Oral Appliance Therapy
in St. Louis MO

At Gateway Center for Sleep Apnea & TMJ Therapy, Dr. Kevin F. Postol provides patients in the greater St. Louis area with advanced, non-invasive solutions for sleep-related breathing disorders. One of the most effective treatments available is oral appliance therapy, a comfortable and scientifically proven option for patients who snore or suffer from obstructive sleep apnea (OSA).

Many patients come to our office after struggling with traditional CPAP machines. While CPAP can be effective, it is not always easy to tolerate. Oral appliances provide a more user-friendly option that is custom-made to fit comfortably in the mouth, making it easier for patients to remain consistent with treatment. For patients in St. Louis who want better sleep without bulky equipment, oral appliance therapy may be the ideal choice.

What is Oral Appliance Therapy?

Oral appliance therapy uses a custom-made device that resembles a sports mouthguard or orthodontic retainer. While small and discreet, the device has a powerful impact. By gently repositioning the lower jaw forward, the appliance helps keep the airway open throughout the night. This forward positioning prevents the tongue and soft tissues in the throat from collapsing into the airway, which is a primary cause of snoring and obstructive sleep apnea.

These appliances are not generic devices that you can buy over the counter. Instead, they are carefully designed and fabricated by dentists with advanced training in dental sleep medicine. Each appliance is unique to the patient, created using impressions, bite registrations, and a detailed analysis of the patient’s oral structure and sleep health.

Why Choose Oral Appliance Therapy in St. Louis?

Patients across St. Louis are increasingly turning to oral appliances because of their convenience, comfort, and effectiveness. Consider the following benefits:

• Proven effectiveness: Studies show that oral appliances reduce snoring in up to 90 percent of cases and successfully treat mild to moderate sleep apnea in 60 to 75 percent of patients. Even for severe sleep apnea, oral appliance therapy provides relief in nearly half of cases.
• Greater compliance compared to CPAP: While many patients struggle to use CPAP machines regularly, oral appliances are lightweight, discreet, and simple to use. Because of this, patient compliance rates are significantly higher.
• Travel-friendly: Oral appliances are small enough to fit in a pocket or purse, making them easy to take on business trips or vacations. This eliminates the hassle of traveling with bulky CPAP equipment.
• Non-invasive: No surgery is required. For patients who cannot tolerate CPAP or who want to avoid surgical procedures, oral appliance therapy offers an effective and low-risk alternative.
• Endorsed by experts: The American Academy of Sleep Medicine (AASM) recognizes oral appliance therapy as a first-line treatment for primary snoring and mild OSA, as well as a reliable alternative for patients with moderate to severe OSA who cannot tolerate CPAP.

Customized Oral Appliances Offered in Our St. Louis Office

Every patient has a unique anatomy and set of needs, which is why one type of appliance is not suitable for everyone. At Gateway Center for Sleep Apnea & TMJ Therapy, Dr. Kevin F. Postol uses his advanced training in dental sleep medicine to carefully select the appliance that best suits each patient. During your consultation, he will evaluate your bite, jaw size, tongue and soft palate, level of teeth grinding or clenching, and the severity of your sleep apnea. Based on these factors, he will recommend the most appropriate device from our collection of proven options.

We proudly offer four advanced oral appliances: EMA, Dorsal Appliance, TAP 3, and Herbst Appliance. Each has its own unique design, advantages, and best-use cases.

EMA (Elastic Mandibular Advancement)

The EMA is a lightweight and less bulky appliance that appeals to patients who may feel hesitant about wearing something in their mouth during sleep. Unlike one-piece devices, the EMA is designed as two separate trays for the upper and lower teeth, connected by elastic straps on the sides. These straps come in multiple lengths and levels of flexibility, allowing Dr. Postol to adjust the jaw position gradually over time.

Who benefits most from the EMA?

• Patients with smaller mouths who want a less intrusive device
• Those who prefer a more comfortable, thinner plastic design
• Patients with mild to moderate sleep apnea or chronic snoring

While the EMA offers excellent comfort and is a great starter option for many patients, it is not as durable as some of the other appliances. Patients who grind their teeth heavily may benefit from a stronger design.

Dorsal Appliance

The Dorsal Appliance is another two-piece design, but unlike the EMA, it does not use straps to connect the upper and lower trays. Instead, it allows for more freedom of jaw movement, making it popular among patients who want a greater sense of flexibility while they sleep. Adjustments are made with a small key-and-screw mechanism on the side of the upper piece, giving Dr. Postol precise control over the advancement of the lower jaw.

What sets the dorsal appliance apart is its durability. The appliance features “wings” on the lower arch that rest against ridges on the upper arch, holding the jaw forward securely throughout the night. This design is especially beneficial for patients who clench or grind their teeth, since it is strong enough to withstand nighttime forces.

Who benefits most from the Dorsal Appliance?

• Patients with moderate sleep apnea
• Those who grind or clench their teeth during sleep
• Patients who want a durable, long-lasting device
• Individuals looking for both comfort and strong effectiveness

TAP 3 (Thornton Adjustable Positioner)

The TAP 3 is one of the most trusted oral appliances available for sleep apnea treatment, and it is often chosen for patients with a wide range of needs, from mild snoring to severe sleep apnea. The device connects the upper and lower trays using a hook-and-socket mechanism located at the front of the appliance.

One of the most significant advantages of the TAP 3 is its adjustability. Patients can use a small, detachable key to make minor adjustments themselves, gradually advancing the jaw into the correct position. This patient-controlled feature makes the appliance easy to adapt to, as it allows for a step-by-step approach instead of sudden repositioning.

With its simple design and high success rate, the TAP 3 has become one of the most popular oral appliances in the United States. In fact, studies show it has a 95 percent compliance rate among patients.

Who benefits most from the TAP 3?

• Patients with mild, moderate, or even severe OSA
• Individuals who want more control over their treatment
• Patients seeking a proven and highly reliable appliance
• Those who want an unobtrusive option that still allows full mouth closure

Herbst Appliance

The Herbst appliance is a highly durable oral device that uses small metal rods and hinges to connect the upper and lower trays. These components hold the lower jaw slightly forward, which prevents airway collapse while still allowing patients to open and close their mouth naturally for speaking or chewing.

The Herbst appliance is highly adjustable, allowing for gradual, precise changes in jaw position over time. This makes it a strong option for patients who need a more advanced solution or who have more complex cases of sleep apnea. Its sturdy construction ensures long-lasting effectiveness even for patients who grind their teeth.

Who benefits most from the Herbst Appliance?

• Patients with moderate obstructive sleep apnea
• Individuals who need a highly adjustable device for gradual jaw advancement
• Patients who grind their teeth or place significant stress on oral appliances
• Those seeking a long-term, durable solution

Choosing the Right Appliance for You

At Gateway Center for Sleep Apnea & TMJ Therapy, we never take a one-size-fits-all approach. Instead, Dr. Postol considers each patient’s oral anatomy, sleep study results, and personal preferences before recommending an appliance. The goal is always to maximize effectiveness, ensure long-term comfort, and improve quality of sleep.

By offering four unique oral appliance options, we give our patients the flexibility to find the treatment that best fits their lifestyle and medical needs. Many of our patients in St. Louis have tried CPAP therapy without success and find that oral appliance therapy finally provides the comfort and results they have been searching for.