Obstructive sleep apnea occurs when the soft tissues at the back of the throat relax during sleep and block the airway, interrupting breathing repeatedly through the night. A mandibular advancement appliance is a custom oral device, worn like a sports guard, that holds the lower jaw slightly forward. This pulls the tongue and soft tissues forward with it, increasing the space in the airway.
Diagnosis comes first
This is important: sleep apnea is a medical condition and must be diagnosed by a physician, usually through a sleep study, before any oral appliance is made. Your dentist at Parkway Dental treats it in partnership with your doctor and cannot diagnose it independently.
The reason matters. Untreated sleep apnea is associated with high blood pressure, cardiovascular disease, stroke and diabetes, as well as daytime sleepiness that affects driving safety. Treating snoring without establishing whether apnea is present can mask a serious condition.
Who it suits
Oral appliances are generally indicated for simple snoring, for mild to moderate obstructive sleep apnea, and for patients with severe apnea who cannot tolerate CPAP. CPAP remains the most effective treatment for severe cases; an appliance that is actually worn every night, however, can outperform a CPAP machine that sits unused in a cupboard.
What to expect
Your dentist will examine your teeth, gums and jaw joints and confirm you have enough healthy teeth to support the appliance. Impressions or digital scans are taken along with a record of your jaw position. The appliance is fitted and then titrated — advanced gradually over several weeks to the position that controls symptoms with the least jaw strain. A follow-up sleep study is often used to confirm it is working.
Side effects and maintenance
Expect some jaw stiffness, tooth tenderness and increased salivation initially; these usually settle. Morning jaw exercises or a repositioning wafer help.
Over years of use, appliances can cause small changes in tooth position and bite, which is why regular dental review is part of treatment rather than optional. Tell your dentist promptly if your bite feels different. Clean the appliance daily with a brush and cool water, never hot.