Oral Appliances: Advantages and Disadvantages of an Oral Appliance

What are Oral Appliances?

Oral appliances are one of the treatment options for snoring and obstructive sleep apnea (OSA). These devices are similar to mouth guards or orthodontic retainers that are worn in the mouth during sleep. They are designed to prevent soft tissue in the airway from collapsing and causing obstruction. These appliances can be used alone or in combination with Continuous Positive Airway Pressure (CPAP) or surgery.

How do Oral Appliances Work?

An oral appliance works by repositioning the lower jaw and/or pulling the tongue forward.  Mandibular-repositioning devices keep the lower jaw in a protruded position during sleep. This keeps the airway open by preventing the tongue and soft tissue in the throat from collapsing. Tongue-retaining devices hold the tongue with a suction bulb, preventing the back of the tongue from obstructing the airway during sleep.

What are the Indications?

Oral appliances are most effective in treating snoring and mild to moderate sleep apnea. These appliances are recommended for patients who are non-compliant with CPAP and fail positional and weight loss therapy. They can also be used for patients with moderate to severe OSA who cannot tolerate CPAP use. They are also recommended for patients who fail, refuse or are otherwise not candidates for surgical treatment.

What are the Advantages?

Oral appliances provide a non-invasive alternative for the treatment of snoring and sleep apnea. In comparison to CPAP, they have a higher compliance rate, are more compact, and less cumbersome.

What are the Disadvantages?

With the use of oral appliances, patients may develop excessive salivation, dry mouth, tooth and jaw discomfort, permanent changes in occlusion, and temporomandibular joint disorder.  Some patients discontinue the use of oral appliances due to these side-effects.

What are the Other Treatment Options for Obstructive Sleep Apnea?

Treatment options for OSA include lifestyle modifications, weight loss, sleep positioning, CPAP and various surgical procedures to reduce airway obstruction.

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