DENTAL SLEEP MEDICINE
Dental sleep medicine connects dental care with a medical sleep pathway. A customised mandibular advancement device (MAD) can help selected adults with obstructive sleep apnoea or snoring by holding the lower jaw forward during sleep.
Snoring, witnessed pauses in breathing or daytime sleepiness deserve medical assessment. A dentist does not independently diagnose obstructive sleep apnoea (OSA). Your GP and an appropriate sleep service assess symptoms, investigate and diagnose OSA, discuss treatment options and arrange monitoring of the response.
Dr Sunie Kundi is a GDC-registered Specialist in Prosthodontics and works as a Specialty Dentist at Guy’s Hospital, where his work includes dental management of patients with sleep apnoea. Dental assessment considers whether an oral appliance is suitable and how it can be made, fitted and maintained alongside the sleep team.
In line with NICE NG202, a customised mandibular advancement splint may be considered for appropriate adults who decline or cannot tolerate CPAP, provided dental and periodontal health is adequate. The recommendation depends on OSA severity and the wider clinical situation; a sleep clinician should agree and monitor the treatment plan.
Arrange a Dental Sleep Medicine ConsultationWe review the diagnosis and medical plan, dental and gum health, remaining teeth and restorations, jaw joints, bite, comfort and likely retention. Active dental disease, unstable periodontal health or significant jaw symptoms may need attention before an appliance is suitable.
Scans or impressions and a jaw record guide a made-to-measure device. Options used in Dr Kundi’s work include SomnoDent Avant and SomnoDent Flex; the design is chosen for the individual mouth and clinical needs. A MAD is a treatment appliance, not a diagnosis or a guarantee of response.
At fitting, we check retention, comfort and use. The lower-jaw position is adjusted gradually (titrated) in response to symptoms and tolerance. The sleep team may arrange objective reassessment to check whether OSA is adequately controlled.
Early effects can include excess saliva or dry mouth, tooth tenderness, gum irritation, jaw muscle or joint discomfort, and a temporary morning change in the bite. Longer use can move teeth or change how the upper and lower teeth meet; these changes may persist. We discuss these risks before treatment, monitor teeth, gums, jaw comfort and bite, and review the appliance for wear, fit and hygiene. Contact your dentist if pain, looseness, damage or bite changes develop.
Clean and store the device according to its instructions, maintain regular dental care and attend planned dental and sleep-service follow-up. Better snoring alone does not confirm adequate treatment of OSA. CPAP intolerance should be discussed with the prescribing sleep team rather than stopping treatment without a plan.
A custom oral appliance may reduce snoring, but suspected OSA needs medical investigation. A sleep clinician determines the diagnosis and whether oral appliance therapy is appropriate.
Possibly. NICE describes customised mandibular advancement splints as an option in selected adults who decline or cannot tolerate CPAP, subject to dental and periodontal suitability. Your sleep team should guide the decision and follow-up.
SomnoDent Avant and SomnoDent Flex are different custom designs. Selection follows the dental examination, the shape and condition of your teeth, available space, retention and comfort—not a brand preference alone.
It is a customised oral appliance that holds the lower jaw forward during sleep. Read the patient guide to mandibular advancement devices for fitting, adjustment and follow-up.
We review the medical sleep diagnosis or referral, your dental and gum health, jaw joints, bite, restorations and whether a device will retain safely. Scans and a jaw record follow if treatment is appropriate.
Sometimes. The assessment considers the condition and distribution of teeth and restorations and the appliance’s retention. Read more about implants, crowns and missing teeth.
Suspected obstructive sleep apnoea needs assessment through an appropriate medical sleep pathway. Your sleep team determines whether a sleep study is required and oversees the diagnosis and response to treatment.