Oral Appliance Therapy Solutions

Oral appliance therapy is one of the most popular alternatives to traditional CPAP for sleep apnea treatment. It’s a custom-fitted appliance that feels very similar to a mouthguard, requires no electricity, takes less than half the time to clean as a CPAP, and is silent.

At Bucks County Dental Sleep Medicine and TMJ Therapy, we find that oral appliances are a fantastic option for patients to effectively treat their sleep apnea and improve their overall health.

How Oral Appliance Therapy Works

This therapy is a noninvasive treatment for sleep apnea or for chronic snoring. This appliance is custom-made to fit comfortably over your teeth while you sleep, like a mouth guard or a retainer.

The oral appliance secures your airway open by repositioning your lower jaw and tongue so they don’t collapse during the night. It’s discreet, quiet, and portable.

Benefits of Oral Appliance Therapy

CPAP is typically the standard treatment for sleep apnea, but many people find it difficult to wear it every single night. Patients tend to prefer oral appliances because they are:

For those who can’t successfully use CPAP therapy or have mild to moderate sleep apnea, oral appliances are a very effective treatment option.

Types of Oral Appliances

Depending on the structure of your jaw and soft tissues, you may need a particular kind of oral appliance.

Mandibular Advancement Devices (MAD)

This is the most common appliance. This device is secured to your teeth, and it moves your lower jaw forward. This then pulls the tongue forward and out of the airway.

The size and material of this device can vary, as can whether it is one-piece or two-piece. MADs with two pieces tend to be more comfortable compared to one-piece MADs and allow for more precise adjustments as needed.

There are also over-the-counter MADs that are fitted by heating the appliance in hot water and then forming it to the teeth. We don’t recommend these as they are often uncomfortable, don’t fit right, and don’t effectively treat sleep apnea like they claim to.

Rapid Maxillary Expansion (RME)

This is a traditional orthodontic treatment device that helps to widen the upper jaw over time. This expander is worn at all times and is most commonly used in children following a comprehensive orthodontic airway plan. Because RME appliances are anchored directly to the teeth, they are highly effective for pediatric growth modification. In adults, RME is an excellent, minimally invasive option for cases that require only mild expansion, or to gently resolve minor crowding without the need for significant skeletal changes to the jawbone.

MARPE & MASPE Adult Expansion

For teens and adults whose jawbones have matured, achieving a larger airway requires a highly specialized approach. This is where MARPE and MASPE come in.

MARPE stands for Miniscrew-Assisted Rapid Palatal Expansion. Unlike traditional RME expanders that push against the teeth, a MARPE appliance uses tiny, temporary implants (miniscrews) placed in the roof of the mouth. This allows the device to gently widen the underlying bone of the upper jaw and nasal cavity directly, rather than just tipping the teeth outward. This true skeletal expansion significantly increases nasal volume and opens the airway, providing profound relief for sleep apnea and chronic breathing issues.

MASPE stands for Miniscrew-Assisted Slow Palatal Expansion. It is important to know that MASPE is not a different appliance than MARPE—it simply refers to the way the appliance is activated. While traditional MARPE uses a "rapid" schedule that can cause temporary gaps between the front teeth and uncomfortable pressure, MASPE uses a slow, gentle, and controlled activation protocol. By expanding the palate slowly over a longer period, MASPE encourages natural bone remodeling. This results in a highly comfortable experience, prevents the sudden cosmetic gap between the front teeth, and provides exceptionally stable, long-term improvements to your breathing and sleep health.

FAQs

Does insurance pay for oral appliances for sleep apnea?

Most health insurance plans, including Medicare, cover oral appliance therapy when certain conditions are met. An oral appliance is typically coded as a type of durable medical equipment (DME).

Do oral appliances hurt?

Oral appliances generally are painless. Some people, however, may experience mild discomfort or jaw soreness in the first few days of wearing their new device as their jaw muscles get used to it.

What’s the success rate of oral appliance therapy?

Oral appliance therapy has a clinical success rate of up to 70% in reducing or eliminating symptoms of obstructive sleep apnea.