Ins and Outs of Sleep Apnea Appliances

Posted on December 31st, 2009 | In General, Gum Diseases, Sedation

When choosing an appliance to treat sleep apnea, the options are many and varied, Dr. Moore said.

Custom-made adjustable appliances require several visits for evaluation, fitting, and follow-up. The initial evaluation includes tests to assess the ability of the upper airway to expand when the jaw is moved forward. After the appliance has been made and fitted, the patient can come in at any time for adjustments, but it’s especially important for the patient to visit after the symptoms have improved.

“Once that point has been achieved, a repeat portable monitoring test is ordered … to assess results of titration,” he continued. “Following this, the patient is sent back to the sleep physician for possible repeat polysomnography.”

In addition, “the patient needs to be followed for the length of time that they continue with use of the appliance—possibly every 6 months to 1 year—in order to monitor for changes in occlusion, TMJ problems, or other problems with the appliance,” Dr. Moore noted.

In contrast to adjustable appliances, there are devices that are not custom made, known as “boil and bite.” These “one-position appliances” are not adjustable after the initial fitting. “Some of these can be effective, and they are generally less expensive than custom-made appliances, which will cost more because they are uniquely patient-specific,” he said.

Costs can range from several hundred to several thousand dollars, which includes the appliance as well as visits for evaluation and fitting. Health insurers typically will cover these costs if the patient has sleep apnea that has been documented by polysomnography, Dr. Moore said.

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