What is oral appliance therapy for sleep apnea?

Oral appliance therapy (OAT) uses a custom-fitted dental device worn during sleep to treat obstructive sleep apnea and snoring. The appliance repositions your lower jaw slightly forward, which helps keep your airway open throughout the night. It's FDA-approved and recommended by the American Academy of Sleep Medicine as a first-line treatment for mild to moderate sleep apnea and for patients who cannot tolerate CPAP.

How effective is oral appliance therapy compared to CPAP?

Clinical studies show oral appliances are highly effective for mild to moderate obstructive sleep apnea, with success rates of 70-80%. While CPAP may achieve slightly higher efficacy in controlled studies, real-world effectiveness depends heavily on compliance. Because oral appliances are more comfortable and easier to use, patients wear them more consistently—often resulting in better overall outcomes. For severe sleep apnea, combination therapy or CPAP may be recommended.

How long does it take to get an oral appliance?

The process typically takes 2-4 weeks from your initial consultation to receiving your custom appliance. After your first visit, we take digital impressions or molds of your teeth, which are sent to a specialized dental lab. Once your appliance is fabricated, you'll return for fitting and adjustments. Most patients need 2-3 follow-up visits for optimal titration.

Will my insurance cover oral appliance therapy?

Most medical insurance plans, including Medicare, cover oral appliance therapy when prescribed for diagnosed obstructive sleep apnea. Coverage typically requires a sleep study (home sleep test or polysomnography) confirming your diagnosis. Our office works directly with insurance companies and can verify your benefits before treatment. Many patients have little to no out-of-pocket cost.

Is oral appliance therapy comfortable to wear?

Yes! Modern oral appliances are custom-made from digital impressions of your teeth, ensuring a precise, comfortable fit. Most patients adapt within 1-2 weeks. Unlike CPAP masks, there are no hoses, no air pressure, and no noise. You can talk, drink water, and move freely during sleep. The appliance is small enough to fit in your pocket when traveling.

Can I use an oral appliance if I have dentures or missing teeth?

Oral appliances require adequate teeth for retention—typically at least 8-10 healthy teeth per arch. If you have partial dentures, we may still be able to design an appliance that works for you. Full denture wearers usually aren't candidates for traditional oral appliance therapy, but we can discuss alternative options during your consultation.

What are the side effects of oral appliance therapy?

Most side effects are mild and temporary. Common initial effects include jaw soreness, tooth tenderness, and increased salivation, which typically resolve within 1-2 weeks. Long-term use may cause minor tooth movement or bite changes in some patients, which is why regular follow-up appointments are important. Our team monitors for any changes and can adjust your treatment as needed.

How do I clean and maintain my oral appliance?

Daily cleaning is simple: brush your appliance with a soft toothbrush and mild soap or denture cleaner each morning. Rinse thoroughly before storing in the provided case. Weekly, you can soak it in a denture cleaning solution. Avoid hot water, which can warp the material. With proper care, quality oral appliances last 3-5 years.

Can oral appliances help with snoring even without sleep apnea?

Absolutely! Oral appliances are highly effective for primary snoring (snoring without sleep apnea). By advancing the lower jaw, the appliance opens the airway and reduces the vibration of soft tissues that causes snoring. Many bed partners notice immediate improvement. However, we recommend a sleep evaluation first to rule out underlying sleep apnea.

What types of oral appliances do you offer?

We offer several FDA-cleared mandibular advancement devices (MADs), including popular options like the Respire, EMA, and Herbst appliances. The best device for you depends on your anatomy, bite, and specific needs. During your consultation, we'll recommend the most appropriate option and explain the differences between devices.

How do I know if oral appliance therapy is working?

You'll likely notice improvements in sleep quality, reduced snoring, and increased daytime energy within the first few weeks. We objectively verify effectiveness through follow-up sleep testing (usually a home sleep test) after your appliance is optimally adjusted. This confirms that your apnea-hypopnea index (AHI) has improved to acceptable levels.

What happens during the oral appliance fitting process?

At your fitting appointment, we ensure the appliance fits comfortably and teach you how to insert, remove, and adjust it. We set an initial jaw position and provide instructions for gradual advancement over the following weeks. You'll also receive a morning exercise protocol to help maintain normal jaw function. Follow-up visits allow us to fine-tune the position for optimal effectiveness.

What is oral appliance therapy for sleep apnea?

Oral appliance therapy (OAT) uses a custom-fitted dental device worn during sleep to treat obstructive sleep apnea and snoring. The appliance repositions your lower jaw slightly forward, which helps keep your airway open throughout the night. It's FDA-approved and recommended by the American Academy of Sleep Medicine as a first-line treatment for mild to moderate sleep apnea and for patients who cannot tolerate CPAP.

How effective is oral appliance therapy compared to CPAP?

Clinical studies show oral appliances are highly effective for mild to moderate obstructive sleep apnea, with success rates of 70-80%. While CPAP may achieve slightly higher efficacy in controlled studies, real-world effectiveness depends heavily on compliance. Because oral appliances are more comfortable and easier to use, patients wear them more consistently—often resulting in better overall outcomes. For severe sleep apnea, combination therapy or CPAP may be recommended.

How long does it take to get an oral appliance?

The process typically takes 2-4 weeks from your initial consultation to receiving your custom appliance. After your first visit, we take digital impressions or molds of your teeth, which are sent to a specialized dental lab. Once your appliance is fabricated, you'll return for fitting and adjustments. Most patients need 2-3 follow-up visits for optimal titration.

Will my insurance cover oral appliance therapy?

Most medical insurance plans, including Medicare, cover oral appliance therapy when prescribed for diagnosed obstructive sleep apnea. Coverage typically requires a sleep study (home sleep test or polysomnography) confirming your diagnosis. Our office works directly with insurance companies and can verify your benefits before treatment. Many patients have little to no out-of-pocket cost.

Is oral appliance therapy comfortable to wear?

Yes! Modern oral appliances are custom-made from digital impressions of your teeth, ensuring a precise, comfortable fit. Most patients adapt within 1-2 weeks. Unlike CPAP masks, there are no hoses, no air pressure, and no noise. You can talk, drink water, and move freely during sleep. The appliance is small enough to fit in your pocket when traveling.

Can I use an oral appliance if I have dentures or missing teeth?

Oral appliances require adequate teeth for retention—typically at least 8-10 healthy teeth per arch. If you have partial dentures, we may still be able to design an appliance that works for you. Full denture wearers usually aren't candidates for traditional oral appliance therapy, but we can discuss alternative options during your consultation.

What are the side effects of oral appliance therapy?

Most side effects are mild and temporary. Common initial effects include jaw soreness, tooth tenderness, and increased salivation, which typically resolve within 1-2 weeks. Long-term use may cause minor tooth movement or bite changes in some patients, which is why regular follow-up appointments are important. Our team monitors for any changes and can adjust your treatment as needed.

How do I clean and maintain my oral appliance?

Daily cleaning is simple: brush your appliance with a soft toothbrush and mild soap or denture cleaner each morning. Rinse thoroughly before storing in the provided case. Weekly, you can soak it in a denture cleaning solution. Avoid hot water, which can warp the material. With proper care, quality oral appliances last 3-5 years.

Can oral appliances help with snoring even without sleep apnea?

Absolutely! Oral appliances are highly effective for primary snoring (snoring without sleep apnea). By advancing the lower jaw, the appliance opens the airway and reduces the vibration of soft tissues that causes snoring. Many bed partners notice immediate improvement. However, we recommend a sleep evaluation first to rule out underlying sleep apnea.

What types of oral appliances do you offer?

We offer several FDA-cleared mandibular advancement devices (MADs), including popular options like the Respire, EMA, and Herbst appliances. The best device for you depends on your anatomy, bite, and specific needs. During your consultation, we'll recommend the most appropriate option and explain the differences between devices.

How do I know if oral appliance therapy is working?

You'll likely notice improvements in sleep quality, reduced snoring, and increased daytime energy within the first few weeks. We objectively verify effectiveness through follow-up sleep testing (usually a home sleep test) after your appliance is optimally adjusted. This confirms that your apnea-hypopnea index (AHI) has improved to acceptable levels.

What happens during the oral appliance fitting process?

At your fitting appointment, we ensure the appliance fits comfortably and teach you how to insert, remove, and adjust it. We set an initial jaw position and provide instructions for gradual advancement over the following weeks. You'll also receive a morning exercise protocol to help maintain normal jaw function. Follow-up visits allow us to fine-tune the position for optimal effectiveness.

Oral Appliance Therapy for Sleep Apnea | Sleep Apnea Treatment | Aloha Sleep Apnea

Understanding Oral Appliance Therapy for Sleep Apnea Treatment

Oral appliance therapy (OAT) has revolutionized the treatment of obstructive sleep apnea (OSA) and chronic snoring. As a leading dental sleep medicine practice serving Aloha, Hillsboro, Beaverton, and the greater Portland metro area, we specialize in custom-fitted oral appliances that provide a comfortable, effective alternative to CPAP therapy.

If you’ve been diagnosed with sleep apnea—or suspect you may have it—understanding your treatment options is the first step toward better sleep and improved health. This comprehensive guide explains everything you need to know about oral appliance therapy, from how it works to what you can expect during treatment at our Oregon clinic.

What Is Oral Appliance Therapy?

Oral appliance therapy uses a custom-made dental device, worn during sleep, to treat obstructive sleep apnea and snoring. The most common type is called a mandibular advancement device (MAD), which gently repositions your lower jaw (mandible) forward while you sleep.

This forward positioning accomplishes several critical functions:

Opens the airway: By advancing the lower jaw, the device physically enlarges the space behind the tongue and soft palate
Prevents tissue collapse: The repositioned jaw keeps the tongue from falling backward and blocking airflow
Reduces soft tissue vibration: Less obstruction means less vibration of tissues—eliminating or reducing snoring
Maintains oxygen levels: With an open airway, oxygen saturation remains stable throughout the night

Unlike CPAP therapy, which uses continuous positive airway pressure to keep the airway open, oral appliances work mechanically without the need for masks, hoses, or electricity.

FDA Approval and Clinical Evidence

Oral appliances for sleep apnea are FDA-cleared medical devices, not over-the-counter mouthpieces you might find online. The American Academy of Sleep Medicine (AASM) and American Academy of Dental Sleep Medicine (AADSM) recognize oral appliance therapy as:

First-line treatment for mild to moderate obstructive sleep apnea
Alternative therapy for patients with severe OSA who cannot tolerate CPAP
Preferred treatment for primary snoring

Clinical research consistently demonstrates that custom oral appliances significantly reduce the apnea-hypopnea index (AHI), improve oxygen saturation, decrease snoring, and enhance quality of life for patients in Washington County and beyond.

How Oral Appliances Work: The Science Behind the Treatment

To understand how oral appliances work, it helps to know what causes obstructive sleep apnea. During sleep, the muscles supporting your airway relax. In people with OSA, this relaxation allows the tongue and soft tissues to collapse backward, partially or completely blocking airflow.

When airflow is blocked:

Oxygen levels drop throughout your body
Carbon dioxide builds up in your bloodstream
Your brain triggers a brief arousal to restore breathing
This cycle repeats—sometimes hundreds of times per night

These constant interruptions prevent you from reaching the deep, restorative stages of sleep you need for optimal health and daytime functioning.

A mandibular advancement device interrupts this destructive cycle by mechanically holding the lower jaw in a forward position. This advancement:

Increases the cross-sectional area of the upper airway
Tenses the pharyngeal muscles, making them less likely to collapse
Positions the tongue forward, away from the back of the throat
Stabilizes the hyoid bone, supporting airway patency

The result? Continuous, unobstructed breathing throughout the night—without the need for pressurized air from a CPAP machine.

Benefits of Oral Appliance Therapy

Comfort and Convenience

The primary advantage of oral appliances over CPAP is comfort. Many patients find CPAP masks claustrophobic, noisy, or disruptive to their sleep. Oral appliances, by contrast, are:

Silent: No motor noise or air sounds to disturb you or your partner
Compact: Fits in a pocket or small carrying case
Simple: No electricity, hoses, water chambers, or complex setup
Travel-friendly: TSA-approved and easy to use in hotels, airplanes, or camping
Natural: Allows normal mouth breathing, talking, and drinking water

Higher Compliance Rates

Treatment only works if you use it. Studies show that oral appliance users have significantly higher compliance rates than CPAP users. Because the device is comfortable and easy to use, patients wear it consistently—often every night without exception.

This improved compliance often translates to better real-world outcomes, even if CPAP shows slightly higher efficacy in controlled laboratory settings. A treatment you wear every night is more effective than one you leave in the closet.

Improved Quality of Life

Patients using oral appliances at our Aloha practice report:

Deeper, more restorative sleep
Reduced daytime fatigue and sleepiness
Improved concentration and cognitive function
Better mood and reduced irritability
Decreased morning headaches
Improved bed partner sleep (no more snoring complaints)
Greater intimacy without CPAP equipment interference

Health Benefits

Effective treatment of sleep apnea—whether with oral appliances or CPAP—reduces the serious health risks associated with untreated OSA:

Cardiovascular disease: Lower risk of hypertension, heart attack, and stroke
Metabolic health: Improved blood sugar control and reduced diabetes risk
Mental health: Decreased depression and anxiety symptoms
Accident prevention: Reduced risk of drowsy driving accidents
Cognitive function: Protection against memory problems and cognitive decline

Who Is a Candidate for Oral Appliance Therapy?

Oral appliance therapy is appropriate for many—but not all—sleep apnea patients. The best candidates include:

Ideal Candidates

Mild to moderate OSA: Apnea-hypopnea index (AHI) between 5 and 30 events per hour
Primary snoring: Snoring without significant apnea events
CPAP intolerant: Patients who have tried and failed CPAP therapy
CPAP non-compliant: Those who cannot consistently use CPAP despite best efforts
Adequate dentition: Sufficient healthy teeth for appliance retention (typically 8-10 per arch)
Good jaw function: Adequate range of motion and no severe TMJ disorders

Patients Who May Benefit with Modifications

Severe OSA: May use oral appliances in combination with other therapies
Partial denture wearers: Custom designs may accommodate partial plates
Mild TMJ issues: Specific appliance designs can minimize jaw stress

Who Is NOT a Candidate

Central sleep apnea: Oral appliances only treat obstructive apnea
Full denture wearers: Insufficient teeth for device retention
Severe periodontal disease: Loose teeth cannot support the appliance
Limited jaw mobility: Inability to protrude the mandible forward
Severe obesity hypoventilation: May require more aggressive treatment

During your consultation at our Hillsboro-area office, we’ll evaluate your specific situation and recommend the most appropriate treatment path.

The Oral Appliance Therapy Process at Our Practice

Step 1: Comprehensive Consultation

Your journey begins with a thorough evaluation at our Aloha office. During this visit, we:

Review your medical history and sleep study results
Perform a comprehensive oral examination and assess your dentition
Evaluate jaw function and range of motion
Screen for TMJ disorders that might affect treatment
Discuss your symptoms, concerns, and treatment goals
Explain the different appliance options available
Answer all your questions about oral appliance therapy

If you haven’t yet had a sleep study, we can coordinate home sleep apnea testing (HSAT) through a referring physician. Remember, sleep apnea diagnosis must come from a medical doctor.

Step 2: Digital Impressions and Records

Once we determine oral appliance therapy is appropriate for you, we take detailed records:

Digital or physical impressions: Precise molds of your upper and lower teeth
Bite registration: Recording your natural jaw relationship
Protrusive range measurement: Documenting how far forward your jaw can move
Photographs: Documenting your starting point for comparison

These records are sent to a specialized dental laboratory that fabricates custom oral appliances to exact specifications.

Step 3: Appliance Fabrication

Your custom appliance is manufactured to exact specifications. This process typically takes 2-3 weeks. We use only FDA-cleared devices from reputable manufacturers, including:

Respire (Blue and Pink series): Highly adjustable, comfortable designs with precision titration
EMA (Elastic Mandibular Advancement): Lightweight with interchangeable straps for easy adjustment
Herbst appliance: Durable metal advancement mechanism with precise adjustment capability
TAP (Thornton Adjustable Positioner): Single-point adjustment mechanism for quick titration

The specific device recommended for you depends on your anatomy, preferences, and clinical needs.

Step 4: Fitting and Initial Calibration

When your appliance arrives, you’ll return for a fitting appointment. During this visit, we:

Verify proper fit on both dental arches
Adjust retention for comfort and security
Set an initial mandibular advancement position (typically 50-60% of maximum protrusion)
Teach you how to insert, remove, and adjust the device
Provide morning jaw exercises to maintain normal function
Give you written care instructions
Schedule your follow-up appointments

Step 5: Titration and Optimization

Oral appliance therapy requires gradual adjustment (titration) to find the optimal jaw position—the setting that effectively treats your apnea while remaining comfortable. Over 4-8 weeks, you’ll:

Advance the appliance incrementally as directed (usually 0.25-0.5mm at a time)
Track your symptoms and sleep quality using our monitoring tools
Return for follow-up visits to assess progress
Report any discomfort or side effects

This careful titration process maximizes effectiveness while minimizing side effects. Rushing this step can lead to unnecessary jaw discomfort.

Step 6: Efficacy Verification

Once you reach what appears to be an optimal setting, we verify treatment effectiveness through a follow-up sleep test (typically a home sleep apnea test). This confirms:

Reduction in apnea-hypopnea index (AHI) to goal levels
Improvement in oxygen saturation
Resolution of symptoms

If the initial results aren’t optimal, we can make further adjustments and retest. Our goal is objective proof that your therapy is working.

Step 7: Ongoing Care and Monitoring

Oral appliance therapy is a long-term treatment requiring periodic follow-up. We recommend:

Annual evaluations: Checking appliance condition and dental health
Periodic adjustments: Fine-tuning as needed over time
Bite monitoring: Watching for any changes in tooth position
Replacement planning: Most appliances last 3-5 years with proper care

Our team remains your partner throughout treatment, ensuring continued success.

Types of Oral Appliances We Offer

Mandibular Advancement Devices (MADs)

The most common and well-studied oral appliances, MADs work by positioning the lower jaw forward. Features vary by brand:

Respire Blue/Pink Series

Fully adjustable titration mechanism
Precision manufacturing for optimal fit
Excellent durability with proper care
Multiple advancement ranges available
Patient-adjustable design

EMA (Elastic Mandibular Advancement)

Lightweight and compact design
Interchangeable elastic straps in different strengths
Color-coded advancement options
Excellent for travel
Easy adjustment for patients

Herbst Appliance

Robust metal advancement mechanism
Highly precise adjustments
Long track record of clinical success
Excellent for patients who grind teeth
Durable construction

TAP (Thornton Adjustable Positioner)

Single-point midline adjustment
Quick titration capability
Proven clinical effectiveness
Hook-and-loop retention design

Tongue Retaining Devices (TRDs)

Less common, TRDs hold the tongue forward without advancing the jaw. They may be appropriate for patients with:

Insufficient teeth for MAD retention
TMJ disorders contraindicating jaw advancement
Specific anatomical considerations

Comparing Oral Appliances to CPAP

Both oral appliances and CPAP effectively treat obstructive sleep apnea, but they work differently and suit different patients.

When CPAP May Be Preferred

Severe sleep apnea (AHI > 30)
Central sleep apnea component
Inadequate teeth for appliance retention
Need for precise pressure titration

When Oral Appliances May Be Preferred

Mild to moderate sleep apnea
CPAP intolerance or non-compliance
Travel requirements
Preference for simpler therapy
Claustrophobia with masks
Bed partner disturbance from CPAP noise

Combination Therapy

Some patients benefit from using both: CPAP at home and an oral appliance for travel. Others may use oral appliances with positional therapy or other adjunctive treatments.

Insurance Coverage and Cost

Medical Insurance Coverage

Oral appliance therapy is a medical treatment covered by most insurance plans, including:

Medicare and Medicare Advantage plans
Blue Cross Blue Shield
Cigna
Aetna
United Healthcare
Providence Health
Kaiser Permanente
Most other medical insurers

Coverage Requirements

Insurance typically requires:

Diagnosis of obstructive sleep apnea via sleep study
Prescription from a physician
Appliance provided by a qualified dental sleep medicine practitioner

Our Insurance Process

We simplify the insurance process by:

Verifying your benefits before treatment begins
Obtaining prior authorization when required
Filing claims directly to your insurance company
Explaining your expected out-of-pocket costs upfront
Offering payment plans for any remaining balance

Many patients have little to no out-of-pocket expense after insurance coverage.

Why Choose Aloha Sleep Apnea & Airway Center?

Specialized Expertise

Unlike general dentists who occasionally provide oral appliances, dental sleep medicine is our specialty. We have extensive training and experience specifically in treating sleep-disordered breathing.

Physician Collaboration

We work closely with sleep physicians, pulmonologists, and primary care providers throughout Washington County and the Portland metro area. Sleep testing is ordered and interpreted by qualified physicians—we focus on providing expert oral appliance therapy.

Convenient Location

Located in Aloha, Oregon, we’re easily accessible from Hillsboro, Beaverton, Portland West Side, Tigard, Tualatin, and surrounding communities.

Take the First Step Toward Better Sleep

If you’re struggling with sleep apnea, snoring, or CPAP intolerance, oral appliance therapy may be the solution you’ve been looking for. Our experienced team is ready to help you achieve restful, restorative sleep.

Schedule your free consultation today to learn if oral appliance therapy is right for you. We’ll answer your questions, evaluate your candidacy, and explain exactly what to expect from treatment.

Don’t let sleep apnea control your life. Contact Aloha Sleep Apnea & Airway Center and start your journey to better sleep tonight.

Important: Home sleep apnea testing (HSAT) is ordered and interpreted by a physician. We coordinate testing and provide oral appliance therapy as a CPAP alternative in collaboration with the patient’s sleep physician.