who is a good candidate?
Oral appliances are typically a good fit for:
- Adults with diagnosed mild-to-moderate obstructive sleep apnea
- Patients who have tried CPAP and found it difficult or impossible to tolerate
- People whose primary complaint is snoring rather than documented apnea
- Patients who travel frequently and find a CPAP machine impractical
They're generally not the first recommendation for severe OSA, for central sleep apnea, or for patients with significant jaw joint issues. We'll review your history and your physician's notes before recommending an appliance.
The fitting process
Getting fitted for a sleep apnea appliance is straightforward and involves no drilling or permanent changes:
Review of your diagnosis and medical history
We'll ask to see your sleep study results and any notes from your physician or sleep specialist. This lets us understand the severity of your apnea and confirm that an oral appliance is clinically appropriate.
Impressions and bite registration
We take precise impressions of your upper and lower teeth, along with a bite registration showing how your jaws relate to each other. These are sent to a dental laboratory that fabricates the appliance to your exact anatomy.
Fitting and initial adjustment
When the appliance arrives, we fit it carefully, make any necessary adjustments for comfort, and set the initial jaw advancement position. We walk you through insertion, removal, and cleaning before you leave.
Follow-up and titration
Over the following weeks, we see you back to fine-tune the advancement. If you have a follow-up sleep study, those results guide the titration further. We communicate with your physician or sleep clinic as needed.
Ongoing follow-up
Sleep apnea management isn't a one-time event. We recommend check-ins every six to twelve months to assess the condition of the appliance, monitor for any changes in your bite (which can occur with long-term wear), and confirm that your treatment is still working for you. If your symptoms change or worsen, a repeat sleep study through your physician is the right next step.
Thinking about related concerns?
If nighttime grinding is also a factor for you, our page on night guards is worth reading alongside this one. And if you're looking for a new dental home or want a comprehensive check-up first, start with general dentistry.
Want to discuss whether an appliance is right for you?
Book a consultation and bring any sleep study results or physician notes you have. We'll review what's there, explain what we can offer, and tell you honestly if we think an oral appliance is likely to help.