Sleep Apnea Treatment in Beverly Hills
Oral Appliance Therapy
A custom oral appliance for diagnosed obstructive sleep apnea, fitted and adjusted here and managed alongside your physician. Quiet, portable, and worn by patients who could not tolerate CPAP.
Where Dentistry Fits Into Sleep Apnea Care
Obstructive sleep apnea occurs when the soft tissues at the back of the throat narrow or collapse during sleep, interrupting breathing repeatedly through the night. Oral appliance therapy treats it with a custom device that holds the lower jaw slightly forward while you sleep, increasing the space in the airway behind the tongue. The boundary matters here. Sleep apnea is diagnosed by a physician on the basis of a sleep study, and a dentist does not diagnose it. What we can do is recognise the signs, several of which appear in the mouth where we look routinely, refer you for testing, and then fit and manage the appliance once a diagnosis exists.
SIGNS, TREATMENT AND WHAT TO EXPECT
The signs worth getting tested for, and what appliance therapy involves once a diagnosis is in place.
Loud, Habitual Snoring
Snoring is airflow forcing past soft tissue partly obstructing the airway. Not everyone who snores has apnea, but most people with obstructive apnea snore, which makes it the most common route to diagnosis.
Witnessed Pauses in Breathing
A partner describing episodes where you appear to stop breathing and then gasp or snort is describing the condition directly. That observation alone is generally reason enough to be referred for a sleep study.
Waking Unrefreshed After a Full Night
Repeated interruptions in breathing fragment sleep, often without the person remembering waking at all. Time in bed and restorative sleep are not the same thing, which is why daytime tiredness persists no matter how early you turn in.
Morning Headaches and Dry Mouth
Headaches on waking are commonly reported in obstructive sleep apnea. Waking with a very dry mouth or throat suggests mouth breathing overnight, which also raises the risk of decay and gum inflammation.
Grinding, Worn Teeth and a Scalloped Tongue
There is a documented association between airway obstruction and nighttime grinding, though the relationship is not fully understood and one does not prove the other. A tongue with indentations along its edges suggests it is being pressed against the teeth. These are signs we notice during ordinary examinations.
Screening Here, Diagnosis by a Physician
We look at wear patterns, tongue posture, tonsil size and, where a cone beam scan has been taken, the visible airway space. That identifies risk. It does not diagnose. Where the picture suggests apnea, you are referred for a sleep study, either in a laboratory or at home.
How the Appliance Works
It holds the lower jaw slightly forward during sleep. Because the tongue and throat tissues are attached to the lower jaw, moving it forward increases the space behind them and makes collapse less likely. The device is roughly the size of a night guard and needs no power.
Fitting and Titration
Digital scans are taken and a custom mandibular advancement device made. It is then advanced gradually across several appointments to find a position that improves symptoms with the least strain on the jaw. Advancing in small increments is what makes it tolerable, and it is why this is not a one-visit treatment.
Side Effects and Monitoring
Jaw tightness and extra salivation in the first weeks are common and settle. Over years of wear, small bite changes can develop, which is why your bite is recorded at the outset and reviewed at every appointment. You should know that before starting rather than discover it later.
ORAL APPLIANCE OR CPAP
Both are legitimate treatments and the decision sits with your physician. This is the comparison patients most often ask us to explain.
ORAL APPLIANCE THERAPY:
Recognised for mild to moderate obstructive sleep apnea, and for more severe cases where CPAP cannot be tolerated. No power required, fits in a pocket, and silent. The practical advantage is consistency, since an appliance worn every night is treating the condition every night.
CPAP:
Generally more effective, particularly for severe apnea, and it remains the first-line treatment where a patient can use it consistently. The difficulty is tolerance. A machine that sits unused in a cupboard treats nothing, which is where appliance therapy becomes the better practical option.
WHY PATIENTS COME TO US FOR APPLIANCE THERAPY
Airway signs are part of how we examine every patient, not a separate service you have to ask for.
Airway Assessed Routinely
Wear patterns, tongue posture and airway space are checked at examinations, so risk is often picked up in patients who came in for something else entirely.
Coordinated With Your Physician
We work alongside sleep physicians rather than around them. Diagnosis and medical management stay where they belong.
Titrated Over Several Visits
The appliance is advanced gradually rather than set to a final position on day one, which is what makes it tolerable enough to wear every night.
Grinding and TMJ Assessed Together
Bruxism, jaw joint problems and airway obstruction overlap constantly. Treating one while ignoring the others rarely holds.
Airway Assessed Routinely
Wear patterns, tongue posture and airway space are checked at examinations, so risk is often picked up in patients who came in for something else entirely.
Coordinated With Your Physician
We work alongside sleep physicians rather than around them. Diagnosis and medical management stay where they belong.
Titrated Over Several Visits
The appliance is advanced gradually rather than set to a final position on day one, which is what makes it tolerable enough to wear every night.
Grinding and TMJ Assessed Together
Bruxism, jaw joint problems and airway obstruction overlap constantly. Treating one while ignoring the others rarely holds.
IF YOU SNORE AND WAKE UP TIRED
Untreated obstructive sleep apnea is associated in the research literature with high blood pressure, cardiovascular disease, stroke and daytime impairment. It is also commonly undiagnosed, because the person experiencing it is asleep for all of it. An airway assessment takes one appointment and will tell you whether a sleep study is worth arranging. Book with Dr. Shir.
FREQUENTLY ASKED QUESTIONS ABOUT SLEEP APNEA TREATMENT
The questions patients ask most often before starting appliance therapy.
Can a dentist diagnose sleep apnea?
No. Diagnosis requires a sleep study interpreted by a physician. A dentist can screen for the signs, many of which appear in the mouth and airway, and refer you for testing. Once a diagnosis exists, we can make, fit, adjust and monitor an oral appliance. Any dental practice presenting itself as able to diagnose the condition is overstating its role.
Is an oral appliance as effective as CPAP?
For severe apnea, CPAP is generally more effective and remains the first-line treatment where it is tolerated. For mild to moderate apnea, oral appliance therapy is recognised as an appropriate option by the American Academy of Sleep Medicine. The practical qualifier is consistency of use, and your physician’s assessment of severity guides the decision.
Is it comfortable to sleep with?
There is an adjustment period of one to two weeks. Jaw tightness in the mornings and extra salivation overnight are both commonly reported early on and generally settle. Because the appliance is advanced gradually rather than set to its final position immediately, that adaptation is considerably easier than it would otherwise be.
Will insurance cover an oral appliance?
Oral appliance therapy for diagnosed obstructive sleep apnea is often processed through medical rather than dental insurance, since it treats a medical condition. Coverage varies by plan and generally requires the sleep study and physician documentation. We will tell you what is typically needed and provide our documentation, and you receive a written fee regardless.