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Orthodontic Treatment for Sleep Apnea ~ Best Practices

Updated: Jun 27

Obstructive sleep apnea, OSA, is a condition that causes repeated breathing pauses during sleep. This disorder is caused by a malfunction in the structure of the upper dental arch and jaw. It is often the result of an improper bite or narrow palate. People with sleep apnea may also suffer from other problems relating to the structure of their jaws and face, such as a narrow arch and overbite.


Side by side diagram of a man showing difference between normal breathing and obstructive sleep apnea

Obstructive sleep apnea (OSA) affects 20 – 30 percent of adults according to the American Journal of Epidemiology.

Other sleep disturbances may include jaw clenching and teeth grinding which can become severe enough to cause jaw pain and result in insomnia, irritability, and other health concerns.

The most common medical approach for diagnosing and treating sleep apnea involves visiting a primary care physician and being referred to a sleep specialist. Once the condition is confirmed, patients are most often prescribed a CPAP machine.

Orthodontists, however, see many patients with this disorder and have extensive training in craniofacial growth. As a result of this specialized training, orthodontists have the necessary skills to diagnose and treat craniofacial abnormalities in adults and children.

Persistent snoring is often a symptom of sleep apnea and may be an indication of more serious underlying issues that can affect a person's quality of life. A new study by John’s Hopkins reveals that sleep apnea is linked to raised metabolic and cardiovascular stress. The sleep study found increased cortisol levels in sleep apnea patients when they did not have their CPAP machines. Cortisol is a stress hormone that elevates blood sugar levels and can lead to weight gain, diabetes, and heart disease. These new findings are indeed a great medical advancement.

Untreated sleep apnea can also cause health complications including fatigue, headaches, dry mouth, and even depression, and anxiety. The good news is that most of these complications are preventable.

A skilled orthodontist can identify the cause of the problem and can often suggest an effective alternative treatment to a CPAP machine.

If you have a sleeping disorder due to sleep apnea, your orthodontist can help!



There are three types of sleep apnea


  • Obstructive sleep apnea (OSA) is by far the most common and affects 84% of those who have a sleep apnea condition.

  • Central sleep apnea is much less common and occurs when the brain does not send the correct signals to the rest of the body. This type is considered a neurological issue affecting only 0.04% of sleep apnea sufferers.

  • Complex sleep apnea is a combination of OSA and central sleep apnea. This type is often more difficult to diagnose, however, treatment options are still available and effective.

If you are suffering from obstructive sleep apnea, orthodontic treatment may be an excellent option.

The most common and effective orthodontic treatment is a mandibular advancement device (MAD). This is an oral appliance that connects the mandible to the maxilla. This device advances the jaw forward so the base of the tongue is positioned higher in the mouth. During sleep, your jaw and teeth will naturally be straightened. The goal of the procedure is to increase the volume of the upper airway. By adjusting the jaw, you can prevent your mouth from closing and reduce the pressure in your throat so you can breathe easier. It can also help with snoring by increasing the airway in the mouth.

The mandibular advancement device is worn during sleep and removed in the morning, however there are several types, including removable, fixed, and custom.

MADs may be a desirable alternative to CPAP. The devices are available in a variety of designs and can range in complexity. Basic MADs are easy to use and less expensive, while more complex devices require more dental expertise. The newer devices are now patient-fitted and designed to be less invasive. They also have many benefits, including reducing pain and are often easier to use and more comfortable than a CPAP machine.

A mandibular advancement device is a dental appliance that helps people with sleep apnea breathe more easily. It looks like a sports mouth guard and moves the lower jaw forward, usually a few millimeters. Your orthodontist will determine what type and position is best for your health.


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