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What Are Custom Oral Appliances?

Unlike generic over-the-counter boil-and-bite mouthguards, a custom oral appliance is made for your mouth after a comprehensive dental exam and diagnostic records. For sleep apnea, it is provided after a written request or prescription from your physician. Appliances used to treat medically diagnosed sleep apnea are Health Canada licensed medical devices.

The most common type is the mandibular advancement device (MAD).

How Mandibular Advancement Devices Work

A mandibular advancement device looks similar to an orthodontic retainer or an athletic mouthguard. Custom-fit trays snap over your upper and lower teeth and are connected by a small adjustable mechanism.

While you sleep, the device gently positions your lower jaw and tongue slightly forward. This may help keep the soft tissues and muscles at the back of the throat from collapsing into your airway, and for some patients it may reduce breathing disruptions and snoring. The forward position is adjustable, often in steps as small as half a millimetre, so comfort and fit can be fine-tuned.

Potential benefits

For carefully selected patients, a custom oral appliance may offer:

• A custom fit: the appliance is thin, lightweight and made for your mouth, so many patients find it comfortable
• Quiet operation: there is no motor, so no noise for you or your bed partner
• Portability: it fits in a small case for travel, with no cords or distilled water
• Simplicity: no tubes, no air leaks and no electricity. You place it in before bed and rinse it in the morning
• Better tolerance: data shows many patients tolerate an oral appliance much better than CPAP
• A non-surgical option

Sleep apnea that goes untreated may be associated with high blood pressure and cardiovascular strain, which is one reason a physician’s diagnosis and an ongoing treatment plan matter. Results vary from person to person, and an oral appliance is not suitable for everyone. Your dentist will look at your oral health, jaw function, number of teeth and existing dental work before recommending one.

Is an oral appliance right for you?

Oral appliances are indicated for mild to moderate obstructive sleep apnea and, in some situations, for severe sleep apnea as well. Your physician’s diagnosis and sleep study guide that decision. An oral appliance is only one option among several, so Dr. Cheung also looks at your overall health, lifestyle and nasal breathing, and works with your physician or other specialists when appropriate.

How to get started

If you already have a prescription or sleep study report, email it to [email protected] before your visit, then book online or call us.

If you think you may have a sleep problem but have no diagnosis, book a sleep consultation. Dr. Cheung will go through medical questionnaires, explain how sleep apnea presents and what health risks it carries, review treatment options, and do a preliminary check of your teeth, gums and oral health to see whether an appliance may be possible. If sleep apnea is suspected, he will refer you to your physician for assessment and diagnosis.

Already have a dentist? Dr. Cheung is happy to work alongside them. We would not seek to become your main dental provider, only to help treat sleep-disordered breathing.

What to expect after you start

Expect regular follow-up visits during the first six months while the appliance is adjusted, then an exam at least once a year. With proper care, a custom appliance may last three to five years.

Sleep apnea treatment is usually claimed under extended medical benefits, not dental benefits, and basic MSP does not cover it. Our sleep apnea page explains how claims work.

Ready to talk?

If you have a diagnosis of mild to moderate sleep apnea, or you can’t tolerate your CPAP machine, we are here to help. Book a sleep consultation with Dr. Cheung at Wellbeing Dental, a dental clinic serving Delta and Surrey, or call 604-596-5585.

This post is for general information and is not medical advice. Obstructive sleep apnea requires diagnosis by a physician.