During sleep, the muscles in the throat and tongue relax. In people with obstructive sleep apnea, this relaxation allows the soft tissue at the back of the throat to collapse into the airway, partially or completely blocking airflow. When the airway is partially blocked, the tissue vibrates — that’s the sound of snoring. When the airway is completely blocked, breathing stops entirely. This is an apneic episode.
The brain, recognizing the oxygen deprivation, triggers a physiological alarm — a surge of adrenaline that wakes you just enough to gasp, reopen the airway, and resume breathing. You may not remember these awakenings, but they pull you out of deep, restorative sleep every time they occur. Patients with moderate to severe OSA can experience these episodes hundreds of times per night.
Obstructive sleep apnea isn’t just a sleep quality issue. The repeated oxygen deprivation has systemic cardiovascular consequences:
This is why snoring should never be dismissed as merely annoying. If you or your partner snores loudly and regularly, a sleep evaluation is warranted.
A sleep apnea oral appliance is a custom-fabricated device worn on both the upper and lower teeth during sleep. It works by advancing the lower jaw forward, which pulls the tongue and the soft tissue attached to the lower jaw away from the airway. By preventing this tissue from collapsing backward into the throat, the appliance keeps the airway open throughout the night.
The result: reduced or eliminated snoring, fewer apneic episodes, better oxygen levels, deeper sleep, and a partner who can finally sleep in the same room again.
Oral appliances are effective for mild to moderate obstructive sleep apnea. For more severe cases, surgery to reduce the soft tissue obstructing the airway may be needed. Dr. Kriston recommends a professional examination and diagnosis by sleep study before any appliance is fabricated — it’s important to know the severity of the condition before determining the right treatment.
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There is a direct relationship between the quality of a sleep apnea appliance and its cost. Appliances with greater adjustability, stronger materials, metal connectors, and more freedom of movement are more expensive to fabricate. But they also last longer, perform better, and — critically — can be fine-tuned to protect the TMJ while maximizing airway opening.
Dr. Kriston evaluates your specific situation — the severity of your sleep apnea, your bruxism history, any TMJ concerns, and your lifestyle demands — and recommends the appliance that balances clinical effectiveness, durability, and budget.
Online retailers sell sleep apnea appliances at lower prices, but without the clinical assessment that makes the device safe and effective. Using an online product carries real risks:
A custom appliance made by a dentist from a precise digital scan, calibrated to your specific jaw anatomy and adjusted over time based on your response, is a fundamentally different product from what you can buy online.
CPAP (Continuous Positive Airway Pressure) machines are the most commonly prescribed treatment for obstructive sleep apnea. They work — but many patients struggle to use them consistently. The compliance rate for CPAP is notoriously low, and the reasons are practical:
An oral appliance eliminates all of these issues. It’s silent, fits in a pocket for travel, requires only basic cleaning, preserves normal saliva flow, and doesn’t touch the face or nose. For patients with mild to moderate OSA, or for patients who have been prescribed a CPAP but can’t tolerate it, an oral appliance is a proven, comfortable alternative.
Dr. Kriston has fabricated sleep apnea devices pre-surgically for hospitals to help determine whether a patient’s obstructive sleep apnea can be resolved with an oral appliance rather than surgery. Surgery to reduce the soft tissue obstructing the airway carries its own risks, and if an oral appliance can achieve adequate airway improvement, the patient may be able to avoid a surgical procedure entirely.
This collaborative relationship between dental and medical teams reflects the reality that sleep apnea treatment is best approached as a multidisciplinary effort — with the sleep physician diagnosing and monitoring, the dentist fabricating and adjusting the appliance, and the surgeon involved only when necessary.
While an oral appliance provides direct mechanical relief by keeping the airway open, two lifestyle factors have the most significant impact on the severity of obstructive sleep apnea and snoring:
Weight. Excess weight, particularly around the neck and throat, increases the amount of soft tissue that can collapse into the airway. Weight loss — even a moderate amount — can meaningfully reduce the severity of sleep apnea and snoring. For some patients with mild OSA, weight loss alone resolves the problem.
Alcohol consumption. Alcohol relaxes the muscles of the throat and tongue more than normal sleep does, making airway collapse more likely and more severe. Reducing or eliminating alcohol, especially in the hours before bedtime, can significantly improve both snoring and apneic episodes.
Dr. Kriston has seen patients with more severe sleep apnea achieve significant improvement when an oral appliance is combined with weight loss and reduced alcohol intake. The appliance provides the immediate mechanical solution while the lifestyle changes address the underlying contributors. Together, these approaches can be very effective — sometimes reducing what was initially diagnosed as severe OSA to a manageable or even resolved condition.
Any appliance that advances the lower jaw forward has the potential to affect the temporomandibular joint. For patients with no TMJ history, this is rarely a concern. But for patients with a history of TMJ clicking, pain, limited opening, or disc displacement, the choice and adjustment of the sleep apnea appliance becomes critical.
Dr. Kriston selects appliances with the greatest adjustability for these patients, allowing him to advance the jaw incrementally — finding the position that opens the airway sufficiently while keeping the TMJ comfortable. This fine-tuning process may take several adjustment appointments, but it ensures the appliance helps the breathing without creating a jaw problem.
This is another reason why an online, one-size appliance is risky: there’s no clinical assessment of the TMJ, no adjustment capability, and no professional monitoring. A sleep apnea appliance should protect your airway and your jaw joint.
We recommend a professional sleep study (polysomnography) to diagnose the type and severity of your sleep apnea before any appliance is made. This may be arranged through your physician or a sleep medicine specialist.
Dr. Kriston evaluates your teeth, jaw, TMJ, bite, and oral health to determine which appliance design is best for your situation. A digital scan with our Medit i900 scanner captures a precise 3D model for fabrication.
The appliance is custom-made by the lab and delivered at a fitting appointment where Dr. Kriston adjusts the jaw advancement to the optimal starting position.
Over the following weeks, Dr. Kriston adjusts the appliance Follow-up and adjustment.incrementally based on your response — advancing the jaw further if snoring or apnea symptoms persist, or reducing advancement if TMJ discomfort occurs. The goal is maximum airway opening with maximum joint comfort.
A repeat sleep study may be recommended to confirm that the appliance is adequately reducing apneic episodes and improving oxygen levels during sleep.
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By far the best dentist I’ve had! Extremely thoughtful in his work, taking time to explain the reasoning behind decisions and will even show you the details of what is going on with your teeth through a micro camera. I had a few significant issues with my teeth, and Michael was the first of four dentists I had seen to provide a thoughtful long term solution in the least invasive way possible. He is truly concerned with the health and function of your teeth and gums, and is extremely skilled to implement great solutions. Would highly recommend.
I had my first visit with Dr. Kriston and had the best experience in a dental office, by far. I was looking for a dentist to revamp my smile and a friend recommended Dr. Kriston. Dr. Kriston spent a lot of time listening to my vision and together we came up with a plan for my smile that I'm very happy with. Everyone in the office was friendly, helpful and welcoming. My bar was set high and Dr. Kriston went well above it with his knowledge, recommendations and real understanding of my situation.
The office is beautiful, modern and spotless. They have relaxing music playing throughout that right away made me feel calm. The front receptionist is very attentive and supportive; she answered all my questions and clearly explained the cost and my insurance. I qualified for an interest free payment plan and was able to afford my dream smile.
I just had to write this review because I'm so happy I found Dr. Kriston. I've been self conscious about my teeth for years and I just couldn't find a dentist I felt this good about. I highly recommend Dr. Kriston.
Clean, professional, and easy to use. Velora gave my agency the polished online presence it needed."
Clean, professional, and easy to use. Velora gave my agency the polished online presence it needed."
Clean, professional, and easy to use. Velora gave my agency the polished online presence it needed."
Clean, professional, and easy to use. Velora gave my agency the polished online presence it needed."
By far the best dentist I’ve had! Extremely thoughtful in his work, taking time to explain the reasoning behind decisions and will even show you the details of what is going on with your teeth through a micro camera. I had a few significant issues with my teeth, and Michael was the first of four dentists I had seen to provide a thoughtful long term solution in the least invasive way possible. He is truly concerned with the health and function of your teeth and gums, and is extremely skilled to implement great solutions. Would highly recommend.
I had my first visit with Dr. Kriston and had the best experience in a dental office, by far. I was looking for a dentist to revamp my smile and a friend recommended Dr. Kriston. Dr. Kriston spent a lot of time listening to my vision and together we came up with a plan for my smile that I'm very happy with. Everyone in the office was friendly, helpful and welcoming. My bar was set high and Dr. Kriston went well above it with his knowledge, recommendations and real understanding of my situation.
The office is beautiful, modern and spotless. They have relaxing music playing throughout that right away made me feel calm. The front receptionist is very attentive and supportive; she answered all my questions and clearly explained the cost and my insurance. I qualified for an interest free payment plan and was able to afford my dream smile.
I just had to write this review because I'm so happy I found Dr. Kriston. I've been self conscious about my teeth for years and I just couldn't find a dentist I felt this good about. I highly recommend Dr. Kriston.
By far the best dentist I’ve had! Extremely thoughtful in his work, taking time to explain the reasoning behind decisions and will even show you the details of what is going on with your teeth through a micro camera. I had a few significant issues with my teeth, and Michael was the first of four dentists I had seen to provide a thoughtful long term solution in the least invasive way possible. He is truly concerned with the health and function of your teeth and gums, and is extremely skilled to implement great solutions. Would highly recommend.
I had my first visit with Dr. Kriston and had the best experience in a dental office, by far. I was looking for a dentist to revamp my smile and a friend recommended Dr. Kriston. Dr. Kriston spent a lot of time listening to my vision and together we came up with a plan for my smile that I'm very happy with. Everyone in the office was friendly, helpful and welcoming. My bar was set high and Dr. Kriston went well above it with his knowledge, recommendations and real understanding of my situation.
The office is beautiful, modern and spotless. They have relaxing music playing throughout that right away made me feel calm. The front receptionist is very attentive and supportive; she answered all my questions and clearly explained the cost and my insurance. I qualified for an interest free payment plan and was able to afford my dream smile.
I just had to write this review because I'm so happy I found Dr. Kriston. I've been self conscious about my teeth for years and I just couldn't find a dentist I felt this good about. I highly recommend Dr. Kriston.
By far the best dentist I’ve had! Extremely thoughtful in his work, taking time to explain the reasoning behind decisions and will even show you the details of what is going on with your teeth through a micro camera. I had a few significant issues with my teeth, and Michael was the first of four dentists I had seen to provide a thoughtful long term solution in the least invasive way possible. He is truly concerned with the health and function of your teeth and gums, and is extremely skilled to implement great solutions. Would highly recommend.
I had my first visit with Dr. Kriston and had the best experience in a dental office, by far. I was looking for a dentist to revamp my smile and a friend recommended Dr. Kriston. Dr. Kriston spent a lot of time listening to my vision and together we came up with a plan for my smile that I'm very happy with. Everyone in the office was friendly, helpful and welcoming. My bar was set high and Dr. Kriston went well above it with his knowledge, recommendations and real understanding of my situation.
The office is beautiful, modern and spotless. They have relaxing music playing throughout that right away made me feel calm. The front receptionist is very attentive and supportive; she answered all my questions and clearly explained the cost and my insurance. I qualified for an interest free payment plan and was able to afford my dream smile.
I just had to write this review because I'm so happy I found Dr. Kriston. I've been self conscious about my teeth for years and I just couldn't find a dentist I felt this good about. I highly recommend Dr. Kriston.
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