Dental Sleep Medicine

Dr. Kary is a Qualified Dentist of the American Academy of Dental Sleep Medicine.

Oral appliance therapy is a clinically validated treatment for obstructive sleep apnea (OSA). A custom appliance worn at night repositions the lower jaw to keep the airway open during sleep. For patients who qualify, this means sleeping without a machine, hose, or mask. For some patients, oral appliance therapy works alongside CPAP (combination therapy) to improve results beyond what either approach achieves alone.

Obstructive sleep apnea is a medical condition. Treatment begins with a confirmed diagnosis, and polysomnography (PSG) remains the gold standard for that diagnosis. If you already have a sleep study on file, bring it. If you have not been tested, we will coordinate with a sleep physician to get the appropriate diagnostic workup completed before starting any treatment. Your physician stays involved throughout, and we send treatment summaries and follow-up results back to them.

We handle medical insurance billing and prior authorizations for oral appliance therapy.

What this includes:

Custom oral appliance therapy (mandibular advancement devices) for obstructive sleep apnea
Combination therapy (oral appliance + CPAP)
Appliance titration and follow-up to optimize jaw position
Coordination with sleep physicians for diagnosis and ongoing care
Outcome documentation with follow-up sleep testing
Medical insurance billing and prior authorization

Frequently Asked Questions

Can a dentist help with sleep apnea?

Yes. Dr. Kary is a Qualified Dentist of the American Academy of Dental Sleep Medicine (AADSM). For patients with obstructive sleep apnea, a custom oral appliance worn at night repositions the lower jaw to keep the airway open during sleep. This is a validated alternative for patients who cannot tolerate CPAP.

Do I need a diagnosis before getting an oral appliance?

Yes. Oral appliance therapy requires a confirmed diagnosis of obstructive sleep apnea. Polysomnography (a sleep study) is the gold standard. If you already have a diagnosis, bring your records. If you do not, we coordinate with your physician or help you find one.

Will my doctor still be involved in my care?

Yes. If you are referred by a physician, you return to that physician for ongoing sleep management. We handle the appliance: fabrication, titration, follow-up, and outcome documentation. We send treatment summaries and follow-up results back to your referring provider.

What about combination therapy?

Some patients benefit from using an oral appliance alongside CPAP. This can allow a lower CPAP pressure setting, improving comfort and compliance. We manage the oral appliance side and coordinate with your sleep physician.

Does medical insurance cover oral appliance therapy?

In many cases, yes. Oral appliance therapy for obstructive sleep apnea is a medical benefit, not dental. We handle medical billing, prior authorizations, and claims.

How does an oral appliance work?

It holds the lower jaw slightly forward during sleep, which brings the tongue and soft tissues with it and keeps the airway from collapsing. It is custom-made to your teeth from a digital scan. No machine, no hose, no mask, and nothing to plug in.

Is an oral appliance comfortable to wear?

Most patients adapt within a couple of weeks. Early on you may notice increased salivation, mild jaw soreness on waking, or tooth tenderness, all of which typically settle. Because the appliance is adjusted gradually rather than set to a final position immediately, discomfort can be managed as you go.

What is titration?

Titration is the process of advancing the jaw position in small increments until symptoms improve without creating jaw discomfort. It happens over several follow-up visits rather than at delivery. This is the part that determines whether the appliance actually works, which is why the follow-up appointments matter.

Will I need another sleep study after treatment?

Usually, yes. Follow-up sleep testing with the appliance in place confirms the treatment is doing what it is supposed to do, rather than just making you feel better. Results are documented and sent to your physician, and many insurers require this confirmation as well.

What if I snore but have not been diagnosed with sleep apnea?

Snoring can be simple snoring or it can be a symptom of obstructive sleep apnea, and the two cannot be distinguished by how it sounds. Because sleep apnea carries cardiovascular and metabolic risk, treatment starts with testing rather than with an appliance. We will help arrange the diagnostic workup.

Schedule an Appointment

You can also call or text (301) 301-3148 to schedule.
New patients: please allow 60 to 90 minutes for your first visit.

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