Sleep Apnoea Oral Appliance in Turramurra

A sleep apnoea diagnosis can be a relief, in a strange way. It explains the daytime fog, the partner's complaints about snoring, and the years of tired mornings. The next question is the practical one. What is the treatment, and how do I get it?

For many people, the answer is a small, custom-made mouth device called a mandibular advancement splint (MAS). It is worn at night, it is silent, and it travels well. Our team at Dental Specialists of Turramurra fits MAS devices for adults across Sydney's upper North Shore, working with sleep physicians and GPs to match each patient with the right device.

This page explains how the device works, who it suits, and what the path from diagnosis to a first good night's sleep looks like at our practice.

What is a sleep apnoea oral appliance?

A sleep apnoea oral appliance is a custom-made mouth device that holds the lower jaw forward while you sleep, keeping the airway open at the back of the throat. The clinical name is mandibular advancement splint, shortened to MAS. The device sits over the upper and lower teeth, like two retainers joined by a small mechanism that lets the lower jaw be set in millimetre increments.

There are 3 main types our specialists use:

• Two-piece adjustable devices , with a screw or strap that lets the jaw position be tuned.
• Two-piece strap devices , with a soft connector that holds the jaw forward.
• Tongue-stabilising devices , which hold the tongue forward with gentle suction. These are used when teeth or jaw joints cannot hold a mandibular device.

For most adults with mild to moderate obstructive sleep apnoea (OSA), a two-piece adjustable device is the first choice. It is precise, easy to adjust, and easy to live with.

How does a mandibular advancement splint treat OSA?

The MAS device treats OSA by holding the lower jaw forward, which pulls the tongue forward and opens the airway at the back of the throat. When the airway is open, air flows freely, the soft tissue does not collapse, and the apnoea events stop.

The 4 things the device does during sleep are:

• Brings the lower jaw forward by 6 to 10 millimetres, depending on the patient's anatomy.
• Holds the tongue forward with it, so the tongue does not fall back.
• Keeps the soft palate away from the back wall of the throat.
• Stabilises the bite so the upper and lower teeth meet in a predictable position.

The result is fewer apnoea events, quieter sleep, more oxygen through the night, and far less daytime sleepiness. Most patients also report that their partner sleeps better, because the snoring drops away.

Who is a sleep apnoea oral appliance for?

An MAS device is a good fit for adults with mild to moderate OSA, and for people with severe OSA who cannot tolerate a CPAP machine. The 4 most common patient groups are:

• Adults with mild to moderate OSA confirmed by a sleep study.
• People with severe OSA who cannot use CPAP comfortably, or who travel often and find CPAP too bulky.
• Snorers with apnoea-like symptoms who want an assessment.
• CPAP users who want a backup for camping, flights, or power outages.

An oral appliance is not usually the right fit for children with OSA, or for adults whose OSA is caused mainly by nasal blockage. Our team works with your GP and a sleep physician to confirm the right treatment for your case.

What is the path from diagnosis to a fitted device?

A sleep apnoea oral appliance is a step-by-step process, not a single visit. Here is the path most patients at our practice follow:

1. Sleep study and diagnosis. Your GP or sleep physician organises a sleep study, either at home or in a lab. The study gives an apnoea-hypopnoea index (AHI) score, which tells us how many times your airway closes per hour.
2. First visit at our practice. A short talk about your sleep, your study, and your day. A look at your teeth, jaw, and bite to see if an MAS device is a safe option.
3. Scan or impression. A digital scan or mould of the upper and lower teeth. The lab uses this to make a device that fits exactly.
4. Fitting visit, 2 to 3 weeks later. The device is fitted, the jaw position is set, and the comfort is checked.
5. Review at 4 to 6 weeks. The jaw position is fine-tuned based on how the nights have gone.
6. Sleep study with the device in place. A repeat study confirms the AHI has dropped to a safe level.

What comfort supports are available during the visits?

A few patient comforts make the fitting and the follow-ups easier, especially for anxious patients. Our practice offers a computerised anaesthetic unit that numbs the area drop by drop through a tiny point, aromatherapy eye packs, virtual reality DVD viewers during longer visits, and premedication or inhalational analgesia when needed. Italian espresso, tea, and herbal infusions are served in the lounge between visits.

How do you care for a sleep apnoea oral appliance?

A custom MAS device lasts for 2 to 5 years with simple daily care. The 4 care steps are:

• Brush it with a soft toothbrush and cool water each morning.
• Let it air dry before putting it in its case.
• Bring it to your review visits so the team can adjust the fit.
• Avoid hot water, which can warp the acrylic.

A short check every 6 to 12 months keeps the device, the bite, and the result on track.

How to get help from our Turramurra team

If you have a sleep apnoea diagnosis, or suspect you do, the first step is a sleep assessment at our practice. We see patients from Turramurra, Wahroonga, Warrawee, Pymble, Gordon, Killara, Lindfield, Roseville, St Ives, and Hornsby, and work closely with GPs and sleep physicians across the North Shore.

• Practice : Dental Specialists of Turramurra
• Address : Suite 1-2 / 1335 Pacific Highway, Turramurra NSW 2074
• Phone : (02) 9488 7455
• Hours : Monday to Friday, 9:00 am - 5:00 pm

To read more about the device, the fitting, and who it suits, see our Sleep Apnoea Oral Appliance page. For an overview of how orthodontics can also play a part, our Orthodontics page is a good next read.

Frequently Asked Questions