As an alternative to CPAP therapy, or in conjunction with CPAP therapy, oral appliance therapy has been proven to be effective in treating obstructive sleep apnea. Oral appliance therapy requires that both the sleep specialist at one of our facilities in San Antonio and Ennis and a specially trained dentist work together as an integrated team to resolve the sleep apnea and optimize the therapeutic response.



What is an oral appliance?

The oral appliance used in oral appliance therapy for obstructive sleep apnea is a small device worn over the teeth much like a sports mouth guard or orthodontic retainer. Worn during the night, it repositions the jaw in a forward position to prevent the upper airway from collapsing during sleep.


How do the sleep specialist and dentist work together to deliver oral appliance therapy?

If indicated, the sleep specialist will write the prescription for oral appliance therapy and then refer the patient to a qualified dentist trained in oral appliance therapy. The treating dentist then sees the patient and custom fabricates and fits the patient with the oral appliance. The patient then generally returns to the sleep clinic for a follow-up titration polysomnography to determine the optimal settings for the oral appliance to be used to eliminate the sleep apnea.


What happens during the titration polysomnography for oral appliance therapy?

For the titration study, the patient arrives at the sleep clinic with the oral appliance that has been custom fabricated and fitted by his or her dentist. In a process analogous to CPAP titration, the oral appliance is adjusted manually or remotely by trial and error during the night to determine the optimal degree to advance the lower jaw forward to resolve the sleep apnea. The titration polysomnography serves to verify whether the oral appliance is effective in treating the sleep apnea.


Can a dentist write the prescription for oral appliance therapy?

No, only a physician can write the prescription for oral appliance therapy. However, only a specially trained and qualified dentist can fabricate and fit the oral appliance. The sleep specialist and dentist must work closely together to provide the patient with optimal care.


Can both oral appliance therapy and CPAP therapy be used together?

Oral appliances can be used alone or, in some cases, in conjunction with continuous positive air pressure (CPAP) devices if CPAP therapy alone is insufficient to treat the sleep apnea.