Oral Appliance Therapy for Snoring in Singapore

If snoring affects your sleep quality or disturbs your partner’s rest, you’re not alone. This is a common concern that can impact daily lives and relationships. Oral appliance therapy offers a comfortable, non-invasive treatment option that may help patients achieve quieter, more restful sleep. This established treatment uses custom-fitted dental devices to maintain proper airway positioning during sleep, addressing the root cause of snoring. ENT specialists provide comprehensive evaluation and personalised oral appliance therapy that aims to help you and your loved ones enjoy peaceful nights. Individual results and timelines may vary.

Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

Overview Candidates Treatment Process Recovery Benefits Risks Cost FAQ

What is Oral Appliance Therapy for Snoring?

Oral appliance therapy involves wearing a custom-made dental device during sleep to help prevent airway obstruction that causes snoring. These devices, similar to sports mouthguards or orthodontic retainers, work by repositioning the lower jaw and tongue to help maintain an open airway throughout the night. The appliances are designed and fitted by dental professionals trained in sleep medicine.

The therapy addresses snoring by helping to prevent the soft tissues in your throat from collapsing and vibrating during sleep. When you sleep, the muscles in your throat naturally relax, which can narrow your airway. This narrowing creates turbulent airflow, producing the characteristic sound of snoring. Oral appliances aim to maintain jaw and tongue positioning to help keep airways open.

This treatment approach may be practical for primary snoring (snoring without sleep apnoea) and mild to moderate obstructive sleep apnoea. The devices are portable, require no electricity, and offer an alternative for patients who cannot tolerate continuous positive airway pressure (CPAP) therapy. Properly fitted oral appliances may help reduce snoring frequency and intensity for suitable candidates.

Who is a Suitable Candidate?

Potential Candidates

Adults experiencing regular snoring that disrupts sleep quality
Individuals whose snoring affects their partner’s sleep
Patients with mild to moderate obstructive sleep apnoea diagnosed through sleep studies
Those who cannot tolerate or prefer alternatives to CPAP therapy
People with adequate, healthy teeth to support the appliance
Individuals with normal jaw function and range of motion
Patients committed to regular device use and follow-up care
Those seeking a portable, travel-friendly snoring option

Contraindications

Severe obstructive sleep apnoea requiring CPAP or surgical intervention
Active temporomandibular joint (TMJ) disorders or severe jaw pain
Insufficient teeth or extensive dental problems requiring treatment
Severe gum disease or loose teeth
Limited jaw mobility or inability to protrude the lower jaw
Central sleep apnoea (different mechanism from obstructive type)
Severe teeth grinding that may damage the appliance

A thorough evaluation by an ENT specialist may determine whether oral appliance therapy is suitable for your specific situation. This assessment includes examining your oral health and jaw function, and reviewing any sleep study results to determine whether this treatment approach could help address your snoring concerns.

Treatment Techniques & Approaches

Mandibular Advancement Devices (MAD)

Mandibular advancement devices are commonly prescribed oral appliances for snoring. These devices work by holding the lower jaw forward during sleep. This forward positioning may help prevent the tongue and soft tissues from falling back into the throat, thereby maintaining an open airway. MADs are adjustable, allowing the dental professional to adjust the amount of jaw advancement. Patients typically adapt to these devices with consistent use.

Tongue Retaining Devices (TRD)

Tongue-retaining devices offer an alternative approach by gently suctioning the tongue forward. These devices may help prevent the tongue from falling back and blocking the airway during sleep. TRDs may be suitable for patients with dentures or those who cannot use jaw-advancing appliances. These devices can provide snoring reduction for specific patient profiles.

Custom vs. Boil-and-Bite Appliances

Over-the-counter “boil-and-bite” devices are available, while custom-fitted appliances created by dental professionals can provide improved comfort, effectiveness, and durability. Custom devices are fabricated from dental impressions to ensure a precise fit and proper jaw positioning. The materials used in custom appliances are designed for long-term nightly use.

Considering which oral appliance approach might be suitable for you?

Our ENT Specialist can evaluate your specific needs and discuss available device options.

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The Treatment Process

Pre-Treatment Preparation

Your journey begins with a comprehensive consultation with our ENT specialist. During this visit, we review your medical history, sleep patterns, and any previous sleep study results. A thorough oral examination assesses your teeth, gums, jaw joints, and airway anatomy. Digital X-rays or 3D imaging may be taken to evaluate your jaw structure and airway dimensions.

If you haven’t had a recent sleep study, we may recommend one to determine the severity of your snoring and rule out sleep apnoea. Some patients undergo home sleep tests, while others may need overnight polysomnography at a sleep laboratory. These tests provide data about your breathing patterns, oxygen levels, and sleep quality.

During the Fitting Process

Once you’re deemed suitable for oral appliance therapy, we take precise impressions or digital scans of your teeth. These impressions capture exact tooth positions and bite relationships needed for appliance fabrication. The fitting appointment is entirely painless.

Your custom appliance is fabricated in a specialised dental laboratory. The device is created according to your specific jaw measurements and the prescribed amount of advancement determined by your specialist.

At the delivery appointment, your specialist fits the appliance and makes initial adjustments. You’ll practise inserting and removing the device, and receive detailed instructions on proper use and care. Initial jaw positioning is conservative, with gradual adjustments made over subsequent visits.

Immediate Post-Fitting

Patients may experience mild jaw discomfort or excess salivation during the first few nights of use. These sensations may resolve as you adapt to wearing the appliance. Your specialist may prescribe jaw exercises to perform each morning to help prevent stiffness and maintain normal jaw function.

Recovery & Aftercare

First 24-48 Hours

Initial use may feel unusual as your mouth adjusts to the appliance. Slight tooth sensitivity and increased saliva production are normal. Begin by wearing the device for short periods while awake to familiarise yourself with the sensation. Gradually increase wearing time before attempting full-night use. Keep the appliance clean by rinsing with cool water after each use.

First Week

Continue wearing the appliance nightly, even if initially uncomfortable. Perform prescribed jaw exercises each morning to maintain flexibility and reduce any residual tension. Clean the device daily with a soft toothbrush and mild soap or specialised cleaning solution. Monitor for any persistent discomfort or areas where the appliance rubs against your gums. Comfort may improve during the first week.

*Individual experiences may vary.*

Long-term Management

Regular follow-up appointments help ensure optimal appliance function and comfort. Initial adjustments may be needed until ideal positioning is achieved. Once comfortable and practical, appointments typically occur at regular intervals. These visits include appliance inspection, cleaning, and assessment of your oral health.

Maintain excellent oral hygiene to prevent dental problems while using the appliance. Brush and floss thoroughly before inserting the device each night. Store the appliance in its protective case when not in use. Device longevity varies based on individual factors, such as teeth grinding and proper care.

Our ENT Specialist provide post-fitting support to help ensure comfort and effectiveness.

Schedule your consultation to learn more about what to expect.

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Benefits of Oral Appliance Therapy for Snoring

Oral appliance therapy may benefit suitable patients. The treatment aims to reduce snoring frequency and volume, which may be noticed from early use. Partners may experience improvement in their own sleep quality when snoring decreases.

Beyond quieter sleep, patients may experience improved daytime energy and concentration. Quality sleep without snoring interruptions can allow for better rest cycles and more refreshing sleep. This may contribute to enhanced mood, work performance, and overall quality of life.

The therapy’s non-invasive nature means no surgical risks or recovery time. Devices are portable and convenient for travel, requiring no electricity or bulky equipment. Patients may find oral appliances more comfortable and tolerable than CPAP masks, thereby supporting long-term compliance. The treatment is also reversible – discontinuing use returns you to your pre-treatment state.

For patients with mild sleep apnoea accompanying their snoring, oral appliances may provide dual benefits. Proper treatment aims to reduce associated health risks while improving sleep quality for both patient and partner.

Risks & Potential Complications

Common Side Effects

Temporary jaw discomfort may affect users but typically resolves. Excessive salivation or dry mouth may occur initially as your body adjusts to the appliance. Some patients may experience minor tooth movement or bite changes with long-term use, though these may be minimal with proper monitoring.

Morning jaw stiffness may occur, but it can be managed with prescribed exercises. Temporary difficulty chewing tough foods immediately after removing the appliance may occur. These effects may diminish as you adapt to the therapy.

Gum or tooth irritation can develop if the appliance requires adjustment. Regular follow-ups allow your specialist to identify and address any pressure points before they become problematic.

Rare Complications

Persistent TMJ pain or dysfunction may occur. This risk may be reduced through careful patient selection and gradual jaw advancement. Significant bite changes may occur and, if they do, may require orthodontic correction.

Loosening of dental work, like crowns or bridges, may occur with appliances. Allergic reactions to appliance materials may occur, even with biocompatible materials.

Your ENT specialist monitors for any complications through regular follow-up appointments. Proper patient selection, custom fitting, and gradual adjustment protocols may help reduce the risk of complications. Side effects may be mild and temporary, and can be managed with professional guidance.

Cost Considerations

The cost of oral appliance therapy varies based on several factors, including device type, the complexity of your case, and required follow-up adjustments. Custom-fitted appliances represent a greater initial investment than over-the-counter options but may provide enhanced comfort, effectiveness, and durability.

Your treatment cost typically includes the initial consultation, oral examination, impressions or digital scans, custom device fabrication, fitting appointments, and initial adjustment visits.

While the upfront cost may seem significant, consider the long-term value of improved sleep quality. The devices typically last several years with proper care. Patients may find the investment worthwhile when considering the potential impact of better sleep on their health and daily productivity.

During your consultation, our team can provide a detailed breakdown of costs specific to your treatment plan. Payment options may be available to make treatment more accessible.

For Singaporeans & Singapore Permanent Residents

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Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.

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Frequently Asked Questions (FAQ)

How long does it take for oral appliance therapy to stop my snoring?

Some patients may notice improvement from early use, though results can develop over several weeks as you adjust to the device.

Can I drink water or speak while wearing my oral appliance?

Patients can typically sip water through a straw while wearing their device, though it may feel awkward initially. Speaking is possible but may sound slightly different, similar to wearing a retainer. The appliance is designed for sleep use, so these activities aren’t typically necessary. If you need to get up during the night, you can temporarily remove the device. With practice, patients may become comfortable performing basic activities while wearing their appliance.

How do I clean and maintain my oral appliance?

Daily cleaning is essential for hygiene and device longevity. Rinse the appliance with cool water immediately after removal each morning. Brush gently with a soft toothbrush and mild soap or specialised dental appliance cleaner. Avoid hot water, which can warp the material. Weekly deep cleaning with denture cleaning tablets helps prevent bacterial buildup. Store the device in its ventilated case when dry.

Will oral appliance therapy work if I grind my teeth at night?

Teeth grinding (bruxism) doesn’t necessarily prevent oral appliance use. Some devices may protect against grinding damage. However, severe grinders may require a specially reinforced appliance or a combined treatment approach. Your ENT specialist can assess your grinding patterns during the initial evaluation. Some patients find that improved sleep quality from snoring reduction may decrease their grinding behaviour.

What happens if I need dental work while using an oral appliance?

Minor dental work, like fillings, typically doesn’t affect appliance fit. However, significant work such as crowns, bridges, or extractions may require appliance adjustment or replacement. Always inform your dentist that you use an oral appliance before any dental procedures. Bring your device to dental appointments so your dentist can ensure any new work won’t interfere with its fit. Your ENT specialist and general dentist can coordinate care to maintain treatment effectiveness.

How often do I need to replace my oral appliance?

With proper care, custom oral appliances may last several years, though this varies based on factors like grinding habits and device material. Regular follow-up appointments help monitor device condition and identify when replacement is needed. Signs that replacement may be necessary include visible wear, cracks, loose fit, or decreased effectiveness. Some patients require replacement sooner due to dental changes or weight fluctuations that affect fit.

Can I use an oral appliance if I have dentures or missing teeth?

Partial dentures don’t automatically disqualify you from oral appliance therapy, though options may be limited. Complete upper or lower dentures generally prevent the use of standard mandibular advancement devices. However, tongue retaining devices may be suitable for denture wearers. A sufficient number of healthy teeth in specific positions is required for certain appliances. Your ENT specialist can evaluate your specific dental situation to determine available options.

Will I need to use the oral appliance forever?

Long-term use is typically necessary to maintain snoring reduction, as the therapy addresses symptoms rather than the underlying cause. However, some patients find their need may decrease with lifestyle changes like weight loss or alcohol reduction. Others may eventually pursue alternative treatments. Regular reassessment helps determine if continued use remains necessary.

Conclusion

Oral appliance therapy represents a treatment option for snoring that may help improve sleep quality for patients in Singapore. This personalised treatment approach aims to address the underlying causes of snoring while avoiding invasive procedures or cumbersome equipment. With proper fitting and adjustment by a qualified ENT specialist, oral appliance therapy can help reduce snoring and support improved sleep quality.

The journey to better sleep begins with understanding your specific needs and exploring whether oral appliance therapy might be suitable for your situation. Our ENT Specialist combine knowledge in dental health and sleep medicine to provide comprehensive care throughout your treatment journey.

Ready to Take the Next Step?

If you’re considering oral appliance therapy for snoring, our ENT Specialist can help you determine whether it’s suitable for your needs. With experience in oral appliance therapy, we provide personalised care throughout your journey to better sleep.

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Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.

Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.

2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
2016 – Best Educator Award (Eastern Health Alliance)
2016 – “Wow” Award (Patient Compliment)

2014 – Eastern Health Alliance Caring Award – Silver
2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
2012 – Human Manpower Development Award (Ministry of Health, Singapore)
2007 – Singhealth Best Doctor Award

Qualifications

MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
FAMS – Fellow of the Academy of Medicine Singapore

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A Specialist Clinic for Sinus, Snoring & ENT

38 Irrawaddy Road #08-45
Mount Elizabeth Novena Hospital
Singapore 329563

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