
If you have been diagnosed with obstructive sleep apnea (OSA) or suspect that you may have it, you may be researching alternatives to CPAP. One treatment option you may have come across is oral appliance therapy.
Oral appliances for sleep apnea are custom-fitted dental devices designed to help keep the airway open during sleep. For appropriately selected patients, an oral appliance can be a comfortable and convenient treatment option.
At Columbia Center for Sleep Apnea & TMJ, Dr. Jared Bloxham is an Orofacial Pain Specialist who provides care related to oral appliance therapy and conditions involving the jaw and oral structures.
It is important to understand that Dr. Bloxham is not a sleep physician. Diagnosis of sleep apnea and management of a patient's overall sleep-related medical care may involve a sleep physician or other qualified medical provider. Our role is focused on the oral appliance and orofacial aspects of care.
What Is an Oral Appliance for Sleep Apnea?
A sleep apnea oral appliance is a custom device worn in the mouth while you sleep. These appliances are designed to help maintain a more open upper airway by repositioning the lower jaw and/or other oral structures.
The most commonly used type for obstructive sleep apnea is a mandibular advancement device (MAD).
Rather than using air pressure like a CPAP machine, an oral appliance works mechanically to help reduce airway obstruction.
Because oral appliances interact with the teeth, jaw, muscles, and temporomandibular joints, proper evaluation, fitting, and follow-up are important.
How Does an Oral Appliance Help Sleep Apnea?
During sleep, the muscles and soft tissues of the upper airway can relax. In people with obstructive sleep apnea, this relaxation can contribute to narrowing or blockage of the airway.
A mandibular advancement oral appliance gently positions the lower jaw forward during sleep. This can help create more space in the upper airway and reduce the tendency for the airway to collapse.
The goal isn't simply to make a device that fits your teeth. The appliance needs to be appropriately selected, fitted, adjusted, and monitored.
That's one reason working with a provider who has specialized training in orofacial pain and jaw function can be important when oral appliance therapy is being considered.
Who Can Benefit From an Oral Appliance for Sleep Apnea?
Oral appliance therapy isn't right for everyone with sleep apnea.
It may be considered for some adults with obstructive sleep apnea, particularly when CPAP is not tolerated, when a patient prefers an oral appliance after discussing treatment options with their medical provider, or when an oral appliance is otherwise considered appropriate based on the individual's circumstances.
The severity and characteristics of sleep apnea, anatomy, dental health, jaw function, and other factors can all play a role in determining whether an oral appliance is appropriate.
At Columbia Center for Sleep Apnea & TMJ, our focus is on the oral appliance and the structures involved in its use, rather than diagnosing or medically managing sleep disorders.
Oral Appliance vs. CPAP: What's the Difference?
CPAP and oral appliance therapy work in very different ways.
CPAP, or continuous positive airway pressure, uses a machine to deliver pressurized air through a mask to help keep the airway open during sleep.
An oral appliance is a custom-fitted device worn inside the mouth that helps reposition the jaw and support airway openness.
Neither treatment is universally “better.” The appropriate option depends on the individual patient and the type and severity of sleep apnea.
For some patients, CPAP may remain the preferred treatment. For others, an oral appliance may be an appropriate alternative or treatment option.
If you're considering an oral appliance for sleep apnea, it's important to discuss your options with the healthcare professionals involved in your sleep apnea care.
What Are the Benefits of Oral Appliance Therapy?
One reason patients ask about oral appliances for sleep apnea is convenience.
Depending on the patient and device, potential advantages may include:
- A smaller and more portable alternative to CPAP equipment
- No external mask or tubing
- Easy travel and storage
- Quiet operation
- A custom fit designed for the individual patient
- An option for patients who have difficulty tolerating CPAP
However, an oral appliance is still a medical treatment and requires appropriate evaluation and follow-up.
It's also important to understand that an oral appliance isn't simply an over-the-counter mouthguard. Custom oral appliances for sleep apnea are designed specifically for the patient's anatomy and treatment needs.
Why a Custom Oral Appliance Matters
You may find inexpensive “sleep apnea mouthguards” or generic anti-snoring devices online or in stores.
These are different from professionally managed oral appliance therapy.
A custom oral appliance is designed around the patient's teeth and jaw. It should also account for factors such as jaw movement, bite, dental health, and the condition of the temporomandibular joints.
Poorly fitting or inappropriate devices may cause discomfort or contribute to unwanted changes in the bite or jaw.
This is particularly important for patients who have a history of TMJ problems, jaw pain, or other orofacial pain conditions.
What If I Have TMJ Problems?
This is an important consideration.
Because sleep apnea oral appliances position the lower jaw during sleep, patients with existing jaw problems may have questions about whether they can safely use one.
Having TMJ symptoms doesn't automatically mean you cannot use an oral appliance. However, your jaw health should be considered when determining whether an appliance is appropriate and how it should be designed and managed.
As an Orofacial Pain Specialist, Dr. Jared Bloxham has specialized training involving the jaw joints, chewing muscles, and other structures of the head, neck, and face.
At Columbia Center for Sleep Apnea & TMJ, we can evaluate the orofacial and jaw-related considerations involved in oral appliance therapy.
What Is the Process for Getting an Oral Appliance?
If oral appliance therapy is being considered, the process generally involves several steps.
1. Sleep Apnea Evaluation and Diagnosis
Sleep apnea should be appropriately evaluated and diagnosed by a qualified medical provider.
A sleep physician or other healthcare professional may use a sleep study or other diagnostic methods to determine whether sleep apnea is present and characterize the condition.
2. Oral and Jaw Evaluation
Once oral appliance therapy is being considered, an evaluation of the teeth, jaw, bite, and surrounding structures can help determine whether an oral appliance is appropriate from an oral health and orofacial perspective.
3. Custom Appliance
If an appliance is appropriate, a custom device can be selected and fitted based on the patient's individual needs.
4. Adjustments and Follow-Up
An oral appliance may require adjustments over time.
Follow-up is important to evaluate comfort, jaw function, bite, and other factors associated with wearing the appliance.
5. Confirming Treatment Effectiveness
The effectiveness of sleep apnea treatment should be evaluated appropriately. Your sleep physician or other medical provider may recommend follow-up testing to determine whether the treatment is adequately controlling your sleep apnea.
How Long Does a Sleep Apnea Oral Appliance Last?
The lifespan of an oral appliance can vary depending on the type of appliance, materials, wear, oral habits, and individual circumstances.
Regular follow-up can help identify wear or changes in the appliance and determine when adjustments, repairs, or replacement may be appropriate.
Your oral appliance is also not necessarily a “set it and forget it” treatment. Ongoing monitoring can help ensure that the appliance remains comfortable and continues to function appropriately.
Frequently Asked Questions About Oral Appliances for Sleep Apnea
Can an oral appliance replace CPAP?
For some patients with obstructive sleep apnea, oral appliance therapy may be an appropriate alternative to CPAP. The appropriate treatment depends on the individual's condition, and treatment decisions should be made with the qualified healthcare professionals involved in their care.
Are oral appliances good for sleep apnea?
Oral appliances can be an effective treatment option for appropriately selected patients with obstructive sleep apnea. Their effectiveness varies from person to person, which is why proper diagnosis, appliance selection, and follow-up are important.
Is a sleep apnea oral appliance the same as a nightguard?
No. A nightguard is generally designed to protect teeth. A sleep apnea oral appliance is specifically designed to help address airway obstruction during sleep.
Although both devices are worn in the mouth, they serve different purposes.
Can I get an oral appliance if I have TMJ?
Possibly. Having TMJ symptoms does not automatically rule out oral appliance therapy, but your jaw health should be carefully considered. An evaluation by a qualified orofacial pain professional can help address the jaw-related aspects of treatment.
Where can I get a custom oral appliance for sleep apnea?
If you're considering a custom oral appliance, look for a provider with appropriate training and experience in oral appliance therapy and orofacial conditions. At Columbia Center for Sleep Apnea & TMJ, Dr. Jared Bloxham provides specialized orofacial pain care and focuses on the oral and jaw-related aspects of sleep apnea appliance therapy.
Considering an Oral Appliance for Sleep Apnea?
If you've been diagnosed with obstructive sleep apnea and are exploring treatment options beyond CPAP, a custom oral appliance for sleep apnea may be worth discussing with your healthcare team.
At Columbia Center for Sleep Apnea & TMJ, Dr. Jared Bloxham, Orofacial Pain Specialist, evaluates the oral, dental, and jaw-related considerations involved in oral appliance therapy.
We work within our area of expertise and coordinate with the appropriate medical professionals when needed. Dr. Bloxham is not a sleep physician and does not replace the role of the physician responsible for diagnosing and medically managing sleep apnea.
If you're interested in learning whether an oral appliance may be appropriate for you, contact Columbia Center for Sleep Apnea & TMJ to schedule an evaluation.
Custom oral appliance therapy. Specialized orofacial pain care. A treatment approach centered around you.











