The following are some of the oral devices currently used in our practice for either benign snoring or sleep apnea. There are over 70 FDA approved oral devices, each with their own advantages and disadvantages. No one device is ideal.

 

Device

Advantages

Disadvantages

Snore Guard

Example of “off the shelf” “boil and bite” non adjustable device.

Dr. Mintz Snore Guard

Less expensive, one visit, no mechanisms

Guessing as to position of jaw, not enough retention to stay in mouth all night, can cause movement of teeth that are not covered by this device.

Device

Advantages

Disadvantages

TRD

(Tongue Retaining Device): Primarily relies on keeping tongue from falling to the back of throat.

Doesn’t require sound teeth, healthy gums, or having a “TMJ” problem. Easy to use.

Not effective in moderate and severe apnea; not a good choice for mouth breathers.

Device

Advantages

Disadvantages

NAPA

Example of non adjustable mandibular (lower jaw) repositioning oral device.

NAPA

Effective in snoring, mild to severe apnea, no mechanics to break or learn how to adjust.

Guessing as to where to position jaw. May not be forward enough to be effective or too far forward causing jaw problems.  Has to fit fairly tight on the teeth.

Device

Advantages

Disadvantages

TAP Devices

Examples of adjustable repositioning devices.TAP I

NAPA

Effective in snoring and all degrees of apnea. Adjustment is ¼ mm. at a time, can be adjusted easily during follow-up sleep study if needed.

TAP I hooks encroach on tongue space and may irritate tongue. Mechanical parts can break or wear out.

Device

Advantages

Disadvantages

TAP 3

Similar to TAP I plus does not have an external hook or external adjustment knob for better patient comfort.

Like the TAP I does not allow patient to open their mouth.

Device

Advantages

Disadvantages

HERBST

Herbst

Approved for Medicare.  Effective in snoring and all degrees of apnea.  Adjustment is 1/4mm at a time.  Allows opening of the mouth to some degree.

Despite ability to allow some opening, has to fit tight on the teeth.  Not as easily adjustable during a sleep study as the TAP or Somnodent.  It needs to be put in the mouth as one piece. Side bars can be annoying to some patients.

Device

Advantages

Disadvantages

Somnodent

An adjustable device that allows mouth to open.

Similar to TAP devices in effectiveness, but allows for the patient to open their mouth to yawn or sip water.  It comes with a three year manufacturer’s warranty.

Has two mechanical adjustment devices, allowing for possible greater chance of breakage. Not as easily adjustable as TAP.

 

This is only a brief listing of advantages and disadvantages. Every patient brings a unique set of circumstances. The clinician needs to have knowledge of many devices to be effective. Also, dental devices can be used with other treatments such as CPAP.