Oral Sleep Appliances

Oral Appliance Therapy

For decades, the standard treatment for sleep apnea was a CPAP machine.  In fact, a CPAP or similar device is the only option sleep physicians can offer besides medications.  And these medications however, only keep you asleep more deeply or for longer; they can’t improve the quality of your sleep.  Many people simply can’t or won’t tolerate a CPAP though, and even now, not many people are aware that oral appliance therapy is an equally effective method to treat snoring and obstructive sleep apnea (OSA). An oral sleep appliance, custom-made by a trained dentist like Dr. Payet, can dramatically improve your sleep quality, thereby restoring your alertness and revitalizing your health.  Please do not try an over-the-counter, generic snore guard or appliance for apnea, as they can cause uncontrolled tooth movement or TMD symptoms. In other words, please don’t try this at home by yourself – let a trained professional make sure the guard is made correctly — you don’t want jaw pain or chipped teeth!

About Oral Appliance Therapy

Oral Sleep Appliances have Two Parts

Worn only during sleep, an oral appliance looks and fits much like custom sports guards or nightguards. There are 2 parts: 1 for the upper teeth and 1 for the lower teeth, and different types use different attachments to position your jaw in a forward position.  As the tongue is attached to your lower jaw, positioning the jaw forward also holds your tongue more forward.  This prevents your tongue from falling back to cover the airway.  It also keeps some muscle stimulus to the neck muscles, stopping them from collapsing together while sleeping, to help maintain an open upper airway. Research shows that oral appliance therapy is an effective treatment option for snoring and obstructive sleep apnea.

Are you a Candidate for an Oral Sleep Appliance?

To find out if an oral sleep appliance is appropriate, you’ll need to complete either an in-lab or at-home sleep test.  These tests typically must be prescribed by a Board-certified sleep physician. Most medical insurance nowadays covers 1-2 day at-home sleep tests, but your physician may recommend an in-lab polysomnogram (sleep study).  Each type has advantages & disadvantages.  If you’re diagnosed with mild or moderate sleep apnea, your doctor may decide that oral appliance therapy is the best treatment option for you. Your doctor will send a prescription to Dr. Payet, authorizing him to make a custom-made oral appliance for you, and Dr. Payet will recommend the oral appliance that is best for you. Oral appliance therapy is typically covered by many medical insurance plans and Medicare, but not by dental insurance.  That’s actually a good thing, since dental insurance doesn’t cover much as it is.

Oral Appliances are for Denture Wearers, too!

While it’s a bit trickier, there are oral appliances to treat patients with sleep apnea, even if you wear complete or partial dentures.  If you wear partial dentures, you do need at least 6 healthy, stable teeth to be a candidate.  If you have 2-4 lower dental implants and a snap-on denture, that’s ideal, but there are options if you don’t.

Combination CPAP & Oral Sleep Appliances

While many people don’t tolerate CPAPs, many do very well with them – Dr. Payet is one of them.  Prior to getting his own ProSomnus Snoring & Sleep Appliance, he was using a CPAP for nearly 3 years.  However, he’s found that his sleep quality is even better by using both the appliance and CPAP.  The reason for this is simple: by positioning his jaw & tongue forward, less pressure is needed from the CPAP to help him breathe, and there’s even less resistance to getting full, deep breaths of air all night long.

Advantages of Oral Appliance Therapy

Oral appliance therapy is an effective, non-invasive treatment that fits easily into your lifestyle. Patients like oral appliance therapy because it is:
  • Comfortable
  • Easy to wear
  • Quiet
  • Portable
  • Convenient for travel
  • Easy to care for

As someone who’s used a CPAP since 2018, Dr. Payet will personally tell you that he hates taking his CPAP on family vacations – as any CPAP user & traveler knows, it’s just a hassle.  You can’t check it, or it’s likely to be stolen, and it’s an extra carry-on to keep up with.  While Dr. Payet prefers using both his CPAP & ProSomnus sleep appliance, he (and his family) do very well on vacation with just the ProSomnus appliance.  Small, light, and effective, he sleeps just fine, and his family doesn’t mind sharing a hotel room with him.  😀

How a Dentist Can Help: The First Visit

Dentists work closely with physicians to treat snoring and sleep apnea. At your first visit, Dr. Payet will talk to you about the risks of sleep apnea & the benefits of treatment. You will also receive information on the potential side effects and the cost of therapy.  He’ll conduct a complete clinical evaluation which will include an examination of your teeth, jaw, tongue and airway, and possibly a new X-ray of your mouth.

Making and Fitting Your Oral Appliance

Dr. Payet uses the 3Shape TRIOS Digital Impression System to make digital impressions of your teeth and bite relationship. The scanned models are sent to a dental lab where your customized appliance is made.  It typically takes 2-3 weeks for your oral appliance to be ready, and you’ll return to Dr. Payet’s office for a fitting where he will adjust the appliance to maximize its comfort and effectiveness. Our team will review how to clean the oral appliance and keep it in good shape. And if at any time you have difficulties, please call our office or email us, as we’re committed to ensuring your success at getting terrific sleep with your new appliance.

You may find that these jaw exercises help in adapting to wearing your new sleep appliance.

Follow-Up Visits

Follow-up visits with Dr. Payet and his team will be scheduled, as it’s normal to need adjustments to maximum effectiveness and comfort.  Dr. Payet also recommends at least annual assessments. You’re always welcome to bring your oral sleep appliance for your routine dental check-ups, too.
Modern oral sleep appliances are well-made, and you should reasonably expect 5-7 years out of one.  Proper home care is necessary, of course.

Living with Oral Appliance Therapy

Treating snoring or obstructive sleep apnea with oral appliance therapy can make you feel like a new person. You will find that your symptoms, and your quality of life, can improve dramatically when you remain committed to your treatment and use it nightly. It is likely that you will sleep better, have more energy and feel sharper throughout the day. You may find that your bed partner begins to sleep better, too!

Treating sleep apnea promotes a healthier heart, body, and mind. With the help of Dr. Payet and his team, you can improve your sleep and your health!