FAQs

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Frequently asked Questions about Appliances

Do they work for everyone?
Are they Comfortable to Wear?
How often must they be replaced?
Are they guaranteed?
Will this appliance change my bite or create a problem with TMJ?
How do I know if it is working?
Is this device covered by insurance?
How does the appliance work?
If I use the appliance, will my sleep apnea improve enough that I will eventually not need the appliance?
What are the advantages of the appliance?
What are the most common side effects?

Do they work for everyone?
No. Appliances work best in mild to moderate cases. They also work better in a patient who is not terribly obese. They can usually provide some benefit to almost everyone, but they are not totally effective in reducing the apnea to normal with patients whose neck size or abdomen is extremely large. There are also cases of thin patients with a steep angle to their lower jaw that can be difficult to treat.

Nazel Diagram

Are they Comfortable to Wear?
Yes. Most patients find that after 1-2 weeks of adjusting they begin to experience the benefit of an open airway and find the appliances are very comfortable. Most patients find that if they forget to wear it by mistake, they experience a poor night’s sleep again. Their bed partner is extremely aware of this difference, and will often times encourage the patient to keep using it.

How often must they be replaced?
The appliances are made of a hard acrylic, which is very durable. They are replaced every 3-5 years depending on the wear and tear. Patients who grind their teeth,or have new restorations have a more frequent rate of repair or replacement.

Are they guaranteed?
We guarantee the appliance for up to one year. After that we simply charge the patient the lab cost of the lab fee for repairs.

Will this appliance change my bite or create a problem with TMJ?
It’s possible; depending on the status of the bone and position of the teeth in a mouth, it can shift teeth. Sometimes patients with a preexisting TMJ problem can have a recurrence of symptoms. Or, if the mandible is brought forward too far or too quickly, it can irritate the TMJ joint. The most common problem is the development of a posterior open bite. We minimize this with the use of a morning repositioning device that is used for a short time.

How do I know if it is working?
The best way to know for sure is to follow up with a sleep study or PSG. We also use pulse oximetry to measure your oxygen at home periodically as we titrate the device. Patients are referred back to their sleep physician for follow up.

Is this device covered by insurance?
Yes, but it is covered by medical insurance rather than dental insurance because sleep apnea is a medical problem. The patient must also have a DME or durable medical equipment rider on the policy. Every policy is different, and some policies cover more of the cost then others.

How does the appliance work?
It works by advancing the mandible forward, and helps to lift the base of the tongue away from the posterior wall of the pharynx. It helps stop oral snoring by reducing the vibration of the soft palate and uvula. It does not improve nasal snoring.

If I use the appliance, will my sleep apnea improve enough that I will eventually not need the appliance?
Rarely. This only happens when the apnea is caused exclusively by obesity and the patient loses a significant amount of weight. Most of the time weight contributes to the apnea, but the cranial facial structures or the anatomy of the patient's airway is the most significant feature contributing to the sleep apnea. This is why young and old patients, heavy and thin patients, and males and females can all have significant sleep apnea. Most people will need the device forever.

What are the advantages of the appliance?
The biggest advantage is the ability to sleep without being connected to the CPAP machine and mask. It is small and extremely portable, fully adjustable, and fits well.  It is excellent for patients who travel. Unlike surgery, the appliance is not invasive nor irreversible. The side effects are minor and are easily tolerated by most patients. Most patients find the appliance much easier to use than the CPAP. Compliance with the appliance is high.

What are the most common side effects?
The most common side effect is morning muscle soreness that usually subsides after a short while. Minor tooth movement occurs in some patients and either excessive dryness or salivation occurs sometimes.

2017  Dr. Kate Bennett: Dental Sleep Medicine   (login)