Overview of oral appliances
Oral Appliances are plastic devices worn over the upper and lower teeth, similar
to an orthodontic retainer or mouth guard. Worn during sleep, oral appliances
prevent the soft tissues of the throat from collapsing and obstructing the
airway. The appliances move the lower jaw slightly forward, bringing the base
of the tongue with it, opening the airway to allow improved breathing, reduced
snoring and fewer apneas during sleep.
Oral appliances can be used alone or in conjunction with other means of sleep
apnea therapy such as continuous positive air pressure (CPAP). Determination
of proper therapy can only be made by joint consultation of your dentist and
Currently there are at least 40 different designs of oral appliances available
to specially trained dentists to treat snoring and sleep apnea.
At The Orofacial Pain Center we use four different mandibular repositioning appliances
as primary treatment.
The Herbst Appliance is a
mandibular repositioner that has been in use
for many years in orthodontic and TMJ therapy
prior to its modification for treatment of sleep
disordered breathing. Using a telescopic sliding
tube connection between the upper and lower retainer
portions, the Herbst permits lateral and vertical
movement while maintaining the desired mandible-forward
position. It is sturdy and fully adjustable
to find the most effective and comfortable
position. Adjustment of position is quick,
easy and very accurate. Base materials available
include thermoactive and soft materials as
well as hard acrylic, with retention by friction
grip and optional clasps.
Adjustable PM Positioner is a mandibular repositioning
appliance designed for use treating snoring and
sleep apnea. With bases of a thermo-active material
fitting over the upper and lower teeth, expansion
screws on the left and right cheek areas control
the anterior-posterior positioning of the lower
jaw to achieve optimal effectiveness with comfort.
Some lateral movement is possible and the tongue
space is unobstructed.
The TAP Appliance uses thermoplastic
bases and a unique adjustable bar and hook arrangement
in the front of the appliance to achieve effective
positioning and comfort. The custom designed
bases are well retained through frictional grip
on the teeth, the hook from the upper engages
the bar on the lower and the projecting handle
is rotated to attain the desired forward position.
Some lateral as well as a little vertical movement
is possible, and all of the adjusting mechanism
is located at the front of the appliance.
Klearway™ is a fully-adjustable oral
appliance used for the treatment of snoring and
mild to moderate Obstructive Sleep Apnea. Fabricated
of thermoactive acrylic resin, Klearway becomes
pliable for easy insertion and conforms securely
to the dentition for an excellent fit while significantly
decreasing soft tissue and tooth discomfort.
Small increments (0.25mm) of forward lower jaw
advancement are initiated by the patient under
the direction of a dentist and this helps avoid
rapid jaw movements that can cause significant
patient discomfort. The appliance does not encroach
on tongue space.
Once warmed under hot water and inserted, the
acrylic resin hardens as it cools to body temperature
and firmly affixes itself to both arches. Lateral
and vertical jaw movement is permitted which
enables the patient to yawn, swallow, and drink
water without dislodging the appliance.
About Oral Appliances Possible
Side Effects Effectiveness,
Rationale and Indications