Snoring and Obstructive Sleep Apnea: Role of Dental Appliances

Snoring is noisy breathing during sleep. It is the sound caused by vibrations in the upper airways of the respiratory system due to partial obstruction of air movement while sleeping. Snoring is common, occurring in 44 percent of males and 28 percent of females who are between 30 and 60 years of age in the general population (1). Nearly 60% of men over the age of 40 snoring regularly. While in many cases snoring can be relatively harmless and nothing more than an annoyance for the partner, there could also be some serious potential health risks connected with frequent snoring.

If your snoring is too loud it may be a good indicator that you might have obstructive sleep apnea (OSA). A CPAP (continuous positive airway) machine is a device that uses mild air pressure to keep your airways open. There are a variety of devices that come in all shapes and sizes to accommodate your comfort level including nasal pillows, nasal masks, and full-face masks. However, some patients may not be able to tolerate CPAP during the night.

Mandibular advancement devices (MADs) push the lower jaw muscles and tongue forward and prevent the throat muscles from collapsing back into your airways. This not only helps in reducing snoring but also helps to increase the airflow by making the airway larger and improving airflow. Tongue retaining devices are used less commonly than MADs especially in people with fewer teeth or temporomandibular joint problems.  These devices hold the tongue forward to keep the airway open. According to the American Academy of Sleep Medicine (AASM) and American Academy of Dental Sleep Medicine (AADSM) statement, when oral appliance therapy is prescribed by a sleep physician for an adult patient with obstructive sleep apnea, a custom made, titratable appliance is recommended over non-custom oral devices that is fabricated by a qualified dentist or dental specialist  (2).

  1. The occurrence of sleep-disordered breathing among middle-aged adults.Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. N Engl J Med. 1993;328(17):1230. 
  2. Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015. Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM, Chervin RD J Clin Sleep Med. 2015;11(7):773-827.