Breathing and Airway

Sleep Apnea and Snoring

What a dentist can and cannot do

Updated September 12, 2026

If you are searching for a dentist about sleep apnea, you should know in the first paragraph what this office does and does not do, rather than after a phone call.

We do not diagnose sleep apnea, and we do not make the appliances. No mandibular advancement devices, no oral appliance therapy. Diagnosis needs a sleep study and that belongs with a physician.

What we do is the part a dentist is genuinely placed to do: look at the anatomy, find out whether your nose actually passes air, and treat the function. That last one is where most of our useful work happens, and it is the reason this page exists rather than a list of appliances we do not sell.

Why a dentist is looking at this at all

Because some of the things that contribute to a narrow airway are sitting in plain view at a dental exam, and because the teeth keep a record.

Worn teeth are the clearest example. A study sent thirty dental patients with tooth wear for proper sleep testing and found a mean apnea-hypopnea index of 32.4, which is the severe range. Only two of the thirty came back under five.

Duran-Cantolla J, Alkhraisat MH, Martinez-Null C, et al. Frequency of obstructive sleep apnea syndrome in dental patients with tooth wear. J Clin Sleep Med. 2015;11(4):445-450. Thirty patients, 77% male, mean age 58, recruited from a dental practice. A small and selected sample, so read it as a reason to ask the question rather than as a population rate.

That is not a diagnosis and we are not going to present it as one. It is a reason that, when we see a worn dentition or a mouth that is obviously dry every morning, we ask about your sleep instead of quietly making you an appliance. Why that matters before a night guard is its own page.

The diagnosis comes first, and then the anatomy means something

This is the ordering that gets reversed constantly, and reversing it is how people end up spending a year on the wrong thing.

There is a great deal of anatomy we can assess and it is genuinely worth assessing: a narrow or high palate, which is the floor of your nose as much as the roof of your mouth; how much room the tongue has and where it rests; tonsils; the shape and position of the jaws; whether the nose passes air on both sides.

But those findings are interpreted in the light of a diagnosis rather than in place of one. A narrow palate in somebody with a normal sleep study means something different from a narrow palate in somebody with an apnea-hypopnea index of 40. The same finding, two different conversations, and only one of them leads anywhere useful.

So the sequence we would argue for is: get the sleep study, then bring us the number. With a diagnosis in hand, an anatomical assessment becomes a real contribution to your care. Without one, it is an interesting observation about your mouth.

Where the anatomy turns out to be the main event, that is a referral rather than something we do here. We work closely with an orthodontist who performs palatal expansion and facilitates jaw advancement surgery, and we have written at length about where those genuinely fit and where the claims made for them outrun the evidence.

Myofunctional therapy: the part we actually do

This is the core of what we offer on the breathing side, and it is worth explaining properly because it is easy to dismiss as exercises.

Myofunctional therapy is physical therapy for the tongue, lips and swallow. No appliance, no surgery, nothing to wear. A set of exercises, done daily, that rebuild strength and change a resting position you may have held for decades. Dr. Lee-Mirzayan is certified in it and runs it here. The full description of the program is here.

The mechanism is not mysterious. The airway is a space, and how open it stays depends partly on the skeletal container around it and partly on the tone and position of the soft tissue inside it. Surgery and expansion work on the container. Myofunctional therapy works on the contents, and the contents are the half that most treatments leave untouched.

What the evidence actually shows

We are going to give you both of the recent reviews, including the fact that they disagree, because the disagreement is the useful part.

A 2024 systematic review and meta-analysis in the Laryngoscope pooled seven randomized trials and 310 patients and found statistically significant improvements in the apnea-hypopnea index of -10.2 events per hour, along with less daytime sleepiness, better sleep quality and better minimum oxygen saturation.

A 2025 systematic review and network meta-analysis pooled fifteen randomized trials and reached a more cautious answer. It confirmed the improvements in sleepiness, sleep quality, arousals and snoring intensity, but its pooled change in the apnea-hypopnea index was -8.73 events per hour with a confidence interval running from -21.19 to +3.74, which is not statistically significant.

Saba ES, Kim H, Huynh P, Jiang N. Orofacial myofunctional therapy for obstructive sleep apnea: a systematic review and meta-analysis. Laryngoscope. 2024;134(1):480-495. Xu Y, Yang R, Yu M, Gao X. Efficacy of myofunctional therapy for obstructive sleep apnea: a systematic review and network meta-analysis. J Evid Based Dent Pract. 2025;25(3):102137.

Notice that the two point estimates barely differ: -10.2 against -8.73. What differs is the precision. One analysis is confident the effect is real and the other cannot rule out zero. That is what a genuine but variable treatment looks like in the literature, and it is a long way from either the enthusiasm or the dismissal you will find elsewhere.

The 2025 review also offers the most practically useful finding of either: when daily training exceeded thirty minutes, the improvement in the apnea-hypopnea index did reach significance. Which is a plausible way to reconcile the two, and a clear statement about what this asks of you. This is not a treatment that works because you agreed to it. It works on the days you do it.

Two honest consequences. Roughly half of people respond strongly and the rest barely move, so nobody can tell you in advance which you will be, which is why we measure a lip seal time at the start and compare it later rather than asking how you feel it is going. And the benefit needs months of consistent daily practice, so the sessions are the start of the work rather than the whole of it.

If you are not going to get a sleep study

Some people will not, and we would rather talk to them honestly than lose them at the door.

The reasons are usually practical rather than stubborn. You do not want a diagnosis on your record. You have been through a study before and will not do it again. You tried CPAP and could not tolerate it. You cannot face the cost or the wait. Whatever the reason, telling you that we can do nothing until you comply is both untrue and a good way to make sure nothing improves.

So here is the honest version of what remains available to you.

  • Getting the nose working. Saline rinses, treating allergy properly rather than seasonally, and an ENT opinion when the obstruction looks structural. A nose that passes air is the precondition for everything else, and this is worth doing whether or not anybody ever measures your sleep.
  • Myofunctional therapy. The review above concluded it is a reasonable option for people who cannot tolerate CPAP or other established treatments, which is a large share of exactly this group. It is reversible, it involves no appliance and no surgery, and the worst case is that you have spent some months on daily exercises.
  • Releasing a genuine tether. No amount of therapy helps a tongue that physically cannot reach the palate. A release is sometimes the precondition rather than the treatment.
  • The unglamorous levers. Sleep timing, evening light exposure, late meals, weight where it is part of the picture, and not sleeping flat on your back. None of these require a diagnosis and all of them act on the same system.
  • Protecting the teeth from what is already happening. If your teeth are wearing, that damage is real regardless of what is causing it, and it can be managed on its own terms.

What none of that can do is tell you how bad it is. Everything on that list is reasonable, low risk, and blind. If you have severe apnea, these measures are not treating it, and the cardiovascular and metabolic consequences of severe untreated apnea are not things a tongue exercise reaches. We will say that plainly every time, and then we will still help with the parts we can help with.

And if the thing standing between you and a sleep study is the idea of the appointment rather than the test, that is a different problem with its own answer. We wrote about that too.

Mouth breathing is the part we can treat

For a fair number of people who arrive asking about snoring, the clearest finding is not apnea at all. It is that they have not breathed through their nose properly in years.

That matters on its own, separately from anything a sleep study would show. Air moving across the front teeth all night dries them at the one time salivary flow is already near zero, which is a direct route to decay and to gum inflammation that stops exactly where the airflow stops. The full account of what chronic mouth breathing does is here, including which of the effects are well established and which are not.

This is squarely a dental problem with a dental answer, and it is the part of the airway conversation where we are most confident we can help.

Who does what

ThisThem or us
Diagnosing sleep apnea, and grading how severe it isA physician, with a sleep study. Not us.
CPAP, and managing itA physician. Not us.
Mandibular advancement and other oral appliancesA dentist who provides them. Not this office.
Palatal expansion, jaw advancement surgeryAn orthodontist and a surgeon, and we refer and coordinate.
Assessing the anatomy and whether your nose passes airUs, and most usefully once you have a diagnosis.
Myofunctional therapyUs.
Tongue-tie release where it is limiting the tongueUs.
The dental damage from mouth breathing and grindingUs.

Where to start

If you snore, wake unrefreshed, wake with a dry mouth, or somebody has watched you stop breathing, the first call is to a physician about a sleep study. That is the step that makes everything after it more useful.

If you have a diagnosis already and want the anatomy and the function looked at, or you are not going to pursue a study and want to know what is genuinely available, that is a conversation worth having. Call 702-734-0776 or tell us what is going on.

Common Questions

Do you treat sleep apnea or make a sleep apnea appliance?

No. We do not diagnose sleep apnea and we do not make oral appliances for it, meaning no mandibular advancement devices and no oral appliance therapy. Diagnosis requires a sleep study and belongs with a physician. What we do is assess the anatomy, establish whether your nose actually passes air, run myofunctional therapy, release a tongue-tie where one is limiting the tongue, and treat the dental damage that mouth breathing and grinding cause. If an appliance is what you are looking for, you want a dentist who provides them, and it is better to know that now than after an appointment.

Then why would I see a dentist about my breathing at all?

Because some of what contributes to a narrow airway sits in plain view at a dental exam, and because the teeth keep a record. Worn teeth are the clearest example: a study that sent thirty dental patients with tooth wear for proper sleep testing found a mean apnea-hypopnea index of 32.4, the severe range, with only two of the thirty coming back under five. That was a small, selected sample and it is not a diagnosis. It is a good reason that when we see a worn dentition we ask about your sleep rather than quietly making you an appliance.

Should I get the sleep study before or after the dental assessment?

Before, and the ordering genuinely matters. There is a lot of anatomy we can assess and it is worth assessing, but those findings get interpreted in the light of a diagnosis rather than in place of one. A narrow palate in somebody with a normal sleep study means something entirely different from a narrow palate in somebody with an apnea-hypopnea index of 40. Same finding, two different conversations. Bring us the number and the assessment becomes a real contribution to your care.

Does myofunctional therapy work for sleep apnea?

It does something real, and we would rather give you the genuine picture than either the enthusiasm or the dismissal. Two recent reviews of randomized trials agree it improves daytime sleepiness, sleep quality and snoring. They disagree on the apnea index itself: a 2024 Laryngoscope meta-analysis of seven trials and 310 patients found a significant improvement of 10.2 events per hour, while a 2025 network meta-analysis of fifteen trials found 8.73 events per hour with a confidence interval from minus 21.19 to plus 3.74, which is not significant. The point estimates barely differ; the precision does. The 2025 review also found that when daily training exceeded thirty minutes the improvement did reach significance, which says something clear about what this asks of you.

What if I will not get a sleep study?

Then we would still rather talk to you than lose you at the door. Several things remain genuinely available: getting the nose working with saline rinses and proper allergy treatment, myofunctional therapy, releasing a tongue-tie if one is physically limiting the tongue, the unglamorous levers of sleep timing and evening light and not sleeping flat on your back, and protecting teeth from damage that is already happening. What none of that can do is tell you how bad it is. All of it is reasonable, low risk and blind, and if you have severe apnea these measures are not treating it. We will say that plainly and then still help with the parts we can.

I tried CPAP and could not tolerate it. Is there anything else?

Talk to your physician first, because CPAP intolerance often has a fixable cause such as the wrong mask, a pressure that needs adjusting, or a mouth leak drying you out overnight. Beyond that, the 2024 Laryngoscope review concluded that myofunctional therapy may be a reasonable alternative for patients who cannot tolerate CPAP or other more established treatments, and that is something we offer. A mandibular advancement appliance is the other common route for CPAP-intolerant patients, and that is not something we make, so we would point you to a dentist who does.

Could my snoring just be mouth breathing?

For a fair number of people who arrive asking about snoring, the clearest finding is not apnea at all but that they have not breathed through their nose properly in years. That matters on its own terms. Air moving across the front teeth all night dries them at the one time of day salivary flow is already near zero, which is a direct route to decay and to gum inflammation that stops exactly where the airflow stops. It is squarely a dental problem with a dental answer, and it is the part of this conversation where we are most confident we can help. It is also not a substitute for finding out whether you have apnea.

Do you do palatal expansion or jaw surgery for the airway?

We refer for both rather than performing them. We work closely with an orthodontist who does miniscrew-assisted palatal expansion and who facilitates maxillomandibular advancement surgery, and referring is a normal part of how we handle these cases. We would also want myofunctional therapy before and after, because expansion and advancement create space while the function determines whether you keep it. We have written separately about where those procedures genuinely fit and where the claims made for them run ahead of the evidence.

Want us to look at the breathing side?

Tell us what is going on and we will help you find the piece that is missing. No pressure, no obligation.