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What is an Oral Appliance (OA):
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 Oral appliances (OA) that treat snoring , UARS, and OSA are devices worn in the mouth similar to sports mouth guards or orthodontic retainers. They are made of plastic and fit partially or completely within the mouth. Currently there are over 40 different types of oral appliances available. OA's may be used alone or in combination with other means of treating sleep apnea, such as weight management, surgery and CPAP. There is no one particular appliance that will work for every patient. Any dentist supplying oral appliances must be familiar with several different types. |
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Categories of Appliances: |
There are currently 2 categories appliances.
1. MRD - Mandibular Repositioning Device
- A more commonly prescribed appliance.
- It repositions and stabilizes the lower jaw, tongue, soft palate, and uvula.
- It increases the muscle tone of the tongue.
2. TRD - Tongue Retaining Device
- This device advances the tongue and actively holds the tongue forward to open airway and preventing it from falling backward and blocking the airway.
- These devices are most useful in patients with large tongues, Poor dental health, no teeth, and chronic joint pain.
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Indications for use of an OA: |
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- Primary snoring/Mild OSA
- Moderate / Severe OSA who are intolerant or refuse nCPAP ( as set forth by the American Sleep Disorders Association)
- Poor tolerance of nasal CPAP
- Poor surgical risks
- Non-successful UPPP surgery
- Use of appliance during travel
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Advantages of using an Oral Appliance (OA): |
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- Oral appliances are small and convenient making them easy to carry when traveling
- Treatment with oral appliances is reversible and non-invasive
- After becoming acclimated to wearing the appliance, most people find them easy to wear and more comfortable than the nCPAP.
- Quiet
- Easily adjustable
- More comfortable than nCPAP resulting in increased compliance
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Are there any side effects from using Oral Appliance Therapy?: |
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| Patients using oral appliance therapy may experience the following side effects: |
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- Excessive salivation or dryness.
- Morning soreness in the teeth or jaw muscles.
- Tooth movements (mostly minor)
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| Most of these side effects improve within a few weeks of regular use and some adjustments of the appliance. Patients with arthritis and chronic jaw joint dysfunction may have difficulty tolerating an OAT. |
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Which appliance is best for me?: |
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| As a specially trained dentist in the treatment of OSA and oral appliance therapy, Dr. Sosenko considers many factors before choosing which appliance maybe best suited for each individual. After your PCP or sleep physician confirms your diagnosis and decides that you are a candidate for OAT, Dr. Sosenko begins with a very comprehensive examination of your oral cavity. Along with evaluating your PSG results, she discusses lifestyle factors and sleeping habits such as: |
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- Manual dexterity
- Travel destinations (3rd world countries, etc.)
- Preferred sleep positions
- Oral cavity restrictions (anatomical structures)
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Samples of FDA Approved Appliances: |
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| SomnoMed MAS Appliance: |
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| Click Image to Enlarge |
The SomnoMed MAS features medical grade stainless steel screws on the side of the appliance to provide incremental levels of jaw advancement. This optimizes the effectiveness and comfort-level of treatment, as the jaw is moved only as far as is required to alleviate snoring and OSA. |
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| SUAD Appliance: |
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The SUAD appliance is similar to the Herbst, but has an internal metal framework which prevents fracture of the acrylic. The hardware is the weak point. This appliance requires heating in hot water to soften it enough to place it every night. |
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| Klearway Appliance: |
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This Mandibular Repositioning Appliance (MRA) is made of a Thermoplastic material which is placed in hot tap water prior to placement into the mouth. The adjustment mechanism is on the roof of the mouth and can be adjusted in .25mm increments. |
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| Herbst Appliance: |
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| Click Image to Enlarge |
This type of MRA is made of hard plastic / thermoplastic material. The site of adjustment hardware is located on the cheek side of the molar teeth. This type of OA does allow for some lateral movement, as the Klearway, this type of OA is completely contained in the mouth. |
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| Tap Appliance: |
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The TAP appliance has separate sections for the top and bottom Jaw. Each portion can be placed into the mouth independently before connecting the two. The mechanism, at least initially, sticks out through the lips making adjustments very easy. |
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| Tap II Appliance: |
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| Click Image to Enlarge |
The Tap II appliance is similar in design to the Tap, but it's adjustment mechanism is internal, eliminating the external (out of mouth part) |
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| Silencer Appliance: |
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Silencer has a titanium based hinge which is beneficial to patients with particular metal allergies. |
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Dental Sleep Medicine of Illinois
Dr. Lydia M. Sosenko, D.D.S.,D.ABDSM
Dr. Bryan Weyneth, D.D.S.
1100 Sherman Ave., Ste.103,
Naperville, IL 60563
1-630-369-5508
1-800-SNORING (766-7464) Northern IL only
Outside Northern IL 630-369-5508
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