Oral Appliance Therapy
An effective alternative when CPAP isn't right for you — custom-fitted devices that keep your airway open while you sleep.
What It Is
Oral appliance therapy uses a custom-fitted dental device — known as a mandibular advancement device (MAD) — to treat obstructive sleep apnea. The device looks similar to a sports mouthguard and is worn during sleep. It works by gently moving your lower jaw forward, which tightens the soft tissue and muscles of the upper airway and prevents the airway from collapsing.
For patients with mild to moderate sleep apnea, or for those who cannot tolerate CPAP, oral appliances offer a proven, comfortable, and portable alternative. They are also an excellent option for patients who travel frequently and want treatment that fits in a pocket rather than a carry-on bag.
How It Works
Evaluation
Dr. Desilva evaluates your sleep apnea severity, jaw health, and dental status to determine if oral appliance therapy is appropriate for you.
Dental Referral
We refer you to a qualified dental sleep specialist who will take impressions and custom-fit your mandibular advancement device.
Device Fitting
Your dental specialist creates a custom device that gently advances your lower jaw forward, keeping the airway open during sleep.
Follow-Up Testing
After you have adjusted to the device, Dr. Desilva orders a follow-up sleep study to confirm the appliance is effectively treating your apnea.
Who's a Good Candidate?
- Patients with mild to moderate obstructive sleep apnea
- Those who cannot tolerate CPAP therapy despite proper support and fitting
- Patients who travel frequently and want a portable treatment option
- People with positional sleep apnea (worse when sleeping on their back)
- Patients who prefer a non-machine-based treatment approach
Honest Pros & Cons
Dr. Desilva believes in giving you the complete picture so you can make an informed decision about your treatment.
Advantages
- No machine, tubing, or electricity required
- Silent — no motor noise for you or your partner
- Highly portable for travel
- Easy to clean and maintain
- No mask-related skin irritation or claustrophobia
- High compliance rates due to comfort and simplicity
Considerations
- Less effective than CPAP for severe sleep apnea
- May cause jaw discomfort or soreness initially
- Can shift teeth over time in some patients
- Requires a healthy jaw joint (TMJ) to use safely
- Needs follow-up sleep testing to verify effectiveness
- Not suitable for central sleep apnea
Working with Dental Sleep Specialists
Oral appliance therapy requires collaboration between your sleep physician and a dental specialist trained in dental sleep medicine. Dr. Desilva works with trusted dental sleep specialists who have the expertise to design and fit your device properly.
After your device is fitted, Dr. Desilva continues to manage your sleep apnea treatment — ordering follow-up sleep studies to verify effectiveness, adjusting your overall treatment plan, and coordinating with your dental provider as needed.
This team approach ensures that both your dental health and your sleep apnea treatment are managed by the right specialists.
What to Expect
Most patients adjust to their oral appliance within one to two weeks. Initial jaw soreness is common but typically resolves quickly. Your dental specialist will make incremental adjustments to optimize both comfort and jaw advancement. Once you are comfortable, a follow-up sleep study confirms your device is effectively treating your sleep apnea.
Wondering If CPAP Is Your Only Option?
Oral appliance therapy is a proven alternative for many patients. Schedule a consultation to find out if it's right for you.