Sleep apnea treatment at a dentist means oral appliance therapy: a custom night appliance that holds your lower jaw forward to help keep your airway open. Redondo Beach Dental Group makes them for adults diagnosed by a physician, a short drive from Torrance, Hermosa Beach and Manhattan Beach.
The diagnosis has to come first. Only a sleep physician can diagnose sleep apnea, usually with an overnight sleep study at a sleep center or at home. If you snore, wake up tired or have been told you stop breathing in your sleep, talk to your physician. Call (310) 542-6988 if you have a diagnosis and want to know whether an appliance could work for you.
What Obstructive Sleep Apnea Is
Obstructive sleep apnea is a sleep disorder in which the airway repeatedly narrows or closes during sleep, usually because the tongue or soft tissue at the back of the throat falls back as the muscles relax. Each pause can briefly wake you without you noticing, so you can sleep a full night and still feel exhausted.
Common signs include:
- Loud, frequent snoring
- Pauses in breathing, choking or gasping that a partner notices
- Extreme drowsiness during the day
- Waking with a dry mouth or sore throat
- Morning headaches
- Difficulty staying asleep, irritability or mood changes
Left untreated, sleep apnea can contribute to serious health problems, including high blood pressure and heart disease, which is why treatment should be guided by a physician.
Who Does What: Your Physician and Your Dentist
The clinical practice guideline from the American Academy of Sleep Medicine (AASM) and the American Academy of Dental Sleep Medicine (AADSM) sets out the roles:
- A sleep physician diagnoses sleep apnea and judges how severe it is.
- If an oral appliance is a reasonable option, the physician prescribes it.
- A dentist makes and fits a custom appliance, then adjusts it over the following weeks.
- The physician arranges a follow-up sleep test to confirm the appliance is working.
- You keep seeing both: the dentist to check your teeth, jaw and bite, and the physician to check your sleep.
Our part is steps 3 and 5. We do not diagnose sleep apnea or offer an appliance in place of testing.
How a Sleep Apnea Oral Appliance Works
A sleep apnea appliance looks a little like a sports mouth guard and fits over your upper and lower teeth. It holds your lower jaw slightly forward while you sleep, which draws the tongue and soft tissues away from the back of the throat. Most designs are called mandibular advancement devices.
The AASM and AADSM guideline recommends a custom-made appliance that can be adjusted, rather than a store-bought one. A custom appliance is made from impressions or a scan of your teeth, and the amount of forward movement can be changed in small steps until it controls your symptoms without straining your jaw.
Who an Appliance Suits, and Its Limits
The AASM and AADSM guideline says CPAP should still generally be the first-line option for obstructive sleep apnea. Under the same guideline, a physician may prescribe an oral appliance for adults with obstructive sleep apnea who cannot tolerate CPAP, the machine that blows air through a mask, or who prefer a different therapy. Many people find an appliance easier to live with, since it is small, quiet and needs no power.
An appliance does not cure sleep apnea, and it does not work equally well for everyone. In one randomized trial reviewed for the 2015 AASM and AADSM guideline, about 43% of patients using an oral appliance had a complete response, compared with about 73% using CPAP. The guideline also found that for moderate to severe sleep apnea, CPAP is more likely to reach the target. The follow-up sleep test shows whether your appliance is doing its job or whether you and your physician need a different plan.
An appliance may not be possible if you have too few healthy teeth to anchor it, active gum disease, or significant jaw joint problems. If your jaw already hurts or clicks, an evaluation for TMJ treatment may need to come first.
Snoring Without Sleep Apnea
Snoring on its own is common and is not always a sign of sleep apnea. The guideline does support oral appliances for adults who snore and do not have sleep apnea, but only after a physician has ruled sleep apnea out. An appliance that quiets snoring can hide the main warning sign of apnea.
A Night Guard Is Not a Sleep Apnea Appliance
A custom night guard for grinding protects your teeth from clenching but does not move your jaw, so it does nothing to open your airway. If you grind your teeth and also snore, tell us, because the two problems are treated differently.
What to Expect at the Dental Office
Once you have a diagnosis and a prescription, your dentist checks your teeth, gums and jaw to make sure an appliance is safe for you, then takes impressions or a scan. Fitting and adjustment visits follow while you get used to it. Ask us how many visits to plan for.
Mild side effects are common, especially at first. The guideline lists sore teeth, sore jaw muscles, extra saliva or a dry mouth, and some stiffness when chewing in the morning. Over time an appliance can also shift your bite, which is why the guideline recommends regular dental follow-up for as long as you wear one. Keeping up with your dental cleanings and exams gives us a regular chance to check your teeth and the appliance together.
Who You Will See
Dr. Moshe Eizdi leads care at Redondo Beach Dental Group. He earned his Doctor of Dental Surgery degree at the University of Southern California, where he graduated with honors, and his work covers cosmetic and restorative dentistry, including implant restorations.
What a Sleep Apnea Appliance Costs and How Insurance Handles It
The cost of oral appliance therapy depends on the type of appliance, the number of fitting and adjustment visits, and any dental work needed before an appliance can be made. Ask for an estimate once we know which appliance fits your case.
Coverage varies more than for most dental care. Because sleep apnea is a medical diagnosis, some medical plans cover part of an appliance, while some dental plans limit or exclude it. Ask us how your plan applies to this treatment. We accept PPO plans, and for costs your plan does not cover we offer payment plans through Cherry, CareCredit and LendingClub, plus an in-office plan for patients without insurance.
Frequently Asked Questions
Can sleep apnea be treated by a dentist?
A dentist can treat sleep apnea with a custom oral appliance once a sleep physician has diagnosed it with a sleep study and prescribed the appliance. The dentist makes, fits and adjusts it, and a follow-up sleep test checks that it works.
Can dentists tell if you have sleep apnea?
A dentist cannot diagnose sleep apnea, but may notice signs that suggest it, such as worn teeth from grinding or a crowded airway at the back of the mouth. If those signs appear, the next step is to talk to your physician about a sleep study.
How much does it cost to get a mouth appliance for sleep apnea?
The cost of a sleep apnea mouth appliance depends on the design, the number of adjustment visits and any dental work needed first. Redondo Beach Dental Group can give you an estimate once your exam shows which appliance fits your case.
Does insurance cover an oral appliance for sleep apnea?
Insurance coverage for a sleep apnea oral appliance varies. Because sleep apnea is a medical diagnosis, some medical plans cover part of the cost, and dental plans differ widely. Ask us how your plan applies to this treatment.
Is an oral appliance as good as CPAP?
An oral appliance is not always as effective as CPAP, especially for moderate to severe sleep apnea, but the AASM and AADSM guideline supports it for adults who cannot tolerate CPAP or prefer another option. A follow-up sleep test shows how well it works for you.
Can sleep apnea contribute to tooth decay?
Sleep apnea does not cause tooth decay directly, but it often comes with mouth breathing at night, which dries the mouth. Saliva helps protect teeth, so a dry mouth can raise the risk of cavities.
What damage can sleep apnea cause?
Untreated sleep apnea can contribute to high blood pressure, heart disease and other health problems, and the daytime sleepiness it causes raises the risk of accidents. A diagnosis and the treatment your physician recommends lower those risks.
Can losing 20 pounds cure sleep apnea?
Losing weight can reduce the severity of sleep apnea in people who are overweight, and sleeping on your side and avoiding alcohol at night can help too. Weight loss does not cure sleep apnea for everyone, so talk to your physician, who may order a new sleep test, before changing treatment.
Ask About a Sleep Apnea Appliance in Redondo Beach
Redondo Beach Dental Group is at 2511 Artesia Blvd, Redondo Beach, CA 90278. We are open Monday 7:30 a.m. to 5:30 p.m., Tuesday 8:30 a.m. to 5:30 p.m., and Wednesday through Friday 7:30 a.m. to 5:30 p.m. Call (310) 542-6988 or request an appointment online, and bring your sleep study results or your physician’s prescription if you have them. If you already come to us for general and family dentistry, you can also raise snoring or tiredness at your next checkup.