Sleep Apnea Oral Appliance NYC — Custom Mandibular Advancement Devices

Yes if there is any suspicion of sleep apnea, which is most patients with snoring complaints. A home or in-lab sleep study and a physician diagnosis establish whether you have primary snoring, mild-moderate OSA, or severe OSA — each has a different first-line treatment. We do not fabricate an oral appliance for undiagnosed snoring as if it were apnea.

A custom mandibular advancement device is priced as a package that includes the appliance, titration visits, and follow-up. Over-the-counter "boil-and-bite" devices are dramatically cheaper but do not retain a stable position and are not a substitute for a custom-fit medical device. We provide a written estimate at consultation.

Medical insurance (not dental) is the relevant coverage and many plans cover oral appliances for diagnosed OSA when CPAP has failed or been declined. Coverage requires the sleep study, physician documentation, and specific medical billing codes. Centre Dental provides all required documentation; reimbursement varies significantly by plan.

CPAP is more effective at reducing apnea events on average, particularly in severe OSA. Oral appliances are typically more comfortable and have higher long-term adherence. For mild-to-moderate OSA, published data shows comparable real-world outcomes because patients actually wear the appliance most nights, while CPAP adherence rates are notoriously low. The right answer depends on disease severity, your tolerance, and what you will actually use every night.

A well-maintained custom MAD typically lasts three to five years. Replacement is needed when the plastic shows wear, the connecting mechanism loosens, or the fit changes due to dental work or tooth movement. Annual review at your dental visits identifies replacement timing before the device fails.

Long-term use is associated with measurable bite changes in 14–30% of patients depending on the published study. We monitor occlusion at every six-month dental visit. A morning repositioner appliance or therapy re-evaluation is offered if changes begin. The risk is weighed candidly against untreated apnea consequences at consultation.

Most patients with primary snoring see substantial reduction or elimination of snoring once the appliance is properly titrated. Bed-partner report at four weeks is the typical confirmation. Snoring is not always benign — we recommend a sleep study to confirm there is no underlying apnea before treating snoring as cosmetic.