Home / Sleep Apnea
Sleep dentistry
The CPAP is in
the closet.
Now what?
Obstructive sleep apnea is diagnosed by a physician and it is a genuinely serious condition. For patients who cannot tolerate a CPAP machine, a custom oral appliance is a recognized alternative — and a dentist is who makes it.
Why people come here
- Surgery and the finished teeth done by one dentist, under one roof
- Clinical Director of the Resnik Implant Institute — 7,000+ CE hours since 1982
- Relaxation and sedation options for anxious patients
- A written, itemized plan before anything is scheduled
How it works
Hold the lower jaw forward and the airway stays open.
During sleep the muscles of the throat relax. In some people the tongue and soft tissue fall back far enough to narrow or close the airway, which is what snoring is — and when it closes completely and repeatedly, that is obstructive sleep apnea.
A mandibular advancement appliance holds the lower jaw slightly forward through the night, which carries the tongue with it and keeps the airway open. It is custom made to your teeth, it is titrated gradually, and it fits in a pocket.
Where the line is
Diagnosis is not a dental job. Sleep apnea is diagnosed from a sleep study ordered and interpreted by a physician, and severe apnea is usually best treated with CPAP. Oral appliance therapy is for patients whose physician has agreed it is appropriate.
Candidacy
Who an appliance suits.
Not the right route
Talk to your physician first
- Anyone who has never had a sleep study — start there
- Severe apnea that is responding well to CPAP
- Too few remaining teeth to retain an appliance
- Significant untreated jaw joint problems
Often a good fit
Oral appliance therapy
- Diagnosed mild to moderate obstructive sleep apnea
- CPAP intolerance — the mask, the pressure, the noise, the travel
- Loud socially disruptive snoring, with apnea excluded or treated
- A patient who travels and needs something that fits in a bag
What it involves
From impression to a settled appliance.
Records
Scans or impressions of both arches and a bite record taken with the jaw in a specific forward position.
Fitting and titration
The appliance is delivered and then advanced in small increments over several weeks until symptoms settle.
Follow-up testing
Your physician re-tests to confirm the appliance is actually doing the job. An appliance that feels fine but does not work is not success.
Questions
Sleep appliances, answered.
Will it change my bite?
Small bite changes over years of use are a recognized side effect and one reason appliance patients are reviewed regularly rather than left alone. It is discussed before you start, not afterwards.
Is it covered by insurance?
Oral appliance therapy for diagnosed sleep apnea is often processed through medical rather than dental benefits. It varies considerably by plan and we will help you find out before you commit.
Do you diagnose sleep apnea here?
No. Diagnosis comes from a sleep study ordered and read by a physician. What happens here is the appliance — designed, fitted and adjusted — in coordination with the physician managing your care.
Start with an exam and a straight answer.
A consultation includes an examination, imaging and a written, itemized plan. If implants are not the right treatment for you, Dr. Robinette will say so and tell you what is.