If you’re looking for a dentist about sleep apnea, you should know right away what we do and don’t do, before you spend a phone call finding out.
We don’t diagnose sleep apnea, and we don’t make sleep apnea appliances. No mandibular advancement devices, and no oral appliance therapy. Diagnosing it takes a sleep study, and that’s a physician’s job.
What we do is the part a dentist is in a good position to do. We look at your anatomy, check whether your nose actually moves air, and work on how your tongue, lips and breathing function. That last part is where most of our useful work happens, and it’s the reason this page exists at all.
Why a dentist is looking at this at all
Some of the things that narrow an airway are sitting right there during a dental exam. And your teeth keep a record.
Worn teeth are the clearest example. One study sent thirty dental patients with tooth wear for a proper sleep study. Their average apnea-hypopnea index was 32.4, which is in 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. It’s a small, selected group, so read it as a reason to ask the question, not as a rate for the general population.
That isn’t a diagnosis, and we won’t treat it like one. But it’s why, when we see worn teeth or a mouth that’s dry every morning, we ask how you’re sleeping instead of just making you an appliance. Why that matters before a night guard has its own page.
Get the diagnosis first. Then the anatomy means something.
This order gets flipped all the time, and flipping it is how people spend a year on the wrong thing.
There’s a lot of anatomy we can look at, and we do look at it: a narrow or high palate (which is the floor of your nose as much as the roof of your mouth), how much room your tongue has and where it rests, your tonsils, the shape and position of your jaws, and whether air moves through both sides of your nose.
But those findings only make sense next to a diagnosis. They can’t stand in for one. A narrow palate in someone with a normal sleep study means something different from a narrow palate in someone with an apnea-hypopnea index of 40. It’s the same finding and two very different conversations, and only one of them goes anywhere useful.
So here’s the order we’d suggest: get the sleep study, then bring us the number. With a diagnosis in hand, looking at your anatomy adds something real to your care. Without one, it’s just an interesting observation about your mouth.
When the anatomy turns out to be the main problem, we refer. We work closely with an orthodontist who does palatal expansion and helps coordinate jaw advancement surgery, and we’ve written in detail about where those procedures fit and where the claims made for them get ahead of the evidence.
Myofunctional therapy: the part we actually do
This is the heart of what we offer on the breathing side. It’s easy to write off as just exercises, so it needs some explaining.
Myofunctional therapy is physical therapy for your tongue, lips and swallow. There’s no appliance, no surgery, and nothing to wear. It’s a set of daily exercises that build strength and retrain a resting position you may have had for decades. Dr. Lee-Mirzayan, a dentist and certified myofunctional therapist, runs it here. The full program is described here.
How it works isn’t mysterious. Your airway is a space. How open it stays depends partly on the bony frame around it and partly on the tone and position of the soft tissue inside it. Surgery and expansion change the frame. Myofunctional therapy works on what’s inside, which is the half most treatments leave alone.
What the research shows
We’ll give you both of the recent reviews, including the fact that they don’t fully agree, because that disagreement tells you something.
A 2024 systematic review and meta-analysis in the Laryngoscope pooled seven randomized trials and 310 patients. It found a statistically significant improvement in the apnea-hypopnea index of -10.2 events per hour, plus less daytime sleepiness, better sleep quality and better minimum oxygen saturation.
A 2025 systematic review and network meta-analysis pooled fifteen randomized trials and came out more cautious. It also found 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 from -21.19 to +3.74, which isn’t 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.
Look at the two main numbers: -10.2 and -8.73. They’re close. What’s different is how precise they are. One review is confident the effect is real, and the other can’t rule out zero. That’s what a real but variable treatment tends to look like in the research, and it’s a long way from both the hype and the dismissal you’ll find elsewhere.
The 2025 review also had the most practical finding of either: when people trained for more than thirty minutes a day, the improvement in the apnea-hypopnea index did reach significance. That may be why the two reviews differ, and it’s a clear message about what this asks of you. It doesn’t work because you signed up. It works on the days you do it.
Two more things to know. Roughly half of people respond strongly and the rest barely change, and nobody can tell you ahead of time which you’ll be. That’s why we measure how long you can hold a lip seal at the start and compare it later, instead of asking how you think it’s going. And it takes months of daily practice, so the sessions are the start of the work, not all of it.
If you’re not going to get a sleep study
Some people won’t, and we’d rather have that conversation than lose them at the door.
Usually the reasons are practical. You don’t want a diagnosis on your record. You’ve done a study before and won’t do another. You tried CPAP and couldn’t tolerate it. The cost or the wait is too much. Whatever the reason, telling you we can’t do anything until you get one isn’t true, and it’s a good way to make sure nothing gets better.
So here’s what’s still on the table.
- Getting your nose working. Saline rinses, treating allergies properly instead of just in season, and seeing an ENT when the blockage looks structural. A nose that moves air comes before everything else, and it helps whether or not anyone ever measures your sleep.
- Myofunctional therapy. The 2024 Laryngoscope review concluded it’s a reasonable option for people who can’t tolerate CPAP or other standard treatments, and that describes a lot of the people in this group. It’s reversible, with no appliance and no surgery. The worst case is that you’ve spent a few months doing daily exercises.
- Releasing a real tongue tie. No amount of therapy helps a tongue that physically can’t reach the roof of the mouth. Sometimes a release is what makes the therapy possible.
- The everyday stuff. When you go to bed, bright light in the evening, eating late, weight if it’s part of the picture, and not sleeping flat on your back. None of these need a diagnosis, and they all affect the same system.
- Protecting your teeth from damage that’s already happening. If your teeth are wearing down, that damage is real no matter what’s causing it, and we can manage it on its own.
What none of that can do is tell you how bad it is. Everything on that list is reasonable and low risk, but it’s done blind. If you have severe apnea, these steps aren’t treating it, and they won’t reach the heart and metabolic effects of severe untreated apnea. We’ll tell you that every time, and then we’ll still help with the parts we can.
And if what’s really keeping you from a sleep study is the idea of the appointment, not the test itself, that’s a different problem. We’ve written about that too.
Mouth breathing is the part we can treat
For a lot of people who come in asking about snoring, the clearest finding isn’t apnea. It’s that they haven’t breathed properly through their nose in years.
That matters on its own, apart from anything a sleep study would show. Air moving across your front teeth all night dries them out at the one time your saliva is already close to zero. That leads straight to decay, and to gum inflammation that stops right where the airflow stops. Our full article on chronic mouth breathing covers which effects are well established and which aren’t.
This is a dental problem with a dental answer, and it’s where we’re most confident we can help.
Who does what
| This | Who does it |
|---|---|
| Diagnosing sleep apnea, and how severe it is | A physician, with a sleep study. Not us. |
| CPAP, and managing it | A physician. Not us. |
| Mandibular advancement and other oral appliances | A dentist who makes them. Not this office. |
| Palatal expansion and jaw advancement surgery | An orthodontist and a surgeon. We refer and coordinate. |
| Looking at your anatomy and whether your nose moves air | Us, and it’s most useful once you have a diagnosis. |
| Myofunctional therapy | Us. |
| Tongue-tie release when it’s limiting the tongue | Us. Dr. Lee-Mirzayan does these. |
| Dental damage from mouth breathing and grinding | Us. |
Where to start
If you snore, wake up tired, wake up with a dry mouth, or someone has seen you stop breathing, your first call should be to a physician about a sleep study. That step makes everything after it more useful.
If you already have a diagnosis and want your anatomy and function looked at, or you’re not going to get a study and want to know what’s still available, we’re happy to talk it through. Call 702-734-0776 or tell us what’s going on.