Why the Device Brand Matters
There are more than 100 FDA-cleared oral appliance designs on the market for treating sleep apnea. While all custom mandibular advancement devices work by the same basic principle — advancing the lower jaw to open the airway — they differ significantly in design, adjustability, comfort, durability, and clinical performance. Your dental sleep specialist will recommend a device based on your specific anatomy, dental health, and clinical needs. Understanding the most popular options helps you have an informed conversation.
SomnoDent
SomnoDent is one of the most widely prescribed oral appliances globally, manufactured by SomnoMed. It features a two-piece design with upper and lower acrylic trays connected by a precision metal coupling mechanism.
- Adjustability — Precise 0.1mm incremental advancement using small calibration keys
- Comfort — Generally rated highly for comfort; the soft inner lining conforms closely to teeth
- Opening while wearing — Some designs allow limited mouth opening, which patients who breathe through their mouth prefer
- Clinical evidence — Extensively studied in clinical trials with strong effectiveness data
- Best for — Patients who prioritize comfort and precise titration control
Herbst Appliance
The Herbst appliance uses a telescoping metal rod-and-tube mechanism connecting upper and lower trays. It was originally developed in orthodontics and adapted for sleep apnea treatment.
- Adjustability — Advancement adjusted in increments by modifying the metal connector length
- Durability — The metal hardware is extremely durable, making Herbst appliances long-lasting
- Mouth movement — Allows unrestricted vertical and horizontal jaw movement during sleep
- Feel — The metal components are more noticeable than acrylic-only designs
- Best for — Patients needing significant advancement, those who move their jaw significantly during sleep, or those prioritizing durability
TAP (Thornton Adjustable Positioner)
The TAP device uses a hook-and-socket mechanism that allows patients to self-adjust their jaw advancement at home, which distinguishes it from most other designs that require an office visit for adjustment.
- Adjustability — Patient-controlled self-titration with a small adjustment key
- Convenience — Patients can increase or decrease advancement based on nightly comfort and effectiveness
- Design — Available in single-arch and dual-arch versions
- Clinical evidence — Well-studied with strong effectiveness data across multiple trials
- Best for — Patients who want active involvement in their treatment or who need frequent adjustments
Other Notable Devices
Beyond these three, other commonly prescribed appliances include the EMA (Elastic Mandibular Advancement), which uses elastic straps of varying tension, and the Narval CC, a digital-printed precision device known for exceptional fit. New device designs continue to emerge as the field advances.
How Your Specialist Chooses
Your dental sleep specialist considers your bite, tooth condition, existing dental work, jaw anatomy, degree of advancement needed, and whether you have bruxism when selecting a device. Many specialists have preferences based on their clinical experience with specific devices. Don't hesitate to ask why a particular device is being recommended for you.
Find a dental sleep medicine specialist experienced with multiple device types at SkipTheCPAP.com.