Oral Appliance Therapy (OAT) is a proven, comfortable and non-invasive sleep apnea solution. It involves a custom-fitted mouthpiece that is worn during sleep to help keep the airway open and prevent the tongue from blocking the airway.

Comfort • Use • Effectiveness


Comfort

Most patients find OAT to be a more comfortable and convenient therapy than a CPAP machine and mask. Most patients find oral appliances are easy to use and not cumbersome while sleeping. Oral appliances are also excellent for those who travel, as they pack small and require no electricity. Studies show that compliance with OAT and wearer satisfaction with these devices are significantly higher than with CPAP.

  • An oral appliance resembles a sports mouthguard, and is worn during sleep.
  • These devices move the lower jaw forward, and to lift the base of the tongue forward and away from the back wall of the throat to keep the airway open.
  • Oral appliances should be custom-fitted and adjusted by a qualified sleep medicine dentist to ensure optimum results, safety and comfort.
  • Periodic follow up examinations are needed to ensure the appliance is performing properly.
  • The appliance is not designed to improve restricted nasal breathing, which is caused by a deviated septum or other nasal blockage, but many oral appliance users experience a significant reduction in chronic nasal congestion.

The majority of patients are able to fall asleep easily while wearing an oral appliance, and after an initial adjustment period of just a few weeks, find they do not want to sleep without the appliance. Because the airway is now open, the body responds quickly and experiences deeper, more refreshing sleep. If a patient forgets the appliance, or chooses not to wear it, they quickly return to previous patterns of poor sleep. A patient’s bed partner can see the difference in restlessness and snoring without the appliance, and often encourages the patient to continue using the appliance.


Fitting & Use

In the United States, oral sleep appliances are considered a Class II medical device by the FDA. They cannot be sold over-the-counter, and must be prescribed by a physician and fitted by a dentist, oral surgeon or ENT physician who has appropriate sleep medicine training and experience.

Simple, non-adjusting oral appliances intended for snoring relief are sometimes offered by online retailers, and adjustable devices may also be offered in conjunction with a remote diagnosis of the patient’s condition based on a bite sample that is mailed in for analysis. These sources cannot provide the same personal assessment of the patient’s condition or the level of care that a qualified sleep medicine dentist such as Dr. Goldberg can provide.

  •  Oral appliances should be custom-fitted and adjusted by a qualified sleep medicine dentist to ensure optimum results, safety and comfort
  • Periodic follow up examinations are needed to ensure the appliance is performing properly
  • The appliance is not designed to improve restricted nasal breathing, which is caused by a deviated septum or other nasal blockage, but many oral appliance users experience a significant reduction in chronic nasal congestion

Because no two patients are the same, selection and fitting of an oral appliance should begin with a thorough examination. Proper adjustment of the appliance and follow up examinations by Dr. Goldberg are an important part of effective treatment.

Oral appliances are made of durable materials that require little in the way of maintenance and are safe for routine cleaning.


Effectiveness

Oral appliances are proven to be effective for reducing or eliminating snoring, and for reducing or eliminating the symptoms of OSA. A wide range of oral appliance devices —currently more than 90—are approved by the FDA for these uses. Numerous studies have shown that oral appliances are able to reduce or eliminate OSA symptoms in 80 percent of all cases.

Based on a measurement known as the Mean Alleviation of Disease (MAD), OAT has a similar or slightly higher overall alleviation of OSA symptoms as compared to CPAP. Both therapies have a MAD of approximately 50 percent.

What this number takes into account is not only the effectiveness of each therapy, but also how well it is accepted and applied by the patient in the real world.

Studies have shown that as many as half of all patients who begin CPAP therapy discontinue its use with in six months, as they find they are unable or unwilling to tolerate the face mask and can’t sleep comfortably. Because the vast majority of patients find oral appliances to be more comfortable and convenient, they tend to wear these devices more often and longer each night. The US Department of Health has reported that some 80 percent of current CPAP users prefer oral appliances when given the option.

The American Academy of Sleep Medicine recommends OAT for the treatment of mild to moderate OSA, and for the all patients who are who are unable to tolerate CPAP therapy. This recommendation is based on studies that show oral appliances to be highly effective for the treatment of mild to moderate OSA, and able to significantly reduce symptoms for patients with severe OSA. For patients with severe OSA who cannot tolerate CPAP, the reduction of symptoms provided by OAT can create numerous health benefits.

One additional option available to patients with severe OSA is combination therapy, in which both oral appliances and CPAP are prescribed. By using these therapies in combination, air pressures delivered through the face mask can be lowered, making CPAP therapy more tolerable.

Most OAT patients experience a noticeable change in how they feel when they wake up and how they are able to function throughout the day. The effectiveness of OAT can be measured with a home sleep study or with follow-up testing at a sleep lab.

  •  Oral appliances should be custom-fitted and adjusted by a qualified sleep medicine dentist to ensure optimum results, safety and comfort
  • Periodic follow up examinations are needed to ensure the appliance is performing properly