Custom oral appliances fitted by Dr. Nelly Silva, a Diplomate in Dental Sleep Medicine who checks for signs of sleep apnea before recommending one.
Snoring is the sound of air squeezing past relaxed tissue in the throat while you sleep.
As the jaw drops back during sleep, the tongue and soft palate narrow the airway. Air forced through that smaller space makes the tissue vibrate, and the vibration is the noise a partner hears. Alcohol, nasal congestion, sleeping on your back and extra weight around the neck tend to make it louder.
Our main treatment is a custom oral appliance: two thin trays worn over the upper and lower teeth at night. It holds the lower jaw slightly forward so the tongue stays clear of the airway. Each appliance is made from a digital scan of your teeth and adjusted in small steps until we find the position that works for you.
Loud snoring can be harmless noise or the most obvious sign of obstructive sleep apnea. The right plan depends on which one you have.
Dr. Silva looks for these signs at your visit. Sleep apnea is diagnosed with a sleep test read by a sleep physician, and a custom oral appliance is a treatment option for many patients with it as well.
Dental sleep medicine is part of Dr. Silva's training, not a side service.
She completed a TMD residency with the American Academy of Craniofacial Pain. That matters in snoring care, because an oral appliance works by repositioning the jaw. She asks patients to call her Nelly.
Dr. Silva wrote Breathe Right: The Link Between Nutrition, Airway and Getting a Good Night's Sleep, which covers the same connections between airway, jaw and sleep that guide her treatment plans.
We ask about your snoring, sleep and daytime energy, then examine your teeth, jaw joints, tongue and airway.
If the signs point to sleep apnea, a sleep test comes first, often done at home, so a sleep physician can confirm the diagnosis.
An iTero Element scan records both arches without putty. The lab builds your appliance from that model, and we fit it in the office.
Over the following weeks we advance the appliance in small steps, checking your bite, your jaw comfort and how you are sleeping.
Both keep the airway open during sleep. They do it in very different ways.
| What matters | CPAP machine | Custom oral appliance |
|---|---|---|
| How it works | Pressurized air through a mask holds the airway open | Holds the lower jaw forward so the tongue stays clear |
| What you wear | A mask over the nose or mouth, a hose and a bedside unit | Two thin trays over your teeth |
| Travel | Machine, tubing and power needed | Fits in a small case |
| Snoring alone | Not usually prescribed for snoring without sleep apnea | A common first treatment |
| Sleep apnea | The standard first option, especially when severe | An option for mild to moderate cases, or when CPAP is not tolerated |
| Who provides it | Prescribed by a physician | Made and fitted by a dentist trained in dental sleep medicine |
Snoring rarely comes alone. These are the related treatments Dr. Silva provides in our Collegeville office.
When a sleep test confirms obstructive sleep apnea, a custom oral appliance can be part of the plan.
Sleep medicine 02Night clenching, grinding and jaw pain often show up alongside disrupted sleep.
TMJ care 03Snoring solutions are also part of our laser services. Ask whether one suits your case.
Laser options 04The digital scan your appliance is built from, with no impression putty.
How it works★★★★"Dr. Silva is incredibly knowledgeable and takes the time to explain procedures, treatment options, and overall dental health in a way that's easy to understand."
Lanae Horsey, Google Review
★★★★★"I also appreciated that my out-of-pocket costs for additional treatment were explained upfront with no surprises."
Jessica Bradley-Morton, Google Review
Cost depends on the appliance design and whether a sleep test and follow-up visits are part of your plan.
We go over your costs and coverage before treatment begins, so you know what to expect.
Snoring can be a sign of sleep apnea, but it is not always. Snoring with pauses in breathing, gasping, morning headaches or daytime sleepiness points toward sleep apnea, and a sleep test is the way to know. Steady snoring in someone who wakes rested is more often simple snoring.
Yes. Dentists trained in dental sleep medicine make and fit custom oral appliances that hold the lower jaw forward during sleep. Dr. Silva is a Diplomate in Dental Sleep Medicine. When sleep apnea is suspected, the diagnosis comes from a sleep test read by a sleep physician, and she plans the appliance around that result.
It is a scoring rule used when sleep tests are read. A shallow-breathing event counts as a hypopnea only when blood oxygen drops by at least 4 percent. Which rule a test uses can change the count of breathing events, and with it how severe the sleep apnea is rated.
For many people, losing weight reduces snoring and can lower the number of breathing events at night, because less tissue presses on the airway. It does not resolve snoring for everyone, since jaw position and airway shape also play a part. An oral appliance can help while other changes are underway.
Many people with treated sleep apnea sleep well and feel normal during the day. Treatment such as CPAP or an oral appliance only works on the nights it is used, so a device that is comfortable enough to wear every night matters. Untreated, sleep apnea tends to leave people tired and is linked with other health problems.
Most patients adjust over the first few weeks. The appliance is moved forward in small steps rather than all at once, which gives the jaw time to settle. We check your comfort and bite at follow-up visits and fine-tune the fit.
Snoring solutions are also part of our laser services. Whether a laser approach or an oral appliance suits you depends on what is causing your snoring and whether sleep apnea is involved. Dr. Silva will go over the options at your visit.
We accept all PPO dental insurance plans, though coverage for a snoring appliance depends on your plan. We go over your costs before treatment begins. For patients without insurance, we offer payment plans and a dental savings plan.
Dr. Silva will explain what is behind your snoring and which option fits, before anything is made.
