A dental device for sleep apnoea is a custom-made splint, worn at night, that holds the lower jaw slightly forward so the airway is less likely to narrow or close. It can work well for the right person. It is also the last step in a process that should start with a doctor, not a dentist.
What obstructive sleep apnoea is
The Sleep Health Foundation describes obstructive sleep apnoea (OSA) as repeated narrowing or closure of the throat during sleep, with breathing reduced or stopped for 10 seconds to a minute or more, sometimes hundreds of times a night.
Common signs include loud snoring, waking up gasping or choking, and daytime sleepiness. Untreated moderate to severe OSA is linked with higher risk of high blood pressure, heart attack, stroke, diabetes, depression and accidents.
How a sleep apnoea dental device works
The usual device is a mandibular advancement splint (MAS), also called an oral appliance. It looks like a double mouthguard, with upper and lower pieces linked together. In the Sleep Health Foundation’s words, these appliances “push your lower jaw forwards”, opening the airway so it is less likely to vibrate (snore) or obstruct.
Because the jaw position has to be right, the splint is made from impressions or scans of your teeth, which takes two to three weeks, then fine-tuned over the following weeks.
A night guard for grinding is not the same thing
A night guard for teeth grinding is a single plate that protects the teeth from wear. It does not move the jaw forward, so it does nothing for the airway. Both are worn at night and both are made by a dentist, but they do different jobs.
The two problems do overlap. Grinding during sleep can be associated with sleep apnoea, so a dentist who sees heavy wear and hears that you snore may suggest you talk to your GP.
Who a dental device suits
Oral appliances generally work best for mild to moderate obstructive sleep apnoea, according to the Sleep Health Foundation. A properly fitted device also works well for snoring on its own.
They are a weaker fit in other situations:
- Severe OSA. CPAP (continuous positive airway pressure, a small pump that delivers air through a mask) stops sleep apnoea in almost everyone who uses it. An oral appliance usually improves it, but may not stop it completely.
- Central sleep apnoea. Here the problem is the brain’s signal to breathe rather than a blocked airway, and an oral appliance will probably not help.
- Individual factors. Body weight and sleeping position both affect how well a device works.
The splint also needs healthy teeth and jaw joints to work with, which is part of the dental assessment.
Why diagnosis comes first
A dental device should only be made after a doctor has diagnosed sleep apnoea, usually with an overnight sleep study. The Australian Dental Association’s policy on dental appliances for sleep-disordered breathing states that both diagnosis and the prescription for therapy require assessment by the patient’s medical practitioner, and that a team approach is essential.
The usual path: your GP assesses your symptoms and refers you for a sleep study, at home or in a clinic, and a sleep physician recommends treatment. If that is an oral appliance, a dentist makes and adjusts it.
Skipping straight to a device risks quieting the snoring while the apnoea goes untreated. Having GPs at King Street Medical in the same building as the dental clinic makes that first conversation easy to start.
Living with a splint
Most people need a few weeks to adjust. The Sleep Health Foundation lists jaw discomfort, extra saliva and tender teeth early on, and over the longer term possible tooth movement, bite changes or jaw joint and muscle problems. The ADA policy treats monitoring of the jaw joint and tooth movement as essential for long-term users, so regular dental reviews are part of the treatment.
Frequently asked questions
Do chemist or online sleep apnoea mouthguards work?
Usually not. The Sleep Health Foundation says over-the-counter devices are cheaper but usually do not work, because every mouth and jaw is a different shape. A device that quietens snoring can also leave apnoea untreated, which is why diagnosis should come before any device.
Is a dental device better than CPAP?
Not as a rule. CPAP stops sleep apnoea in almost everyone who uses it, while an oral appliance usually improves it without always stopping it. Some people find a splint easier to use every night. The right choice depends on how severe your apnoea is, and is best made with your doctor or sleep physician.
Can a night guard for teeth grinding help sleep apnoea?
No. A grinding night guard protects the teeth but does not reposition the jaw, so it does not open the airway. A sleep apnoea device is a mandibular advancement splint built to hold the lower jaw forward. If you grind and also snore or wake unrefreshed, ask your GP whether sleep apnoea should be investigated.
Do I need a referral to get a sleep apnoea splint?
You need a diagnosis. The Australian Dental Association’s position is that diagnosis and the prescription for therapy come from your medical practitioner, typically after a sleep study arranged through your GP. A dentist then makes and adjusts the device and monitors your teeth and jaw over time.
Getting a sleep apnoea splint in Warrawong
If your doctor has diagnosed obstructive sleep apnoea and recommended an oral appliance, King Street Dental makes nightguards and splints at its Warrawong dental clinic and can check whether your teeth and jaw suit one. If you have not yet been assessed, start with a GP.
This article is general information, not advice about your own health. See a doctor about snoring or daytime sleepiness, and a dentist about whether an oral appliance suits your mouth.