5 Reasons Why I Don’t Like Dental Appliances for Sleep Apnea

Work of dentist is not so easyIn my last post, I described 5 reasons why I like oral appliances to treat obstructive sleep apnea. This is a continuation of my love/hate, pro/con blog posts about various sleep  apnea tests and treatment options.
Here are my 5 reasons why I don’t like oral appliances:
1. It’s challenging to find a qualified dentist for every patient. For most people who live in metropolitan areas, there are lots of options. If you live in rural areas or if you have insurance that’s not common accepted (like medicaid plans) it’s much more challenging.

2. It can change your bite. This is an expected, and common side effect. If you work with a good dentist, this can be minimized or reversed. Some people don’t care, since they’re sleeping so much better.

3. It’s much more expensive than CPAP. If you don’t have insurance, it can cost a few thousand dollars, whereas CPAP is well below $1000. 

4. It can be lost or damaged. Because it’s so small, it’s easier to lose. I’ve also had a handful of patients that told me that their dog chewed up their devices.

5. Although these devices will pull the tongue forward, it also takes up space within the mouth, leaving less room for the tongue. 

For the most part, I find that mandibular advancement devices are helpful and in general, better liked by patients. This is in line with published studies. 
In my next post, I’ll describe the 5 things you need to know before you see a dentist, to maximize the chances that an oral appliance will work for you.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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5 thoughts on “5 Reasons Why I Don’t Like Dental Appliances for Sleep Apnea

  1. Perhaps as an adjunct to a mandibular device? It’s probably very safe and possibly effective.

    “The effect of Lactobacillus helveticus fermented milk on sleep and health perception in elderly subjects”


    (I’m not presenting this as conclusive, rather, it’s an interesting preliminary finding that supports a logical and potentially important hypothesis, viz., symbionts help regulate vital bodily functions such as sleep.)


  2. I tried CPAP 10 years ago and failed because I felt it was forcing air at the wrong time for my breathing. So 7 years later I asked for a mandibular advancement device instead of trying a CPAP again.
    I had worse results with a mandibular advancement device than without it. I went from an AHI of 9 without anything to an AHI of 17 while using the device. I think this was because the device caused my tongue to move back a bit and this blocked my airway more. An ear, nose and throat specialist later evaluated my throat and found that my tongue base is large for my throat and that my throat easily colllapses. He offered me UUPPP surgery for it but I decided to try a CPAP again.
    Now I have a CPAP machine as of 2 months ago and with it I have an AHI of 0.9 while lying on my stomach. I found that the CPAP machine has come a long way in usability during the 10 years since I first tried it. I appreciate my CPAP all the more after the experiences with the mandibular advancement device and prospect of surgery.

  3. I tried using a mandibular device for about 2 years but it changed my bite so much that when I smiled with me teeth showing, my teeth did not meet.

  4. Many of the older dental appliances for apnea and snoring did, in fact, take up too much tongue space. However, two companies have reduced the amount of plastic on the tongue side so the space is not limited. So noted is one company that’s done this, and the other is Microdental with the Micro2 appliance. The micro2 is especially interesting because it has no metal pieces (which can create space between teeth) and no weak points for fracture. If your dog eats your appliance (which DOES happen), the company can just mill you a new one without new impressions!
    If the AHI worsens with a dental appliance, your dentist made too arbitrary of a position, you should see someone who is trained as a neuromuscular dentist to make the appliance fit in a less strained muscle position.

  5. I have just been diagnosed with probable UARS due to a narrowed retrolingual space, and fitted for a Somnowell device. But I’m finding it impossible to get to sleep with it in my mouth. It’s not exactly uncomfortable; I’m just too aware of its presence. I’ve tried over-the-counter sleeping tablets to help me acclimatise, but even with them, I just can’t get to sleep with a mouthful of metal. My next possibility is the stronger prescription tablets, but I don’t want to risk dependence.

    What have other patients tried to help them acclimatise to the appliance?