Understanding Oral Airway Devices

An oral airway device (“OAD”), commonly referred to as an oral sleep appliance or mandibular advancement device, is a dental device used to treat obstructive sleep apnea (OSA) and snoring. Oral airway devices are custom-fitted to the patient’s mouth by their provider. They are worn at night.

How does an OAD treat Sleep Apnea?

The main goal of an oral appliance is to prevent the collapse of the tongue and soft tissues at the back of the throat, which can obstruct the airway during sleep and cause apnea episodes. 

The device works by repositioning the lower jaw (mandible) and tongue slightly forward. This forward positioning opens up the airway, allowing for easier breathing and reducing the chance of airway collapse.

OAD Treatment | Considerations

These devices are best suited for individuals with mild to moderate OSA, those who cannot tolerate CPAP therapy, or those who prefer an alternative treatment option. 

Benefits of an OAD vs Other Sleep Apnea Care

Portability: They are compact and lightweight, making them easy to travel with.

Simplicity: They are easy to wear and require no power source.

Quiet: Unlike CPAP machines, oral devices do not make noise.

Comfort: Some people find them more comfortable than CPAP masks.

Limitations and Side Effects

OAD may not be as effective as continuous positive airway pressure (CPAP) therapy for severe OSA.

Possible short term side effects can include jaw or tooth discomfort, changes in bite, or excessive salivation.

Device can cause bite changes due to jaw repositioning during use. This is uncommon and can be avoided by performing a simple bite-seating exercise every morning upon taking out the device.

Insurance Information

Insurance companies will pay only for services they determine to be medically necessary under their current policies. It is the patient’s responsibility to understand their insurance plan coverage as reimbursement is not guaranteed.

At base, patients must have the following to be considered for insurance coverage: 

  • AHI – apnea hypopnea index >5 
  • Epworth Sleep Scale over 13
  • Sleep Study in the past 5 years
  • Intolerance to CPAP

Patients who do not meet the above criteria may still be considered for OAD treatment, however cash payment will likely be necessary.

Authorization Timelines

Please note that it can take a month or more for your device order to receive approval from your insurance. Once approved, the manufacturing process takes between 2-3 weeks.

To expedite the process, please ensure that all necessary documentation has been faxed to our office at (760) 436-5123.

Cash Payment

Cash payment is recommended for those seeking immediate treatment, as it bypasses the insurance approval period. We are willing to advocate for you if you choose to use insurance coverage, however please be aware of the potential wait times and adjust your expectations accordingly.

OAD Appointments and Follow-Up

Once it’s determined that a patient needs an OAD, follow-up care is required to maintain device functionality. Below is a brief timeline of ongoing care:

Consultation

Provider will meet with a new sleep patient to review sleep study and determine whether the patient is a candidate for OAD treatment. If OAD is confirmed, the patient will receive an itero scan to custom fit their device.

OAD Fitting

Patient returns to the office to pick up their device and have it custom fitted for comfort.

90 Day “Global Period”

Post OAD fitting, patients have 90 days to return for adjustments to their device, free of cost.

Follow-Up

In order to ensure device safety and monitor treatment progress, patients are required to come in for four follow-up appointments. These must be scheduled within six months of receiving the device.

OAD Discharge Instructions

During OAD treatment, patients should follow certain guidelines to ensure optimal results and minimize potential complications. Below are recommendations to follow throughout your treatment plan:

  • Maintain good dental care – prior to use of and while using an OAD
  • Avoid hard sticky foods for the first meal of the day
  • DO NOT adjust your own appliance

Within 1 Week

Common symptoms include tooth sensitivity or feeling that bite is “off” upon waking. These symptoms should resolve themselves. 

Patients feeling any persistent pain and/or damage to teeth, gums, or surrounding area should schedule a follow-up appointment immediately.

Within 3 Months

Within 90 days, any adjustments to OAD are free of charge. 

  • Monitor any persistent discomfort or pain
  • Schedule follow-up fittings as needed

Within 6 Months

Stay current with the recommended follow-up care plan to maximize success. 

Detailed OAD Maintenance Instructions available here.

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