Sleep apnea
oral appliance therapy
Obstructive sleep apnea causes repeated airway collapse during sleep. Each event lowers blood oxygen and fragments rest, which increases long-term risk of hypertension, type 2 diabetes, and stroke.
What obstructive sleep apnea is
OSA involves repeated pauses or reductions in airflow during sleep. These events are measured as apneas and hypopneas on a sleep study.
In OSA, the soft tissues of the throat and tongue narrow or collapse the airway. Breathing effort continues, but airflow reduces or stops for at least ten seconds at a time.
A sleep study summarizes these events as the Apnea–Hypopnea Index (AHI). Mild OSA ranges from 5 to 15 events per hour, moderate from 15 to 30, and severe above 30 events per hour.
Recurrent drops in oxygen strain the cardiovascular and nervous systems. Untreated OSA associates with higher rates of high blood pressure, insulin resistance, and motor vehicle accidents due to daytime sleepiness.
Who oral appliances are for
Oral appliances do not replace CPAP in every case. They focus on carefully selected patients with physician-diagnosed sleep apnea.
Typical candidates include:
- Patients with mild or moderate OSA on a recent, physician-interpreted sleep study.
- Patients with severe OSA who cannot use CPAP despite documented attempts.
- Patients who travel frequently or need a compact therapy option for nights away from home.
At Blanc, every oral appliance case starts from a medical diagnosis and a formal prescription from your sleep physician. We do not diagnose sleep apnea or change your diagnosis on this page.
How oral appliances compare to CPAP
CPAP remains the first-line treatment for most moderate and severe OSA. Oral appliances offer a mask-free alternative or adjunct in specific situations.
CPAP delivers gently pressurized air through a mask to keep the airway open. Large trials show CPAP improves daytime symptoms and blood pressure when patients use it for at least four hours per night, most nights of the week.
Custom mandibular advancement devices work differently. The appliance positions the lower jaw slightly forward to increase space behind the tongue. This change reduces airway collapse in many patients with OSA related to jaw position and soft tissue crowding.
In selected patients, oral appliances can reduce AHI and improve daytime sleepiness. They work best when the device is precisely titrated, the patient receives follow-up sleep testing, and the dentist and physician review results together.
The Blanc oral appliance process
The workflow is structured and repeatable. Each step has a defined deliverable, from prescription to follow-up study.
Your sleep physician provides a current sleep study, diagnosis, and prescription for oral appliance therapy. We review your medical history, medications, and prior CPAP experience.
During the consultation, we examine your airway, jaw joints, and dentition. Appliance design depends on your jaw anatomy, dental restorations, and any bruxism or TMJ history.
We scan your teeth and bite with an intraoral scanner rather than traditional trays. The laboratory fabricates a custom device to the prescribed starting position.
After delivery, we adjust the device over several weeks to balance airway opening and comfort. Your physician then orders a follow-up sleep study or home sleep test to confirm effectiveness.
Comfort, side effects, and maintenance
Oral appliances are small and quiet, but they still require monitoring. The goal is effective treatment with a stable bite and healthy joints.
Most patients adapt to wearing the device over one to two weeks. Temporary side effects can include morning bite changes, tooth tenderness, or jaw stiffness, which usually improve with adjustment and exercises.
We review your bite and jaw joints at each visit. If we see progressive bite changes or joint symptoms, we adjust the device, modify use, or coordinate re-evaluation with your physician.
Appliances require daily cleaning with a soft brush and periodic replacement when wear becomes visible. Typical replacement intervals range from several years, depending on grinding, material, and use.
Coordination with your sleep physician
Oral appliance therapy is a shared project. Your physician remains responsible for diagnosis, medical management, and long-term sleep health.
We correspond with your physician at three key points: at referral, after appliance delivery, and after follow-up testing. Each update includes your reported symptoms, device settings, and any dental findings that may affect treatment.
If your follow-up study shows incomplete control of sleep apnea, your physician can adjust your overall plan. Options may include further titration, adjunctive positional therapy, renewed CPAP trial, or evaluation for surgical or nerve-stimulation options.