Unlike CPAP, which uses pressurized air to hold the throat open, oral appliances for sleep apnea promote a slight repositioning of the mouth and neck in order to maintain normal breath. They resemble sports mouth guards, are made of soft but resilient thermoplastics, and are custom-fitted to the wearer. There are a number of oral appliance designs now approved for the treatment of sleep apnea. They go by many names, and offer a number of subtle design differences, but the majority function in a similar fashion: they hold the lower jaw slightly forward, which helps keep the tongue from blocking the throat, and prevents soft tissues from collapsing into the airway. As a group, they are often referred to as mandibular advancement device or MADs. Dr. Timmerman is familiar with a number of these devices, and will select the oral appliance that is best suited to your individual needs.
To be safe and effective, an oral appliance must be fitted and adjusted by a trained sleep medicine dentist such as Dr. Timmerman. Generic appliances and “snore guards” sold by mail order cannot be adjusted for proper fit and function, and may cause damage to the wearer's bite. Once fitted and adjusted, oral appliances need very little maintenance or care other than regular cleanings. Because they are compact and require no complex bedside machinery or electrical outlet, they are far more discrete and easy to pack for travel than CPAP equipment. This combination of convenience and comfort have earned oral appliances far higher rates of approval with users than CPAP. While CPAP often has an acceptance rate of 50 percent or less, more than 90 percent of oral appliance wearers report satisfaction with their treatment, and tend to stick with it far longer.
Based on the overall rate of cure made possible by the high acceptance rate of oral appliances, they are now considered as a primary option for persons with mild to moderate sleep apnea. They are also recommended for all patients who are unable to tolerate CPAP, and are even used in conjunction w in certain cases to lower the required CPAP pressures to make the system more effective and acceptable.
A Personal Note After witnessing the benefits of oral appliances, and the way their use can help restore a person's quality of life, Dr. Timmerman has become a firm believer in oral appliances. Though he himself does not suffer from sleep apnea, but does snore, he how wears an oral appliance each night as a courtesy to his wife. He says both he and she now enjoy more restful sleep.