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Oral Appliance Therapy

Obstructive Sleep Apnea (OSA) is a serious medical condition that can rob you of the rest you need. At Pennsylvania Dental Sleep Medicine Oral Appliance Therapy (OAT) offers a solution.

If you or a loved one is searching for relief from the symptoms of sleep apnea, call the office book your visit with Dr. Becky Fox, or use the link below to request an appointment.


What is an Oral Appliance?

An oral appliance is a device that works in your mouth during sleep. It looks a lot like an orthodontic retainer or a sports mouth guard, although the technology behind oral appliances is more advanced. 

Oral appliances are available from many dental offices, but most prefer to select one type of oral appliance and offer it to all patients. The team at Pennsylvania Dental Sleep Medicine recognizes that not everyone has the same set of needs (or the same anatomy) and that offering a range of options is a better way to help you find the right fit for your needs. 

Most oral appliances fall into one of two categories: mandibular repositioning devices or tongue-retaining devices. A tongue-retaining device works by engaging the tongue and moving it to a more forward position in your mouth during sleep. Mandibular repositioning devices change the position of your jaw during sleep, which helps open your airway. 

What Conditions Can Oral Appliances Treat?

Oral appliance therapy is an excellent treatment for obstructive sleep apnea, snoring, and TMD (Temporomandibular Joint Disorders). 

Obstructive Sleep Apnea

Obstructive sleep apnea occurs when the muscles in your throat relax to the point they block your airway. Normal breathing is interrupted, sometimes hundreds of times each night, and your body doesn’t get the rest needed to thrive. This often leads to serious medical problems as well.


Loud snoring can get in the way of a good night’s sleep, both for you and for those who sleep nearby. Oral appliances can help by changing the way air enters and exits your throat, which can reduce or eliminate the snoring noise.

Temporomandibular Joint Disorder (TMD / TMJ)

Certain oral appliances are a great treatment for temporomandibular joint disorder or TMJ. This medical condition occurs when the joint that attaches your lower jaw to your skull experiences traumatic or repetitive injury or when disease alters the components of the joint. A specially designed oral appliance helps relax the muscles in your face while you sleep and prevents teeth clenching or grinding.

It’s important to understand that finding the right oral appliance for you is only the first step. You must also incorporate using your oral appliance into your bedtime routine to reap the benefits of this form of therapy. 

What to Expect During Oral Appliance Therapy

What to expect during treatment

The first step in being treated for snoring or obstructive sleep apnea is to obtain an evaluation by a physician who will provide a formal diagnosis based on a medical sleep study.

After that, an evaluation by a sleep-disorders dentist at PDSM will determine whether you are a good candidate for oral appliance therapy and which oral appliance will be most effective for you.

Your first dental appointment will involve a discussion of your sleep apnea condition, a review of your medical status, and a detailed focus on the advantages, limitations, and risks of oral appliance therapy.

Different appliance types will be discussed and one x-ray will be taken of your teeth and jaw joint. A thorough examination of your teeth, jaw joint, and bite will be performed. Impressions or digital images will be taken of your teeth for the fabrication of the appliance and a photograph will be taken of your bite.

Your second appointment will involve custom-fitting the oral appliance and learning how to use and care for it. After that, you will return in several weeks for a follow-up visit to monitor the effects of the appliance and to make any necessary adjustments to ensure comfort and effectiveness.

Ultimately, when the snoring and daytime sleepiness have improved, you will be referred back to your physician for a follow-up sleep study to ensure the effectiveness of the appliance. You will be evaluated again in six (6) months and then annually to ensure adequate long-term success and to monitor any possible side effects.

Choosing a Dentist

Choosing a dentist

Snoring and obstructive sleep apnea can be serious medical problems. Improperly treated obstructive sleep apnea can increase the risk for heart attack, stroke, diabetes, daytime sleepiness, and other serious illnesses. Choosing a sleep-disorders dentist who is qualified to work with your physician is essential to your health or the health of a loved one.

The Sleep Dentist Diplomate that you choose to treat your problem with sleep-disordered breathing must be properly educated and have adequate experience. Legally, any dentist can treat snoring and/or sleep apnea with an oral appliance, however, that does not mean that every dentist has the necessary experience and training to provide proper therapy. Because no special qualifications are required, it is your responsibility to choose your dentist wisely.

A Qualified Dentist Should Have:

  • Appropriate knowledge of sleep medicine
  • Adequate training in oral appliance therapy
  • Experience with many different appliance types
  • Solid relationships with local sleep labs and sleep physicians
  • Current knowledge of emerging trends
  • Ability to derive maximum insurance benefits for you
  • A team approach with other professionals
  • A proven follow-up system to ensure healthy long-term results
  • In-depth knowledge of oral appliance research
  • Ideally, be board certified in dental sleep medicine

Patient Instructions

Dr. Becky Fox will carefully follow and guide your progress throughout your treatment. You will be seen in the office several times to ensure acceptance, comfort, and effectiveness of the therapy. Instructions will be given on the proper adjustment of the appliance and any areas of concern will be addressed. The objective will be to resolve your snoring and daytime sleepiness by gently and gradually repositioning your lower jaw.

Daily Jaw Exercises

Very often patients find that they are unable to close their teeth completely in the morning immediately after removing the appliance. This is normal and is due to a temporary jaw joint change and some transient microscopic tooth movement. This will generally resolve on its own in 15 to 30 minutes as the joint and teeth drift back into their normal positions. After 30 minutes (not sooner) jaw exercises are helpful to reestablish joint position and good tooth contact. This can be accomplished by several minutes of clenching on a morning aligner that will be fabricated for you at the time the appliance is delivered.

Care of Your Oral Appliance

Your oral appliance is easy to care for. Each morning, use the cleaning product recommended by your sleep dentist. Rinse it well and allow it to sit in its case all day with the top open. Be sure it is up, out of the way, where no curious dogs can chew on it! Avoid extremes of temperature. Certain soaking solutions are also available to enhance cleaning.

Examine your appliance frequently and call Dr. Fox if you observe any broken or bent areas.

Side Effects

Most of the side effects encountered during appliance use are minor and temporary and do not preclude use. They include tenderness to teeth, muscles, and jaw joints. Loose or weak dental work may become dislodged. Dry mouth and increased salivation are also noticed frequently but are generally not major issues.

As mentioned above, teeth may not meet properly for 15 to 30 minutes after first removing the appliance after each night’s use. Occasionally bite changes can become permanent. Your sleep dentist will work with you to manage these occurrences and minimize any problems.

When to Call the Office

Please feel free to call the office any time you have a concern that you feel needs personal attention. You can also contact us through this website. We will try to respond within 24 business hours. In this way, we can quickly and easily answer any questions or recommend that you schedule an appointment to make an office visit. We

What Does it Feel Like to Use an Oral Appliance?

Using any type of oral appliance while you sleep requires a period of adjustment. That said, the materials used to craft high-quality, custom-fitted oral appliances have never been better. These devices are made of materials that do not generally cause friction or abrasions to your cheek, gums, or other soft tissues. 

During your consultation, your practitioner works with you to determine what type of oral appliance is right for you. They fit your device to the exact specifications of your mouth, and you receive detailed instructions on when and how to wear your oral appliance and how to care for it so you can reap the benefits of oral appliance therapy for sleep apnea, snoring, or TMJ, for many years. 

When you’re ready to learn more, schedule an appointment online or by phone. Pennsylvania Dental Sleep Medicine is an in-network provider for most major insurance plans, and the front desk staff can answer questions regarding coverage.