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Here’s what you should know about oral appliance therapy

Posted on January 17th, 2023

If you have mild to moderate sleep apnea, one of the treatment options is oral appliance therapy.

Oral appliance therapy isn’t suitable for all sleep apnea patients. To get the most effective care, patients should use a CPAP machine. But if patients find CPAP machines to be too noisy, uncomfortable, or difficult to use, oral appliance therapy is the next best option.

With this treatment, patients use a dental appliance or oral mandibular advancement splints (MAS) to keep their airways open while they sleep. These devices work either by preventing the tongue from blocking the throat or by advancing the lower jaw. 

While effective for treating less severe cases of sleep apnea, oral appliance therapy does have potential side effects. And one of these side effects is changes in bite alignment, also known as occlusal changes. 

Significant occlusal changes don’t happen in all cases. But they are a possibility. And patients need to be aware so they understand the potential risks. That way, patients can make informed decisions about their oral health.

Around one-third of patients who use oral appliance therapy experience occlusal changes. Other possible side effects of oral appliances include…

  • Jaw and tooth pain (especially in the morning)
  • Loose teeth
  • Mouth dryness
  • Hypersalivation

How to prevent changes in bite alignment 

Occlusal changes are the most common side effect of oral appliance therapy. But if patients follow the guidelines for using the appliance, they can minimize the changes that take place. 

After taking the appliance out in the morning, patients should perform jaw exercises or use a repositioning device. To reduce morning stiffness, patients should move the joint around until their jaw returns to its correct position. Additionally, patients may chew hard gum.

Other issues with oral appliances 

Whether or not patients experience occlusal changes, they should expect an adjustment period with their new oral appliance. 

Some people, especially those with sensitive gag refluxes, may experience gagging. Others may find the device feels strange at first if they aren’t used to wearing a mouth guard or night guard. And most people will experience hypersalivation or drooling. The mouth produces more saliva when the oral appliance is being used. 

If patients have trouble getting used to their oral appliances, they can use them for short periods during the day to help them grow accustomed. While using the appliance, they should inhale slowly through the nose. Then, exhale slowly through the mouth to help their body relax. After two to three weeks, most patients adjust and feel more comfortable with their oral appliances. 

Patients should weigh the side effects of using oral appliance therapy against the benefits of managing their sleep apnea. 

Oral appliance therapy is an effective treatment for patients with mild to moderate sleep apnea and those who can’t tolerate CPAP machines. Patients generally tolerate oral appliance therapy well. And a qualified dentist can recognize and treat common side effects and offer remedies. Patients should follow up with their dentists every six months to a year to evaluate any side effects. 

Do you have any questions about oral appliance therapy or potential occlusal changes? If so, please don’t hesitate to reach out. We can discuss your concerns in more detail.

Dr. Meghna Dassani has practiced dentistry for over two decades and is passionate about the role dentists play in whole-body health. You can learn more at her website:

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