Dental appliances for sleep apnoea / apnea, hold your jaw forwards to aid breathing, while you sleep. They are prescription medical devices, for diagnosed obstructive sleep apnoea (OSA) patients.
In the UK?
If you snore or are worried you may have sleep apnoea (but are not yet diagnosed), then its easy to find out, and get signposted to the most appropriate professional to help you.
Dental appliances for sleep apnoea are an option for diagnosed obstructive sleep apnoea patients, who are unable to use Positive Airway Pressure (PAP) therapy. PAP therapy is considered the most effective way to treat obstructive sleep apnoea.
Sleep apnoea dental appliances are prescribed by sleep-trained dentists upon referral from a sleep unit.
A dental appliance may also be recommended by the doctor to be used in combination with PAP therapy, when pressures are very high. The idea is for the dental appliance to mechanically open the airway and it is hoped to reduce the PAP pressure required. This is typically for patients with severe obstructive sleep apnoea (OSA).
Then read our free, definitive step-by-step how to stop snoring Guide.
This comprehensive Guide walks you through self-help, signposting, screening, professional assessment and diagnosis, the three categories of prescription treatment, follow-up and rounds off with a substantial FAQ.
Dental appliances for sleep apnoea may seem a good idea because apart from being far more discreet than PAP (Positive Airway Pressure therapy) what’s that?, there is no need for:
How to know before buying one, if a dental appliance for sleep apnoea, will actually work?
The trouble with a custom-made dental appliance for sleep apnoea, is that you have to wait for it to be made for you.
Expensive (don’t forget to factor in the dentist’s fees)
There is no guarantee they will work
You don’t know if you can even tolerate wearing it in your mouth
“Hang on, before I get one, I’d like to know if it works, and if I can wear it!”
Then keep reading. You’re not alone in wanting to know if they work before they’re used:
The inability to determine BEFOREHAND, who will and who will not find oral appliance therapy effective, has impacted upon wider adoption of dental appliances (by the medical community) for patients with anything other than snoring or mild obstructive sleep apnoea.
So then, you’ll be interested in this brief introduction to the topic of a little known, third category of dental appliance for sleep apnoea.
But first, are dental appliances effective for sleep apnoea?
Yes. Prescription, custom-made, adjustable dental appliances are a valid option for sleep apnoea. They are however, considered second-line therapy (meaning there is a preferred therapy [first-line] i.e. PAP).
‘Second line’ means that PAP is considered the best option and dental appliances are only considered when a patient fails with PAP therapy.
A qualified yes:
When a patient has been medically diagnosed and is then referred to a sleep-trained dentist, with a view to the dentist prescribing a custom-made dental appliance.
Such a sleep apnoea patient would require ‘objective titration’. This means that the protrusion (forward movement of the jaw achieved through use of the dental appliance) would be adjusted with reference to data obtained from repeat sleep studies, to ensure the patient’s sleep apnoea was effectively treated.
Positive Airway Pressure (PAP) is considered by the medical profession to be the best treatment for sleep apnoea.
However, PAP is an arduous therapy and compliance (those who actually use it) for more than 4 nights a week and more than 4 hours each night are surprisingly few.
Consequently, dental appliances for sleep apnoea, although they may be considered less effective in terms of overcoming sleep apnoea (measured by oxygen desaturation), there is evidence that patients use them more than PAP.
Dentists cannot diagnose obstructive sleep apnoea (OSA). The diagnosis of obstructive sleep apnoea (OSA) is the exclusive preserve of the specialist consultant respiratory physician.
Uniquely, sleep-trained dentists in the UK may:
If you’re a dentist interested in training to provide dental appliances for snoring and sleep apnoea patients, then Snorer.training is for you!
‘One-size fits all’ and custom-made dental appliances comprise two categories of dental appliance for snoring and sleep apnoea:
Not a lot positive to say about category 1 dental appliances. Read this to understand more about the exaggerated claims made for OTC anti-snoring devices.
Here are some examples of the 2nd category of dental appliance for sleep apnoea:
The prescription, custom-made, bi-bloc design, dental appliance:
Figure 3, shows the actual predictor prototype ‘in the flesh’ and Figure 2 illustrates where predictor dental appliances fit in the overall taxonomy.
Predictor dental appliances for sleep apnoea are not the same as over-the-counter (OTC) anti-snoring devices. OTC anti-snoring devices have been researched (learn how they faired in this definitive guide ↗).
Some years ago (struth it was 2011), I witnessed the competitive emergence of a third category of dental appliance for obstructive sleep apnoea / apnea and snoring:
A Predictor dental appliance is NOT intended to provide long-term therapy.
Below is short video animation of a prototype sleep apnoea dental appliance (predictor)there is no sound.
Remember, this is an early prototype and it’s NOT intended to be worn for any length of time!
Figure 5. CAD prototype of a predictor dental appliance for sleep apnoea and snoring
The predictor dental appliance finally emerging commercially, interests me as in 2003, I patented (yup, that long ago) a dental appliance with the design intention being to determine:
Can a patient wear a dental appliance? Something that I consider is an underestimated challenge
Does it work?
This second point means both:
If obstructive sleep apnoea (OSA) patients’ are to be effectively treated the medical and dental profession must work together in a more patient-centric way.
Predictor dental appliances are perhaps the means to ‘build the bridge’ between the two.
The medical professional knows:
If the patient responds to mandibular protrusion prior to referral to a dentist for a dentally prescribed custom-made dental appliance
That the patient will be effectively treated with a dental appliance, and is ‘prescribing’ a jaw relationship
And the patient knows BEFOREHAND if a dental appliance will work!
I let my patent lapse. This was over 15 years ago! (2003) Damn.
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Co-author by Adrian Zacher MBA
Co-author Dr Roy Dookun BDS
Peer reviewed by Dr Shouresh Charkhandeh DDS
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Author and Founder of Snorer.com
Co-founder and former President British Society of Dental Sleep Medicine
Award winning Dental Sleep Medicine Dentist
We provide enhanced CPD (continuing education) training courses for dentists and pharmacists wishing to further their knowledge and understanding about treating patients who snore and/or may have obstructive sleep apnea / apnoea (OSA).
Created by Adrian Zacher | Page last updated 5th Dec 2020