Reviewed by Dr. Adel Elbaz, DDS, general dentist · Last reviewed
Snoring and Sleep Apnea Appliances in London, Ontario
Snoring happens when the soft tissues at the back of the throat relax during sleep and vibrate as air moves past. In obstructive sleep apnea, those tissues collapse far enough to block the airway, so breathing stops for seconds at a time, often many times an hour, until the brain briefly wakes you to breathe again.
A custom oral appliance, a small device worn over the teeth at night, holds the lower jaw slightly forward to keep the airway open. At Lunar Smile Dentistry we make these appliances for people who snore and for patients diagnosed with sleep apnea by a physician.
Signs of sleep apnea
- loud, regular snoring
- gasping, choking or pauses in breathing that someone else notices
- waking up tired even after a full night in bed
- daytime sleepiness, or nodding off while reading or driving
- morning headaches or a dry mouth
- trouble concentrating, memory problems or irritability
- waking often to use the bathroom at night
Untreated sleep apnea has been linked with high blood pressure, heart disease, stroke, diabetes and car accidents from drowsy driving, so it’s worth taking seriously.
Risk factors
- carrying extra weight, especially around the neck
- a naturally narrow airway, a small or set-back lower jaw, or large tonsils
- being male, or a woman after menopause
- older age
- a family history of sleep apnea
- alcohol, sedatives or smoking
- sleeping on your back
- nasal congestion
Diagnosis comes first
Snoring alone can be a nuisance; sleep apnea is a medical condition. Before we make an appliance for suspected sleep apnea, it needs to be diagnosed by a physician with a sleep study, either overnight in a sleep clinic or with a home test. Your family doctor can arrange one. If we notice signs at your dental check-up, such as a narrow airway, large tongue or worn teeth from grinding, we’ll suggest you talk to your doctor.
How an oral appliance works
The appliance we use is a mandibular advancement device: two thin, custom trays, one for the upper teeth and one for the lower, linked so that the lower jaw sits slightly forward while you sleep. That pulls the tongue and soft tissues away from the back of the throat and keeps the airway open.
Oral appliances are a recognized treatment for:
- snoring without sleep apnea
- mild to moderate obstructive sleep apnea
- people with sleep apnea who can’t tolerate CPAP (a mask and air pump), which remains the first-line treatment for more severe cases
Appliance vs CPAP
| Oral appliance | CPAP machine | |
|---|---|---|
| What it is | Custom trays over the teeth | Mask connected to an air pump |
| Noise | Silent | Quiet hum |
| Travel | Fits in a small case | Needs a machine and power |
| Best for | Snoring, mild to moderate apnea, CPAP intolerance | All severities, especially severe apnea |
| Comfort | Most people adjust within a few weeks | Some people find the mask hard to tolerate |
The process
- Consultation. We review your sleep study, medical history and symptoms, and check your teeth, gums and jaw joints. Teeth and gums need to be healthy enough to hold the appliance.
- Records. We take a digital scan of your teeth and record your bite.
- Fitting. The appliance is made by a dental lab. We fit it, adjust it for comfort and show you how to use and clean it.
- Adjusting. Over the following weeks we gradually move your jaw position forward until snoring and symptoms improve.
- Follow-up. For sleep apnea, your physician may arrange another sleep study with the appliance in place to confirm it’s working.
Getting used to it
For the first few weeks, you may notice extra saliva, mild jaw or tooth tenderness in the morning, or that your bite feels slightly off for a short while after taking it out. These usually settle. We’ll check your bite and jaw at regular visits, because long-term use can gradually shift teeth.
If you also grind your teeth, the appliance protects them in much the same way as a night guard. Jaw pain? See TMD treatment.
Cost and coverage
Some extended health plans cover oral appliances for diagnosed sleep apnea, often under medical rather than dental benefits, and usually with a sleep study report and a physician’s note. Appliances for snoring alone are less often covered. We’ll help with the paperwork and give you the cost before we start. Our fees follow the Ontario Dental Association fee guide.
Common questions
Will an appliance stop my snoring?
For many people it reduces or stops snoring, but results vary. We’ll adjust it in steps to find what works for you.
Can I get an appliance without a sleep study?
For snoring alone, sometimes. If there are signs of sleep apnea, such as pauses in breathing or daytime sleepiness, a sleep study should come first, because a snoring appliance can mask a serious problem.
How long does an appliance last?
Typically several years, depending on wear and whether you grind. We’ll check it at your regular visits.
Book a consultation in London
Tired of snoring, or diagnosed with sleep apnea and struggling with CPAP? Book online or call 226-884-2573. We’re open six days a week, with evening appointments until 9 pm on weekdays.
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