Podcast #7: The 7 Reasons Why I Like Dental Appliances for Sleep Apnea

Many people hate the idea of using a CPAP mask attached to a hose every night. Fortunately, a good alternative to this is a mandibular advancement devices (also called oral appliances)  come in various models, but they all have one thing in common: The lower jaw is pushed forward against the upper jaw, moving your tongue forward, opening up your airway.
In this podcast episode, I will go over the 7 reasons why I like using mandibular advancement devices to treat obstructive sleep apnea.  
1. No headgear or straps around your face.
2. It’s silent. CPAP 26 dB. 30 is a quiet whisper
3. It’s small and convenient
4. More dentists are available to make these devices, and are usually covered through most major insurances. 
5. Equal to CPAP for people with mild to moderate obstructive sleep apnea.
6. An oral appliance can be used as a CPAP mask holder
7. It can be used effectively for snoring and UARS, even if you don’t have obstructive sleep apnea.
Resources and links mentioned:

American Academy of Dental Sleep Medicine

Photo of hybrid oral appliance / CPAP nasal pillow

Unstuffy Your Stuffy Nose E-book

Breathe Better, Sleep Better, Live Better Podcast on iTunes (#54)



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11 thoughts on “Podcast #7: The 7 Reasons Why I Like Dental Appliances for Sleep Apnea

  1. MADs may be good for some but dentists who make them need to ask a few questions.

    Do you have acid reflux?
    Have you ever had TMJ.?
    Do you have gum disease?
    Do you have any loose or broken teeth.

    If you answered yes, I’d be cautious in recommending this device. You can have a serious choking episode even if your reflux is treated with acid blockers. You still reflux and the reflux is full of bacteria.
    TMJ can be made worse with these devices and existing teeth may be loosened or shifted.

  2. I used a Somnodent oral appliance after several frustrating months attempting to sleep with cpap and all the issues that came with it in the spring of 2012. I should mention I’m somewhat of a special case…i had upper and lower jaw surgery in 2001 for a severe underbite. Although i could tolerate the mouthpiece in my mouth (was used to retainers and such), the jaw pain and stiffness the next morning was not comfortable, i didnt get as much lower jaw extention as a “normal person” and every time i moved my mouth at night the “fins” on the device would rub and squeek and wake me up. Somnodent had no fix for this supposedly (they acted like they didnt believe me, nor did the inexperienced dentist that fit it) and despite trying my own remidies (using clear tape over the contact points helped some) and lots of sleep meds, the sleep study showed not only that it wasnt helping, but maybe “could be making the apnea worse”. Now ive got nothing else to try and a $4000 bill for a device that is in a drawer somewhere. So despite pushing aside the fears of my underbite coming back and the new tmj pain and trying a MAD, the failure of another expensive product is definitely the worst thing because i still sleep poorly. Hope they find something else for us “special cases”

  3. Thanks, the show was great.

    Could you please post or email me the link for how to unstuff your stuffy nose please?

    Also, a possible idea for another show, if you haven’t done it (which i thought about listening to your show): What is sleep apnea? The amount of AHI, or the amount of multiple arousals (which is ultimately what makes sleep poorly)?

    How to know when your stuffy nose is operable or not? I had nose surgery several years ago. They corrected my deviated septum. I still have a stuffy nose and tests show i still have a deviated septum and big turbinates. Some of the doctors i’ve seen tell me i should get surgery and some of them say i shouldn’t, cause the problem is functional. So, with the nose being such an important issue in sleep apnea, how to know when you should or shouldn’t get nose surgery could be another topic for your show. Taking into account the Empty Nose Syndrome. Which i don’t wanna get if i get another nose surgery.

    Which machine to get according to the type of sleep apnea/UARS you have? Am i using the right type of XPAP machine?

    I hope these ideas don’t sound stupid. Thanks.

  4. John,

    Thanks for your comments and suggestions. We definitely will have a program about how to treat your stuffy nose in the near future.

    You can get the ebook How to unstuff your stuffy nose here.

  5. Jeanette,

    Sorry to hear about your dental appliance problems. While many people do very well with these appliances, some people (like you) will have problems. This is why the most important step in using mandibular advancement devices is to select patients carefully beforehand.

  6. Hello
    I enjoyed listning to you podcast, making it a conversation with your wife was a great idea.
    About the team aproach: I am sitting in an hospital ENT outpatient clinic with an ENT doctor who practices similarly to you, I have the opportunity to discuss the success rate of different treatment modalities while we watch the effect of protrusion.
    About bite changes due to using the dental appliance: I am using for all my patients a morning repositionner , that is a bite registration made of thermoplastic material, after removal of the oral appliance the patient squeezes it’s teeth into the repositionner, that reduces the bite changes to almost nothing.
    I am using a SomnoDent device for already few years for primary snoring,and I place that morning repositionner every morning.
    Trying the boil and bite appliance : I don’t recommend them at all because they apply too much pressure on the front teeth.
    A last point I want to enlight: Using the oral appliance has a side effect of drying your mouth during the night.I am sleeping with a micropor tape accross my mouth to keep my mouth sealed.The idea came from the Buteyko practice .At first it sounds “crazy” but the plaster is so gentle that if you need to cough the plaster is removed painlessly in a blink. I use the one inch tape, folding the sides.I will send you a picture of myself sleeping with that tape.
    I appreciate a lot your mission. Best regards.

  7. Your podcast is interesting and informative to listen to. A very friendly approach of the video. I started investigating about the SomnoDent device for my first use. A lot of information available in the net which makes me pretty confused after reading. The post is much clearer but still wondering about how to use and should be used or not? Need some expert advices.

  8. I have mild OSA, cannot tolerate CPAP, and just finished my first week on a MAD and was doing well during sleep until this morning when I experienced acute TMJ re-inflammation (had it several years back; stopped about 3 years ago) on my right side after removing the device. The pain subsided within 45 minutes, but is sensitive to the touch. The device is adjustable. I appreciate any suggestions.

  9. I have been on a full mask CPAP for years on and off. The last year I use it religiously since my sister developed an enlarged damaged heart when she refused to wear hers. She is now back on the CPAP. I now use the the Airfit model F10 medium size which is at least comfortable but still allows air to seep pass the mask. This wakes me up which disrupts my sleep and makes me tired during the day. I have never felt “refreshed” after using any CPAP head gear.
    I have tried the nasal pillow to prevent air seeping by the masks and experience bad stuffiness, coughing and wake up. The prescribing sleep apnea doctor says I have severe sleep apnea and an oral appliance would not work for me. Now this is strange since my sleep test results showed mild to moderate sleep apnea. Wonder if an expensive CPAP machine means more money for the doctor.

    Why the severe stuffiness with the nasal pillow but none with the full face mask? If you live in a humid environment, is water neccessary to operate either device in any season?