Dr. Denbar has used Oral Appliance Therapy to treat sleep disordered breathing for 24 years in the Austin area. He has treated thousands of cases, ranging from the simplest to the most difficult. Dr. Denbar is a credentialed, in-network medical provider for most major medical insurance companies. These insurance carriers include Aetna, Humana, United Healthcare, Cigna, Seton Healthcare and Scott & White Healthcare. Dr. Denbar is also a Medicare and Tricare provider. Our office provides the most extensive medical insurance coverage for this therapy in Central Texas.

What is Oral Appliance Therapy?

Could it free you from the head straps, chin strap, hose and CPAP mask?

Oral Appliance Therapy uses FDA approved oral appliances which can be the answer to treating your snoring or Obstructive Sleep Apnea. Snoring can diminish the quality of life for you and your loved ones. Obstructive sleep apnea affects your overall health and you should seek treatment from qualified doctors with extensive experience in treating this condition. If you can not tolerate CPAP or had surgery which has failed to fully treat the situation, oral appliances can be your answer.

How do Oral Appliances Work?

If you have ever worn a custom orthodontic retainer, orthotic for nighttime teeth grinding or an athletic mouth guard, you have an idea what it is like to wear one of these oral appliances. Oral appliances can vary in design as there are over 100 FDA approved appliances. All of them, in one way or another, advance the lower jaw to open your airway.

The principle behind oral appliance therapy is not new. During the 1930s, the first oral appliance to keep the lower jaw forward and assist in keeping the airway open was used. In the 1970s, the surgical procedure to move the lower jaw forward was developed. In the 1980s, the Tongue Retaining Device was developed and is still used on selected cases today. Only recently have the adjustable mandibular advancing oral appliances been developed and utilized. Although there are a number of mandibular advancing devices, they all are striving to do essentially the same thing. That is:

1. Move the lower jaw, tongue, soft palate, and hyoid bone into a position to help create a more open airway.
2. Help to prevent airway closure during sleep by stabilizing the tongue, mandible, and hyoid bone.
3. The appliance gives the tongue muscles an artificial muscle tone. This increased muscle tone makes the tongue less likely to relax and cover the airway during sleep.

Multiple peer review studies in prestigious medical journals have shown that oral appliances are better tolerated by patients than CPAP therapy.

Excerpts from the Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015
"In recent years, oral appliances (OAs) have become an increasingly common treatment modality for OSA and snoring. Although positive airway pressure (PAP) remains the most common and most efficacious treatment for sleep disordered breathing, OAs offer effective therapy for many patients with OSA. These devices offer advantages over PAP in that they do not require a source of electricity and are less cumbersome, especially with travel. Oral appliances are well tolerated in most patients, and therapeutic adherence may be better than CPAP. The improvement in quality of life produced by custom, titratable OAs is not inferior to that reported with CPAP therapy. The overall improvement in physiologic sleep parameters with the use of OAs in adult patients with OSA should result in an improvement in daily function and quality of life."

Oral Appliance Therapy has developed into a fully recognized form of therapy for snoring, Upper Airway Resistance Syndrome and Obstructive Sleep Apnea. This treatment works hand-in-hand with current medical therapy and therefore your treating dentist is an integral part of the medical team treating your medical problem. The dentist must also be familiar with all of the types of therapy to treat snoring and sleep apnea. This includes surgery, cpap, oral appliance therapy, and any combination of these treatments. Standards of care now dictate that some form of follow-up testing be performed to verify a patient's treatment success or failure. Symptoms alone are not an accurate indicator that your airway is open. That is why it is so important for you to be re-evaluated by your physician after our treatment is finished.

Once a patient has an oral appliance and their problem is controlled, it must be understood that they are only managing their problem, not curing it. For this reason, all patients are seen once a year to make sure there are no problems with the appliances, their bite, muscles, TMJ.

For those patients who require more treatment than an oral appliance due to the severity of their sleep apnea, we can provide Combination Therapy. Combination Therapy allows for the use an Interface to attach your CPAP machine to the oral appliance without the need for the normal head and chin straps and with significantly lower air pressures. This equates to more comfort, better compliance and a viable option for those individuals that cannot use CPAP by itself. Combination Therapy can work with a normal CPAP, auto-CPAP, BiPAP, BiPAP ST and adaptive servo-ventilation ASV machines.

Dr. Denbar is a leader in this form of therapy nationally and has successfully treated hundreds of patients with Combination Therapy. His successful cases have included patients who stop breathing over 100 times/hour, have low nighttime oxygen levels down to 41% and significantly reduced pressure as high as 20+cmH2O to comfortable levels. Read more here ...