Mandibular Advancement & Sleep Apnea Devices
Make sleep apnea easy to treat.
- Herbst Appliance
- Dorsal Appliance
Why offer sleep apnea appliances at your practice?
Sleep apnea is one of the hottest areas in dentistry right now. Patients are realizing that they can easily improve their quality of life by adequately treating this without CPAP machines and dental practices have recognized that there is significant opportunity to grow their practice by offering dental appliances for sleep apnea.
Dandy is here to help practices ease into dental sleep medicine.
Flexible mandibular advancement device options
Dentists can offer both the Herbst and the Dorsal intraoral device for sleep apnea with Dandy. Both products are 3D printed to ensure a high level of accuracy and comfort. This ensures a high degree of efficacy when treating sleep apnea.
Medical billing, simplified
We provide your practice with the education, enablement, and clinical support necessary to confidently treat sleep apnea with intraoral appliances. All Dandy sleep apnea customers receive an exclusive discount with our medical billing partner, Nierman Practice Management. We simplify the process so you can focus on what you do best.
Grow your practice
Sleep apnea provides an opportunity to significantly increase your practice’s revenue and profitability. Dental practices can receive medical billing reimbursements while requiring minimal chairtime.
Ready to start offering sleep apnea dental appliances at your practice?
Oral appliances vs CPAP
For several patients, an oral appliance for sleep apnea is a better solution to sleep apnea than CPAP.
A CPAP machine has been reported to be uncomfortable and harder to get used to sleeping with. The machine is relatively more complicated than an intraoral appliance and requires maintenance.
The Herbst and Dorsal sleep apnea appliances are easy to use and adjust. They come with detailed instructions on how to insert the appliance, keep them clean, and change the therapeutic position.
Intraoral scanning recommendations for mandibular advancement devices
✔️Are all surfaces of the posterior teeth captured?
✔️Are both of the retromolar pads captured?
✔️Are there any distortions, holes, or layering?
✔️Is the entire palate captured?
The bite scan
To start, set the therapeutic bite position. Leave roughly 3mm vertical clearance between the arches and roughly 5 mm between the opposing anteriors.
Ensure stable jaw position with a gauge, gig or firm makeshift device, in the therapeutic bite position.
The bite scan should cover at least 3-4 teeth to get proper alignment.
Scan the bite on both sides.
The arch scan
When scanning the arch, do your best to capture the full arch and scan those hard to reach back teeth.
Try and make sure there aren’t any voids/distortions on the scans (this is to ensure we fabricate an oral appliance for sleep apnea that most accurately fits the patient’s mouth).
Ready to start offering sleep apnea dental appliances at your practice?
Learn more about offering a mandibular advancement devices at your practice with these resources:
Mandibular advancement device FAQ
Mild and moderate sleep apnea.
Protruding the lower jaw until the patient is not able to easily snore and then it is held in place with a bite gauge.
They can, which is why we include a free morning repositioning device, which is a simple tray that reminds jaw muscles how to move into the natural bite position after using a sleep apnea appliance, with every Dandy Herbst and Dorsal order.
There is no formal requirement to prescribe but the AADSM recommends that they be a qualified dentist, which can be achieved by taking the course listed on the AADSM website.
Dandy offers Herbst and Dorsal appliances as solutions for treating sleep apnea.
The Herbst sleep apnea appliance is covered by Medicare. It’s also more comfortable for the patient, with thinner sides and material that allows for more excursive and lateral movements.
The Dorsal sleep apnea appliance completely separates the arches allowing more vertical movement. There is also no metal hinge in the appliance.
There are four widely accepted intraoral appliances for sleep apnea: Herbst, Dorsal, TAP, and EMA. There are other lesser used appliances, but they are less proven in clinical efficacy. Of the main four appliances listed, Dandy holds the belief that the Herbst and the Dorsal are the best options. And that together these provide a strong sleep apnea offering that can meet different types of patient needs.
The TAP and EMA appliances are widely used but have downfalls:
- The TAP locks the patient’s arches together, limiting essentially all movement vertically and horizontally. This can be very uncomfortable for the patient; it may be particularly troublesome for patients who have bruxism.
- The EMA appliance is a cheaper alternative. However, the mechanism depends on acrylic notches and rubber bands; this system has been found to be less durable.
Long term, Dandy is exploring expanding our sleep apnea offering. While there are downsides of the TAP and EMA appliances, there are some cases where they work well and some patients may prefer them.
Sleep apnea is a great way to increase practice profitability. Sleep Apnea falls under the category of Medical Insurance which provides relatively high reimbursements (approximately from $3,000-$5,000) for these appliances compared to other potential lab products (i.e. crowns, night guards, etc). Note that medical reimbursements fluctuates with geography and insurance plans. In some states this reimbursement could be even higher. Regardless, this presents a very profitable product.
In addition to high reimbursements, delivering this product only requires two short appointments:
- Scanning appointment- takes roughly the same time as night guard scanning
- Delivery appointment. – useful to explain how to use the device and to make chair side adjustments. Dandy provides instructions to facilitate patient education for the dentist. Chair side adjustments can be expected to be limited because these are digitally milled, creating an ideal fit.
Therefore, the input costs of chair time and scanning time are low relative to the payout.
The common oral appliances for sleep apnea are as follows:
Mandibular Advancement Devices (MADs)
Mandibular advancement devices are the most widely used sleep apnea dental appliances and are designed to hold the lower jaw and tongue forward, which helps to keep the airway open during sleep. MADs are usually custom-made. The most common types are the Herbst and Dorsal sleep apnea appliances.
Continuous Open Airway Therapy (COAT)
COAT consists of a small plastic mouthpiece worn in the mouth. The mouthpiece is designed to keep the airway open by using a vacuum to pull the soft palate forward.
Tongue Retaining Devices (TRDs)
TRDs use a suction cup or similar mechanism to hold the tongue forward. This prevents the tongue from falling back and blocking the airway during sleep.
This device is inserted into the nostrils to help keep them open during sleep. They are often used by people with nasal congestion or other issues that make breathing through the nose difficult.
Some mandibular advancement devices have potential side effects, such as soreness in the jaw and teeth, and may not be suitable for all patients.
Grow your practice offering
Ready to start offering your patients a dental appliance for sleep apnea? Learn more about how partnering with Dandy as your lab will work for you!
View Dandy sleep apnea dental appliance turnaround times
Looking for information on sleep apnea dental appliances and turnaround times? Download our product guide for more information on our sleep apnea dental appliance offering.