What's new in oral appliances for snoring and sleep apnea: an update.

The number and kind of oral appliances have proliferated in recent years as dentists have responded to the challenge to develop more sophisticated devices for the control of socially disruptive snoring and obstructive sleep apnea. Sleep-disordered breathing is now recognised as being a highly prevalent problem which carries increased social, economic, cognition and health risks. The popular mandibular-advancement devices have a greater level of acceptance by patients than the standard nasal continuous positive airway pressure (CPAP) treatment in recent head-to-head studies. It is important that these patients be followed by sleep clinicians as these appliances are less successful in controlling sleep apnea when the level of severity is high. Research is needed to determine the patients most appropriate for an oromandibular treatment and when CPAP is the treatment of choice. Potential sequences of treatments are suggested.