Dental Sleep Medicine

Oral Appliances for Obstructive Sleep Apnea

One option for treating Obstructive Sleep Apnea (OSA) is with Oral Appliance Therapy (OAT) using a Mandibular Advancement Device (MAD). The appliance holds the lower jaw forward which brings the tongue forward which creates more space at the back of the throat to breathe. This helps reduce the obstruction that contributes to snoring and obstructive sleep apnea.

A dentist experienced with this form of therapy is the best person to give you advice on this option. They will review the results of sleep testing, review your dental history, examine your teeth and mouth, discuss the likelihood of an oral appliance being effective for you, and answer your questions.

OAT is effective in about 80% of patients with snoring and mild obstructive sleep apnea. However, it is only effective in about 50% of patients with moderate to severe obstructive sleep apnea. For those for whom it works for, it works well. Unfortunately, a dentist cannot tell if a device is going to be effective just by looking in your mouth. You have to invest in a custom made dental appliance before you know if it will work.

Traditionally, if you decide to proceed with making an oral appliance the dentist would take an impression of your teeth and send it away for the appliance to be built. After the appliance is fitted, there is a period of time during which the jaw is gradually adjusted forward until the patient feels rested, the bed partner is no longer aware of snoring or the jaw has had enough. Follow-up testing is necessary to determine if the appliance is effective at controlling the sleep apnea. This process takes time, is costly and provides no guarantee that it will be effective at controlling your snoring or sleep apnea.

At the Kelowna Sleep Clinic, we use a new device called MATRx which is available only in a few sleep labs in North America.

The MATRx device enables us to remotely adjust an inexpensive, custom, temporary dental appliance overnight in the lab where we can discover two things. First, we will know if the dental appliance will fully control your snoring and sleep apnea. Second, we will know how far we need to advance your jaw in order to get this control. We can then write a very specific prescription for OAT knowing ahead of time that it will work and what degree of jaw advancement is required. This is an inexpensive way of testing if OAT is for you. If it is effective, you will also save yourself the time normally required to gradually adjust it.