Treatment

Oral Appliance Therapy

Mandibular Advancement Devices (MADs) are the most common oral appliance for treating OSA. The custom made oral appliance is worn over the teeth much like a orthodontic retainer or sports mouth guard. It is worn while sleeping to reposition the jaw in a forward position to prevent the upper airway from collapsing during sleep. Moving the jaw forward also pulls your tongue forward allowing for more airflow. It may take some time to adjust to wearing an oral device. You put the device in before you go to sleep and wear it throughout the night. You remove it in the morning when you wake up.

An important step to achieving successful outcomes is determining the optimal degree of lower jaw protrusion at which to set the oral appliance. Titration studies will be completed to determine the optimal degree of lower jaw advancement to alleviate or improve sleep apnea symptoms. 

Oral appliance therapy should improve your OSA symptoms. Most patients experience restorative sleep with fewer sleep interruptions. It can eliminate or reduce snoring. Some people with mild to moderate OSA find an oral appliance completely resolves their symptoms.

How it Works

  • First Consultation: Dr. Malan will complete an oral evaluation and examine your airway and anatomic structures. He will review your medical and family history and discuss your sleep issues with you. Our office can set you up to take a home sleep study if you have not completed one already. Only a sleep physician can write the prescription for oral appliance therapy. Only a qualified dentist can fabricate and fit the oral appliance. The sleep specialist and dentist will work closely together to provide you with optimal care. If you have already been diagnosed with OSA please bring your sleep study results with you or let us know who to contact to obtain a copy prior to your appointment. If you wear a night guard or retainer please bring that with you. If you have already completed a sleep study, Dr. Malan will discuss the best treatment options for you. He will share the recommendations made by the certified sleep physician who conducted your home sleep study test. Our staff will review your medical benefits and provide an estimated cost for oral appliance treatment. 

  • Next appointment: If our office helped you set up your home sleep study test, the test results will be discussed during this visit. This visit can be conducted in office or via telemedicine. If your sleep study was completed prior to your consolation and was discussed during that visit, this appointment is not necessary. 

  • Comprehensive Sleep Exam: During this appointment we will complete a digital scan and obtain measurements for your custom made mandibular advancement device.

  • Delivery of Device: We will deliver your custom made appliance to you with care instructions.

  • Follow up visits: It is important to determine the correct adjustment of your device. The oral appliance is adjusted by trial and error throughout the titration study to determine the optimal degree of lower jaw advancement to alleviate sleep apnea. We want to make sure you are comfortable and not having any issues. While you will likely feel better, it is important to have a follow up sleep study to make sure the oral appliance is effectively treating sleep apnea.