Sleep Apnea & Oral Appliances
For snoring and mild-to-moderate obstructive sleep apnea, a custom-fitted oral appliance is often a comfortable, quiet alternative — or partner — to CPAP.
When breathing pauses become a health issue
Obstructive sleep apnea (OSA) is what happens when the soft tissues in the back of the throat collapse during sleep and block the airway — sometimes hundreds of times a night. The American Academy of Sleep Medicine estimates that roughly 26% of American adults between 30 and 70 have OSA, and a large portion are undiagnosed.
Left untreated, OSA is associated with cardiovascular disease, high blood pressure, daytime fatigue, increased accident risk, and reduced quality of life. The good news is that it's highly treatable — and for many patients, the treatment doesn't require a CPAP machine.
For mild-to-moderate OSA and snoring, a custom-fitted oral appliance worn at night can be remarkably effective. It's quiet, portable, and far easier to travel with than a CPAP. The FDA-cleared appliances we fit work by gently advancing the lower jaw forward, which keeps the airway open while you sleep.
Symptoms that warrant a sleep evaluation
Sleep apnea often goes unrecognized because the patient doesn't experience the apneic episodes consciously — a bed partner usually notices first. If several of these sound familiar, it's worth a conversation with your physician or a sleep medicine specialist.
A formal diagnosis through a sleep study (in-lab or at-home) is required before we can fit an oral appliance. We coordinate with sleep medicine doctors throughout the Bay Area.
Small device, big difference
The most common appliance is a mandibular advancement device (MAD). It looks similar to a sports mouthguard, except it has two pieces — one for the upper teeth and one for the lower — connected by a small adjustable mechanism that positions the lower jaw slightly forward.
That small forward shift opens the airway behind the tongue, which is where the obstruction usually occurs. For the right patient, it dramatically reduces snoring and apnea episodes — and the patient sleeps without any of the noise, equipment, or travel hassle of a CPAP.
The AASM and the ADA both endorse oral appliance therapy as a first-line option for mild-to-moderate OSA, and as a second-line option for moderate-to-severe OSA when CPAP isn't tolerated.
Which one is right for you?
Both treatments work, but they suit different patients and different cases. Severity matters most: CPAP remains the gold standard for severe OSA. For mild-to-moderate cases, oral appliances are often the better fit because patients actually use them.
| Oral Appliance | CPAP | |
|---|---|---|
| Best for | Mild-to-moderate OSA & snoring | All severities; gold standard for severe OSA |
| How it works | Repositions jaw to open airway | Pressurized air keeps airway open |
| Comfort | Small, quiet, no machinery | Mask, hose, motor; takes adjustment |
| Travel | Pocket-sized | Carry-on with power adapter |
| Adherence rate | High — patients tend to keep using it | Lower — many discontinue within a year |
| Side effects | Minor jaw soreness, tooth movement over time | Dry nose, mask marks, claustrophobia |
From diagnosis to nightly use
- Sleep study firstAn oral appliance can't be prescribed without a documented sleep apnea diagnosis. Your physician or sleep specialist orders an at-home or in-lab sleep study.
- Consultation with usYou bring the sleep study results. We examine your bite, jaw range of motion, and oral health to confirm oral appliance therapy is appropriate.
- Digital impressionsWe take precise impressions of your upper and lower teeth — no goopy material, just a quick digital scan.
- Custom fabricationThe appliance is custom-made in a lab to your bite. Typical turnaround is 2–3 weeks.
- Fitting & adjustmentYou return for the fitting. We make small adjustments to ensure comfort and proper jaw positioning. You'll wear it home that night.
- Follow-up & titrationOver the next several weeks, we fine-tune the jaw advancement based on how you feel and (often) a follow-up sleep study to confirm the appliance is doing its job.
Frequently asked
Do I need a diagnosis before getting an appliance?
Yes. We can't fit an oral appliance for sleep apnea without a documented diagnosis from a physician or sleep specialist — usually based on a sleep study. If you suspect OSA but haven't been evaluated, we can recommend trusted Bay Area sleep medicine practices.
Is it comfortable to wear?
Most patients adjust within a week or two. There may be mild jaw soreness or extra salivation early on, but those typically fade. The vast majority of patients report sleeping better, not worse, once they're past the initial adjustment.
Will it stop my snoring?
For most patients with snoring or mild-to-moderate OSA, yes — the appliance significantly reduces or eliminates snoring. Bed partners are often the first to notice the change.
Can I use an appliance if I have severe sleep apnea?
CPAP is the first-line treatment for severe OSA. However, if you can't tolerate CPAP, an oral appliance is recognized by the AASM as a reasonable alternative. We'll discuss this with your sleep physician.
How long does an appliance last?
A well-cared-for custom appliance typically lasts 3–5 years before needing replacement. We assess it at your regular cleanings and recommend replacement when wear becomes noticeable.
Is it covered by insurance?
Oral appliances for OSA are often covered by medical insurance (not dental), since they treat a medical condition. We'll help you understand your coverage and submit claims appropriately before treatment begins.
Our offices
Same standards, same team, three convenient locations. Call the office closest to you, or book online.
Cupertino
10440 S. De Anza Blvd, #D4Cupertino, CA 95014