Obstructive sleep apnoea (OSA) affects an estimated one in four Australian men and one in ten Australian women over 30. If you have been diagnosed with OSA or chronic snoring, you may have been told that CPAP is the standard treatment. For many people it works well. For others, the mask, the noise, and the maintenance make it difficult to use consistently.
That is where dental sleep medicine comes in. A custom oral appliance, worn during sleep, can be an effective alternative for certain patients. At Ivy Dental, we design and fit mandibular advancement splints (MDSA) at our Everton Park and Nundah clinics in Brisbane.
Important clarification: Dental sleep medicine is not sedation dentistry. We do not offer IV sedation, happy gas, or general anaesthesia. Dental sleep medicine treats a sleep disorder. Sedation dentistry manages anxiety during dental procedures. They are entirely different services. We have a separate article explaining the difference.
How obstructive sleep apnoea works
During sleep, the muscles in the throat and tongue relax. In people with OSA, this relaxation narrows or blocks the airway, causing repeated pauses in breathing throughout the night. Each pause can last from a few seconds to over a minute and may occur dozens or hundreds of times per night.
These interruptions reduce oxygen levels and fragment sleep, even if you do not fully wake up. The result is daytime fatigue, poor concentration, morning headaches, and increased cardiovascular risk over time.
Common signs include loud snoring, gasping or choking during sleep, waking with a dry mouth, and excessive daytime sleepiness. A partner often notices the symptoms before the person with OSA does.
What is a mandibular advancement splint?
A mandibular advancement splint (MDSA) is a custom-fitted oral appliance that looks similar to a sports mouthguard but is more precisely engineered. It holds the lower jaw slightly forward during sleep, which opens the space behind the tongue and reduces airway obstruction.
The appliance is made from dental impressions or digital scans and is adjusted over several appointments to find the jaw position that provides the most benefit with the least side effects. Most patients adapt to wearing the device within one to two weeks.
Unlike CPAP, an MDSA is silent, portable, requires no power source, and fits in a small case for travel. It does require regular dental review to monitor jaw health, tooth position, and appliance fit. For a comparison of different oral appliances, see our guide on night guards, splints, and retainers.
Who may benefit from oral appliance therapy
Not every sleep apnoea patient is a candidate for MDSA treatment. Oral appliances are most commonly recommended for:
- Mild to moderate obstructive sleep apnoea where CPAP is not preferred or not tolerated
- Primary snoring that disrupts a partner's sleep, with or without a formal OSA diagnosis
- CPAP-intolerant patients who have tried CPAP but cannot use it consistently due to mask discomfort, claustrophobia, or other factors
- Combination therapy where an oral appliance is used alongside CPAP to allow lower pressure settings
For severe OSA, CPAP remains the first-line treatment recommendation. However, a device that is used consistently may provide more benefit than a device that sits in a drawer. Your sleep physician and dentist can discuss what is appropriate for your situation.
A current sleep study is required before we can assess suitability. If you do not have a recent study, your GP can arrange a referral.
The treatment process
Oral appliance therapy at Ivy Dental follows a structured process over several appointments.
Appointment 1: Assessment. We review your sleep study results, examine your teeth and jaw, and assess whether you are a suitable candidate. Factors such as tooth condition, jaw joint health, and the severity of your OSA all influence suitability.
Appointment 2: Impressions or scans. If you proceed, we take detailed impressions or digital scans of your teeth. These are sent to the laboratory to fabricate your custom appliance.
Appointment 3: Fitting. The appliance is fitted and adjusted. We show you how to insert and remove it, how to clean and store it, and what to expect in the first few nights.
Follow-up appointments. Over the next few weeks, the appliance is progressively adjusted (titrated) to find the jaw position that reduces your apnoea events without causing jaw discomfort. A follow-up sleep study may be recommended to confirm the appliance is working effectively.
Ongoing reviews. We recommend six-monthly reviews to check the appliance for wear, assess your teeth and jaw, and make any necessary adjustments. Long-term monitoring is an important part of oral appliance therapy.
Book a dental sleep medicine consultation at Ivy Dental to discuss whether an oral appliance may suit your situation.
Cost and health fund considerations
Custom mandibular advancement splints at Ivy Dental start from $1,600. The written quote states which records, fabrication, fitting, and review appointments are included.
Some private health funds provide partial rebates for MDSA appliances, particularly if you have a confirmed OSA diagnosis and a sleep physician referral. Coverage varies by fund and level of extras cover. We can provide item numbers in advance so you can check your expected rebate before committing.
Payment plans may be available to approved applicants if you prefer to spread the cost.
It is worth noting that the cost of untreated sleep apnoea extends beyond the dental fee. OSA is associated with increased risk of hypertension, stroke, type 2 diabetes, and motor vehicle accidents related to daytime sleepiness. Treating the condition is a health investment, not just a dental one.
Oral appliance vs CPAP: a practical comparison
Factor | CPAP | Oral appliance (MDSA) |
|---|---|---|
How it works | Delivers pressurised air through a mask | Repositions the jaw to open the airway |
Noise | Some noise from the machine | Silent |
Portability | Requires power, water, and space | Fits in a small carry case |
Compliance rates | Many patients struggle with long-term use | Generally higher nightly compliance |
Effectiveness for mild-moderate OSA | Highly effective | Research supports comparable outcomes in many cases |
Effectiveness for severe OSA | First-line recommendation | May be considered when CPAP is not tolerated |
Side effects | Mask discomfort, dry mouth, skin irritation | Jaw stiffness, temporary bite changes in the morning |
Neither option is universally superior. The right choice depends on your diagnosis severity, your ability to use the device consistently, and your personal preferences. Some patients use both, depending on the situation.
Common concerns about oral appliances
Will it change my bite? Some patients notice temporary bite changes when they first remove the appliance in the morning. These typically resolve within 30 to 60 minutes. Long-term bite changes are possible and are monitored at review appointments.
Will it work for my snoring? Oral appliances can reduce snoring significantly in many cases. If snoring is your primary concern and you do not have OSA, your dentist can still assess whether an appliance may help.
Is it comfortable to sleep with? Most patients adapt within one to two weeks. The appliance is custom-fitted to your teeth, so it should feel secure without being tight. Adjustments are made if comfort is an issue.
Next steps
If you have been diagnosed with obstructive sleep apnoea or chronic snoring and want to explore whether an oral appliance may be appropriate, the first step is a clinical assessment. Bring your sleep study results to the appointment if you have them.
You can learn more about dental sleep medicine at Ivy Dental, read about the difference between dental sleep medicine and sedation, or explore our general dentistry services. Book a consultation at our Everton Park or Nundah clinic, or call (07) 3266 7120.
Individual outcomes vary. Oral appliance therapy is not suitable for all patients. A clinical assessment and current sleep study are required before treatment can begin.
