Removable intra-oral devices for snoring and sleep apnoea

Intra-oral devices, Oral appliances or Mandibular advancement devices describe a range of appliances that can be used to improve snoring or obstructive sleep apnoea (OSA). The appliance fits onto the teeth and holds the lower jaw forward to increase the diameter of the upper airway. The forward positioning only occurs when the appliance is worn.

Mandibular advancement device

These appliances have been found to be effective in the care of patients with snoring and mild symptomatic OSA when patients are unable to tolerate CPAP (continuous positive airway pressure). Response to therapy varies with studies reporting a 50% improvement in 70% of cases. Patients should be under the care of a sleep specialist and have had a sleep study undertaken prior to considering a mandibular advancement device.

It is important that the patient has healthy teeth and gums to support the appliance. Some people report excess salivation, effects on speech and occasionally tooth and jaw ache. Most side effects subside in the first few months of use. In some cases adverse tooth movement can occur with prolonged use of the appliance so it is important to maintain regular checkups with your dentist if you wear the appliance for a long period.

The appliances can be more effective when patients have certain underlying jaw relationships, which can be assessed during an orthodontic examination and measured on a profile jaw x-ray. At your consultation photographs and x-rays will be taken to assess if you are likely to benefit from a device.

Following an assessment, impressions of the mouth are needed so that a technician in a laboratory can construct a custom made adjustable appliance for your mouth. Our preferred design is constructed in 2 parts with each part attached to upper and lower jaws. The appliance is adjustable and a soft inner lining improves fit and comfort.