What is an oral appliance?
Answer: It is a retainer-like device that fits completely or partially within the mouth and holds oral structures in a position that allows easier breathing when you sleep.
Are oral appliances an effective treatment option?
Answer: Research has shown that oral appliance therapy (OAT) is as effective as CPAP for mild to moderate obstructive sleep apnea (OSA). It reduces cardiovascular mortality rates similarly to CPAP and has shown to have a self-reported compliance median rate of nearly 77% of nights. For patients diagnosed with severe OSA, oral appliance therapy is also a viable alternative treatment for those who are CPAP-intolerant.
Will an oral appliance help me?
Answer: Research shows that certain patients respond better to oral appliances. Characteristics, I like to see are:
- Normal weight or moderately overweight.
- Younger age groups
- Lower BMI
- Lower AHI
- Retrognathic patients
Even though there are many successful oral appliance users who do not fall within these guidelines, the fewer positive characteristics a patient has, the less successful he or she is expected to be.
How do mandibular advancement appliances (MAD) work?
Answer: Through support of the teeth, a mandibular advancement device works to protrude (or maintain) the position of the mandible and associated soft tissues. When the base of the tongue is positioned anteriorly, the oropharyngeal and hypopharyngeal airway size is increased. Additionally, physiological changes occur, as there is an increase in the baseline activity of the genioglossus as well as the pharyngeal constrictors, creating a splinting effect of the upper airway.
How do I choose the correct appliance for me?
Answer: My job to help guide the patient to selecting an appliance that fits their lifestyle and their anatomy. Due to a number of variabilities such as the dental condition of a patient, we find much greater patient acceptance and compliance when a patient is fitted with an appliance that aligns with their anatomical characteristics. We offer several different appliances so we can select the most appropriate option to effectively treat the patient’s condition while also preserving their comfort.
How long do they last?
Answer: Our appliances have a 3-year warranty and medical insurance typically covers a new appliance every three to five years. The lifespan of an oral appliance varies depending on its design.
How do I know it's working?
Answer: It is recomended that you take a home sleep test after the device is adjusted to verify effectiveness.
Will my insurance pay?
Answer: Oral appliance therapy is considered medical treatment, and only medical insurance will pay for this. We know how important it is that patients pay as little out-of-pocket as possible. By filing in-network with all major medical plans including Medicare, we’re able to maximize a patient’s benefits and minimize their out-of-pocket cost, which is often dependent on their deductible balance. We will never move forward with treatment without the patient first knowing exactly what their cost will be.
Do oral appliances change my bite (the way the teeth come together)?
Answer: This is certainly possible with all appliances, but we prefer types that are the least likely to do so. Additionally, we take a full set of photos for every patient so that we know what their baseline is, and we check this at every appointment. We also give patients an option of different exercises they can do to help maintain their normal bite relationship.