For patients who snore or suffer from sleep apnea, available treatment options are not limited to nighttime airway pressure (CPAP) machines or surgery. At Winchester Dental, we offer Day and Night Appliances to deliver gentle, comfortable treatment and permanent breathing improvement. These appliances work gradually to adjust cranial and facial structures and open the airway, and patients love the results!

What is a Day and Night Appliance, and how does it work?

A Day and Night Appliance—also known in dentistry as a DNA—is a mandibular advancement device used to treat snoring or sleep apnea by helping to enlarge a patient’s airway. Over time, the appliance gradually increases the size of the nasal cavity by expanding the upper arch in three dimensions. As this expansion occurs, the lower jaw moves forward to a more natural position, as do the tongue and soft tissues, opening airway space and increasing the airway’s size. This typically results in a significant improvement in a patient’s ability to breathe easily.

There are over 100 types of devices available. Most of them consist of an upper and lower appliance with a connector between the two to move the jaw forward. Moving the lower jaw forward brings the tongue with it, thus opening the airway. What differentiates the DNA are its little springs and screws that allow patients to make permanent changes—the widening of the upper arch that makes way for the lower jaw to come forward. These types of changes are permanent.

How many hours do patients wear the DNA each day? Do they need to wear it for the rest of their lives?

Depending on the case, patients wear the DNA from 8 to 16 hours each day. A patient might begin wearing it in the evening after arriving home, and then wear it overnight. Wearing it more hours allows treatment to progress faster, and for most patients, the treatment timeframe is 12-18 months. After patients have reached the results they want, they usually don’t need another appliance. With other devices used to treat sleep disorders—mandibular advancement devices (MADs), which advance the lower jaw but do not make permanent changes—patients usually need to wear them or something similar for the rest of their lives.

So the difference is that the MAD holds patients’ mouths in the right position while they sleep, and a DNA corrects the problem at its source?

That’s right. Widening the upper jaw lowers the floor of the nose, and this is what allows the airway to enlarge, and this is a permanent structural change. Ideally, our noses should be our primary means of breathing; our mouths are backup breathing organs.

What is the difference in the design of the MAD and the DNA?

The MAD consists of an upper mouth guard and a lower mouth guard, made of acrylic. It’s something like a retainer with a connector between the two parts to help the lower jaw move forward. Meanwhile, the DNA has axial springs and screws. Patients turn these midline screws themselves—every turn widens the jaw by a quarter of a millimeter. As this widening occurs, the soft palate lifts and opens the back of the airway, which improves breathing ability through the nose and the back of the mouth.

How frequently do patients turn the screws?

Patients usually turn the screws once a week, and we follow up with them and take measurements every month.

Are there other benefits to using the DNA?

There are certainly other benefits. With improved breathing ability comes improved sleep, which leads to more energy and improved ability to focus. The widening of the arch creates more room in the mouth for the tongue, and frequently patients notice cosmetic changes such as straighter teeth and enhanced cheekbones.

Is the DNA treatment painless?

Yes, it is painless.

Is this treatment available to patients of all ages?

Yes, the DNA is designed for children and adults; patients as young as age five have been successfully treated.

We thank Victor D. Woodlief, DMD for kindly sharing this information.