Are oral appliances worth the thousands of dollars?

[Janknitz]

Here's what my dentist told me: "I'll be happy to charge you $4,500 for an oral appliance, but it won't work for you." (I have severe apnea with a very small jaw and narrow airway because of a genetic condition). He told me he occasionally recommends it for people with very mild sleep apnea, but even then, it can cause problems with the jaw ( such as TMJ) so users have to be vigilant about doing jaw exercises when they remove the appliance in the morning to realign the jaw. He is not a fan.

[elsueno]

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[zonker]

found this in another thread, fwiw-

CPAP literally brought me back from the depths of despair. I used an oral appliance four years, then it broke. The new one was not properly made and then decided I should go on CPAP. After using CPAP since February, it made me realize the extent of under treatment of my apnea with the oral appliance. I was in a cognitive fog during those four years and now have my brain back to normal function since using CPAP.

Getting the CPAP machine to work optimally requires a lot of tweaking, especially with respect to correct pressure range if you end up on an APAP.

But that's the purpose of a forum like this, where many members have more knowledge of sleep apnea treatment than a lot of medical professionals. So feel free to ask questions about any aspect of sleep and fine tuning of your CPAP machine.

[boxofrain]

Zonker, thanks for that. That’s pretty much what I said in an earlier reply in this thread. I am a retired dentist. I have used both. There’s no question in my mind that the CPAP is far superior. I don’t care what any studies may say or what anybody says anecdotally. The MAD will screw up your bite, potentially cause TMJ issues and not do nearly as good of a job as a CPAP. I am a CPAP believer for sure.


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[zonker]

Zonker, thanks for that. That’s pretty much what I said in an earlier reply in this thread. I am a retired dentist. I have used both. There’s no question in my mind that the CPAP is far superior. I don’t care what any studies may say or what anybody says anecdotally. The MAD will screw up your bite, potentially cause TMJ issues and not do nearly as good of a job as a CPAP. I am a CPAP believer for sure.


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whatever it takes to keep folks on this forum informed, i'm all for it!

seems to me that there is(or were) more dentist hanging out here and i think they had pretty much the same attitude about MAD.

[elsueno]

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[elsueno]

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[zonker]

Zonker, thanks for that. That’s pretty much what I said in an earlier reply in this thread. I am a retired dentist. I have used both. There’s no question in my mind that the CPAP is far superior. I don’t care what any studies may say or what anybody says anecdotally. The MAD will screw up your bite, potentially cause TMJ issues and not do nearly as good of a job as a CPAP. I am a CPAP believer for sure.
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I don't care what you say, I used both and my teeth are perfect.
iu.jpeg

[boxofrain]

Boxofrain, if you had to go without CPAP for a week or a month, e.g. because of a massive power outage or because you are somewhere where there isn't power, would you use an oral appliance or go without treatment?

My current and longtime answer is that I'd rather use the oral appliance in a pinch than go without.

dpeterzell, it's a fantastic question.
My answer would be that going without treatment would not be an option for me. So yes, I agree, I would use a properly fitted MAD before going with no tx.
Also, nice teeth!!! It reminds me of several of my completed cases that I was very proud of back in the day!

[centrum]

Did use MAD for few months. Stop it as it wasn't effective enough for my OSA... And too much jaw pain. It was a custom made perfect fit. My friend dentist did it at cost (500$). 4500$ seem to be expensive to say the least.

[ChicagoGranny]

I think she was quoted something like $4500.

This is too much. Gramps and I each had custom appliances fitted by a dentist. Between our copays and what the insurance paid, the dental practice got $1700 for each appliance.

According to the American Sleep Apnea Association:

The average cost for a sleep apnea mouth guard is estimated at $1800 – $2000. This includes the actual sleep apnea mouthpiece, dentist visits, adjustments, follow-ups, and modifications to the dental device. Most health insurance companies and Medicare cover oral devices for sleep apnea.

https://www.sleepassociation.org/sleep- ... uthpieces/

Neither Gramps nor myself could tolerate that junk in our mouths - CPAP mask is much easier. We could also tell the appliances weren't effective. CPAP is the gold standard.

Does your wife have health insurance? Most policies and Medicare cover oral appliances.

[elsueno]

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[ChicagoGranny]

I'm not dropping this stick yet.

Why is the expensive solution (oral appliance fit by a professional for thousands of dollars) better than the $50-$100 solution? And why not try the inexpensive solution before gambling away thousands?

Maybe the wife should just quit whining and use CPAP? Worst case - she's a CPAP loser and the OP inherits a backup machine?

[elsueno]

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[ChicagoGranny]

First, I'm not the person who started this thread

That's why I specified the OP. Did you miss that or not understand it? https://www.webopedia.com/definitions/op/

And while I'm on the topic, why wouldn't ANYONE with intact teeth want a cheap MAD device as a BACKUP for when the CPAP can't be used?

Because MADs can't compare to the good treatment we have been getting with CPAP? Because using a MAD for an occasional night of CPAP loss makes for a miserable night?

Gramps and I each have a custom MAD and an adjustable OTC MAD (Somnomed). If our power fails, we leave this in the drawer and make other arrangements. Going from a highly effective CPAP therapy to a MAD makes for a miserable night.