Types of Oral Appliances for Sleep Apnea Choosing the Right Fit

Sleep apnea is a sleep disorder in which airways collapse during restful sleep, leading to breathing interruptions. This can happen hundreds or even thousands of times per night, increasing daytime fatigue, mood disturbance, and health complications.

Sleep apnea treatment options vary widely, including oral appliances. Oral appliances are custom-made devices designed to fit over the teeth and move forward during sleep to open up airways. Oral appliances may be an attractive option for people who find CPAP machines too cumbersome or prefer non-invasive approaches as an option for treating sleep apnea.

Your oral appliance choices depend on your individual needs and preferences, so it is wise to consult your healthcare provider or dentist about which appliance would best meet those.

This article will go into greater depth about the various sleep apnea appliance types. Additionally, we’ll address how to select the ideal option. Let’s go!

Types of Oral Appliances

There are various oral appliances designed specifically to treat sleep apnea, each featuring its own design and method of action.

Mandibular Advancement Devices (MADs)

MADs are among the most frequently prescribed oral appliances for sleep apnea, typically consisting of two separate trays for upper teeth and lower teeth joined together by a hinge.

MADs work by gradually moving the lower jaw forward to open up airway passageways, helping provide uninterrupted airflow when sleeping.

Tongue Retaining Devices (TRDs)

TRDs are oral appliances used to keep airways open by moving the tongue forward to prevent it from blocking the upper airway. 

Usually consisting of a suction cup or bulb that grasps onto the tip of your tongue while the rest of the tongue rests comfortably within your oral cavity, these TRDs can prevent your tongue from falling back and blocking your throat to reduce or eliminate sleep apnea events.

Occlusal Splints

Occlusal splints, also referred to as bite splints or night guards, can help treat bruxism (teeth grinding), sleep apnea and Temporomandibular Joint Disorder (TMJ).

Worn during sleep hours, these devices help protect teeth from grinding forces while simultaneously stabilizing jaw joint pain and muscle tension relief.

Orthodontic Appliances

Orthodontic appliances are used to correct misalignments of teeth and jaw alignment issues by applying pressure. Over time, they help restore proper positioning to each individual tooth in the mouth. There are various kinds of orthodontic appliances, including:


Braces are one of the most frequently used orthodontic appliances, consisting of brackets bonded directly onto teeth connected by wires that apply pressure to them. They gradually move the teeth into their proper positions.


Aligners are a relatively newer type of orthodontic appliance made out of clear plastic that are worn over the teeth to gradually move them over time.


Headgear is an orthodontic appliance worn over the head and attached to the teeth in order to correct jaw alignment issues.

The Effectiveness of Oral Appliances

Oral appliances are successful at treating mild to moderate obstructive sleep apnea. Multiple studies have revealed their ability to decrease the frequency and severity of apnea episodes, improve the quality of sleep, and alleviate daytime symptoms such as excessive fatigue.

Oral appliances’ effectiveness varies based on individual factors, including the severity of sleep apnea, anatomical characteristics, and patient compliance.

On average, oral appliances have proven successful in reducing apnea-hypopnea index (AHI), which measures how often events like apnea or hypopnea occur during an hour of sleep.

Studies published in the Journal of Dental Sleep Medicine demonstrated that MADs significantly reduced AHI by an average of 50% while also improving oxygen saturation levels during sleep.

Another American Journal of Respiratory and Critical Care Medicine study notes that TRDs reduced AHI by roughly 50% for persons diagnosed with mild-moderate sleep apnea.

Noting the limitations of oral appliances is key when considering their efficacy; success often hinges on patient adherence to wearing the device night after night while sleeping.

Considerations When Selecting an Oral Appliance

When selecting an oral appliance to treat sleep apnea, several key aspects should be kept in mind in order to achieve maximum effectiveness:


Comfort is of utmost importance in order to achieve compliance and long-term use of an oral appliance. The device should fit correctly without causing excessive irritation, pain or discomfort to teeth, jawbone or oral tissues.


Certain oral appliances feature adjustability features that enable you to customize them to your unique needs, including being able to alter advancement or position of the lower jaw or tongue to optimize treatment outcomes.

Ease of Use

Oral appliances should be easy to insert and remove without impeding speech or swallowing ability. They should also be suitable for travel or use outside the home.

Severity of Sleep Apnea

The severity of sleep apnea as measured by AHI and other diagnostic tools, may influence which oral appliance to select for treatment.

Mild to moderate cases may require specific devices, while more serious cases might require multiple forms of therapy and treatments to bring relief.

Individual Preferences

Understanding individual preferences is essential to ensuring patient satisfaction and compliance. Take into account aesthetics, maintenance requirements, and lifestyle considerations when selecting an oral appliance.

Consultation and Assessment

Prior to selecting an oral appliance, consulting with a healthcare provider who specializes in sleep medicine or dental sleep medicine is highly recommended.

This will allow for a detailed evaluation of your sleep apnea condition as well as help identify which appliance would best meet your needs.

At the initial consultation, a healthcare provider will carefully review your medical history, taking note of any pre-existing conditions or medications which could affect treatment options for sleep apnea. They may also inquire into your sleeping patterns, symptoms, and lifestyle choices, which they believe might contribute to sleep apnea.

Long-Term Maintenance and Care

In order to extend the longevity and effectiveness of oral appliances, ongoing care and maintenance is crucial.


Oral appliances should be professionally cleaned on a daily basis using a soft toothbrush and mild soap or denture cleaner in order to effectively eliminate plaque, bacteria, and odor. Avoid using toothpaste as it can be too abrasive and damage the appliance.


Oral appliances must be kept in a clean and dry case to prevent contamination and damage.

Follow-Up Visits

Regular follow-up visits are vital in order to monitor treatment progress, make any necessary adjustments, and address any concerns or issues that arise during care.

Personalized Considerations

Every patient is different, so taking into account individual considerations when selecting an oral appliance to treat sleep apnea is vital. Some key factors include:

Anatomical Factors

Your specific airway, jaw, and tongue anatomy will determine which oral appliance you need. Your dental care professional will evaluate these features to help you select an appliance that provides maximum effectiveness.

Dental Condition

Your dental health may influence your choice of oral appliance. Factors like crowns, bridges, or other forms of dental work could potentially require modifications and customization in order to accommodate your oral appliance. 

Cost and Insurance Coverage

Oral appliances vary in cost, and insurance coverage may depend on the type of your individual plan, making the financial considerations during purchase essential to identifying out-of-pocket expenses and outlays.

Final Thoughts

In conclusion, it’s evident that choosing the right oral appliance to treat sleep apnea episodes is key to effective treatment and better sleep quality.

Oral appliances provide non-invasive alternatives to more invasive forms of treatment like CPAP or surgery, providing greater freedom from discomfort during sleep apnea episodes.

So if you’re experiencing sleep apnea episodes, speak to your dentist immediately to get the best oral appliance for your individual needs.