Oral Appliance, a mouthguard-like device, fits on the upper and lower teeth, worn during sleep, holds the jaw and the tongue in a slightly forwarded position enlarge and stabilize the oropharyngeal airway (behind the throat and the tongue airway space), have been shown to be very effective and successful in the treatment and management of primary snoring and mild to moderate obstructive sleep apnea, and is known as the best alternative treatment modality to patients who are intolerant to CPAP or surgery.
The American Academy of Sleep Medicine published "Practice parameters" in February 2006 for the treatment of obstructive sleep apnea (OSA) with oral appliances:
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Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy.
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Oral appliances (OAs) are indicated for use in patients who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP.
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Patients with severe OSA should have an initial trial of nasal CPAP because greater effectiveness has been shown with this intervention than with the use of OAs.
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Oral appliances are indicated for patients who refuse or are not candidates for tonsillectomy, adenoidectomy, craniofacial operations or tracheotomy.
Oral appliance therapy offers several advantages over other therapy choices: non-surgical, non-invasive, non-forceful air supply, natural way of breathing, easy to use and care, reversible, removable, no side-effect (very few if any), and quite well accepted by patients.
Oral Appliance therapy involves the selection, fabrication, fitting, adjustments, and long term follow-up care, which involves management of potential complications such as malocclusion and TMJ disorders. There are over 40 different types of FDA approved oral appliances and dentists, who are practicing dental sleep medicine should familiar with mechanical and physiological function of these oral appliances and also have to have in depth knowledge of occlusion and TMJ.