Oral Appliance Patient Guide: Our Role After Delivery
Comprehensive sleep medicine monitoring after oral appliance delivery. Efficacy testing, outcome assessment, and long-term management with our team.
Our Collaborative Care Model
We do NOT fabricate oral appliances. We refer to AADSM-certified dentists who specialize in dental sleep medicine and custom appliance fitting.
Our Role: Sleep Medicine Expertise
- • Initial Assessment: Our physicians determine if you're a candidate for oral appliance therapy
- • Dentist Referral: We connect you with AADSM-certified dentists for appliance fabrication and fitting
- • Post-Delivery Care: You return to us 3-4 months AFTER appliance delivery for efficacy testing
- • Our Team: Orders follow-up sleep studies and determines if appliance is adequately controlling OSA
Note: The dentist handles all appliance adjustments, bite modifications, and dental follow-ups. We focus on verifying the appliance is actually treating your sleep apnea effectively.
Patient Journey: What to Expect
Initial Consultation with Our Team
Candidacy assessment and treatment planning
During This Visit:
- • Our physicians review your sleep study and medical history
- • Evaluates jaw anatomy and dental health for appliance candidacy
- • Discusses all CPAP alternative options (oral appliance, Inspire, Genio)
- • Provides referral to AADSM-certified dentist if appropriate
Months 1-3: Appliance Fabrication & Fitting
AADSM dentist manages this phase
What Happens with Dentist:
- • Week 1-2: Dental impressions, bite registration, jaw measurements
- • Week 3-4: Custom appliance fabrication (1-2 weeks)
- • Week 5-6: Initial appliance delivery and fitting
- • Weeks 7-12: Multiple adjustment appointments to find optimal jaw position
During this phase: Continue CPAP if you were using it. Do not stop CPAP until we verify with a follow-up sleep study that the oral appliance is effectively treating your OSA.
Months 3-4: Efficacy Assessment with Our Team
Critical evaluation checkpoint
Our Team Orders Follow-Up Sleep Study:
Our team will:
- • Order comprehensive sleep study with oral appliance in place
- • Schedule study after dentist confirms appliance is optimally adjusted
- • Our physicians review study and compare AHI to baseline
- • Determine if oral appliance is adequately controlling OSA
What Our Physicians Evaluate:
- • AHI Reduction: Is apnea severity adequately reduced (goal: AHI less than 10)?
- • Residual Events: Remaining apneas, hypopneas, or oxygen desaturations
- • Sleep Quality: Overall sleep architecture and efficiency
- • Clinical Improvement: Symptom resolution, Epworth Sleepiness Scale scores
Why This Matters: Symptom improvement doesn't always mean your OSA is controlled. Follow-up sleep studies are the only way to objectively verify the appliance is working. This is mandatory for proper medical care.
Possible Outcomes & Next Steps
Based on follow-up sleep study results
Treatment Success (AHI less than 10):
- • Continue oral appliance therapy: Use nightly for sustained OSA control
- • CPAP discontinuation: Safe to stop CPAP if previously using
- • Maintenance schedule: See dentist every 6 months for appliance check and adjustments
- • Annual monitoring: Return to us yearly for follow-up sleep studies to verify sustained effectiveness
Partial Success (AHI 10-20):
Appliance is helping but OSA not fully controlled. Options include:
- • Further appliance adjustment: Dentist advances jaw more to optimize efficacy
- • Combination therapy: Oral appliance plus positional device or weight loss
- • CPAP at lower pressure: Use oral appliance with reduced CPAP settings
- • Alternative evaluation: Consider Inspire or Genio if further adjustments don't improve results
Treatment Failure (AHI still greater than 20):
Oral appliance is not adequately treating your OSA. Next steps:
- • Resume CPAP therapy: Return to proven treatment while evaluating alternatives
- • Inspire Therapy: We're a Center of Excellence for surgical hypoglossal nerve stimulation
- • Genio Therapy: We're first in Texas for this newer FDA-approved option
- • No referral needed: You don't start over at a new clinic. We have next-step solutions.
Long-Term Monitoring & Maintenance
Ensuring sustained OSA control
If Oral Appliance is Successful:
- • Dental visits every 6 months: Appliance adjustment, bite monitoring, replacement as needed
- • Annual sleep studies with our team: Verify OSA remains controlled
- • Weight monitoring: Significant weight gain or loss can affect appliance effectiveness
- • Symptom tracking: Return of snoring, gasping, or daytime sleepiness requires evaluation
When to Call Us for Earlier Evaluation:
- • Worsening OSA symptoms despite appliance use
- • Appliance becomes uncomfortable or stops fitting properly
- • Significant weight change (plus or minus 20 lbs)
- • Dentist cannot achieve adequate jaw advancement
- • Developing TMJ pain or bite changes
The Value of Physician-Supervised Oral Appliance Therapy
Our Comprehensive Monitoring Approach
AADSM-certified dentists provide excellent appliance fitting and dental expertise. We complement their work with objective sleep medicine monitoring to verify treatment success.
- Follow-up sleep study at 3-4 months (mandatory)
- Objective AHI measurement with appliance in place
- Our physicians review results and determine treatment success
- Coordinate with dentist for further adjustments if needed
- Alternative therapies available (Inspire, Genio) if appliance doesn't achieve goals
- Annual monitoring to ensure sustained OSA control
- Long-term physician oversight for optimal outcomes
Why This Matters: Symptom improvement doesn't always mean OSA is controlled. Some patients feel better due to reduced snoring but still have elevated AHI levels. Follow-up sleep studies provide objective verification that the appliance is working. This collaboration between dental and sleep medicine expertise ensures the best patient outcomes.
A Full Spectrum of CPAP Alternatives
Oral appliances work well for many patients, but not everyone achieves adequate OSA control. We have multiple next-step solutions available without additional referrals.
Your Treatment Options Under One Roof:
- Oral Appliance Therapy: Referral to AADSM-certified dentists with physician oversight
- Inspire Therapy: Center of Excellence for hypoglossal nerve stimulation
- Genio Therapy: First in Texas for this newer FDA-approved treatment
- CPAP Optimization: Advanced fitting and pressure adjustment if needed
- Combination Therapy: Multiple treatment modalities for complex OSA
Seamless care transitions. If one therapy doesn't achieve your goals, we can pivot to alternatives without delays or additional referrals. This comprehensive approach ensures you get effective OSA treatment.
Your Role in Treatment Success
For Best Results:
- Attend all dental adjustment appointmentsMultiple visits required for optimal fitting
- Use appliance nightlyConsistent use required for effectiveness
- Complete follow-up sleep studyMandatory for verifying treatment success
- Continue CPAP until verifiedDon't stop until sleep study confirms appliance works
- Clean appliance dailyPrevents bacteria buildup and odor
- Report discomfort immediatelyTMJ pain or bite changes need attention
- See dentist every 6 monthsOngoing adjustment and maintenance
- Annual monitoring with our teamLong-term OSA control verification
Comprehensive Oral Appliance Therapy Management
AADSM-certified dentist expertise for appliance fitting. Board-certified physician oversight for outcome verification and next-step options.