Clinical Guidance on how to wear your dental oral appliance on long flights

Wearing your oral appliance on a long flight is effective in reducing snoring and sleep apnea. By physically positioning the lower jaw forward, the device can prevent gravitational jaw collapse. This keeps the airway open in a seated position that ensures a quiet, restful sleep without the hassle of a CPAP machine. Our team at Enamel Dentistry South Lamar discusses ways to prevent snoring while flying at 30,000 feet.

Wearing oral appliances for long flights

When sleeping in a bed, gravity pulls the tissues down. However, when you are seated upright on an airplane, gravity will pull the jaw down and back toward your throat. This is known as gravitational jaw collapse. Because the airway is already narrowed by the change in air pressure and dry cabin conditions, this collapse will cause snoring or obstructive events. Custom-fit oral appliances act as a precise stop for the mandible. By maintaining a slight forward protrusion, the device ensures that even in a vertical position, your airway remains open, allowing for deep REM sleep despite the cramped area.

The logistics of a CPAP machine are a travel issue. When comparing the two for longer duration flights, the oral appliance is better in three ways. 

  1. Power independence: Airplane outlets are unreliable. An oral appliance requires no electricity, ensuring that treatment does not stop over the Pacific. 
  2. Silent operations: Medical literature supports that CPAP machines’ maximum noise levels can potentially cause patient discomfort (Cavaliere et al., 2008). CPAP machines produce a rhythmic him and hiss of air that can be disruptive in a quiet cabin. Oral appliances are completely silent. 
  3. Space efficiency: In the battle for carry-on space, a device that fits in a pocket is better than a machine that requires a carry case.

Feature 

MAD 

CPAP

Portability 

Travel size 

Requires a dedicated carry-on 

Power 

None 

Requires a battery pack or outlet 

Discretion

Silent 

Audible hum 

Upright efficiency 

High 

Moderate 

Maintenance 

Simple rinse 

Needs distilled water

To get the most out of sleep apnea treatment while flying, follow this protocol: 

  1. Hydration: Clinical research indicates that airplane air has roughly 10-15% humidity (Bagshaw et al., 2019).  Drink a bottle of water before boarding to prevent the appliance from feeling stuck against your cheeks. 
  2. Lights out: You do not need to wear your device during meal service. Wait until the cabin crew dims the lights. Since the device is low-profile, you can use it discreetly without a mirror. 
  3. Incline adjustment: If you are in a standard economy seat, use a neck pillow in reverse to keep the head from tilting forward. This can work together with your appliance to keep the airway open.

Airplane bathrooms are not ideal for dental care, but maintaining your appliance is a necessity. 

  1. Avoid tap water: Because airplane bathroom water is stored in tanks and could contain bacteria, we advise you to never rinse your device using the airplane’s bathroom water.
  2. Container: When waking up for breakfast, immediately place the device back into the protective case. Never wrap your MAD with a napkin. 
  3. Deep Clean: Once you reach your destination, give the device a thorough soak using a cleaning tablet to remove the biofilm that accumulated during the long flight.

Insurance navigation: We assist patients in determining if medical insurance will cover durable medical equipment, which often includes oral appliances. 

Financing: We offer options like cherry and SunBit to afford the best technology for sleep apnea without the stress of cost. 

Custom-fitting: Unlike kits that are found online, MAD is a digitally scanned 1:1 fit, ensuring that they will not fall out while sleeping on an airplane. Clinical research supports that custom-made mandibular repositioning devices effectively increase patient compliance and tolerance in the treatment of sleep apnea [3] (Johal et al., 2017).

1.Can a sleep apnea device be worn if sleeping upright? 

Yes. Custom appliances are designed to lock the jaw in a stable position. This makes them more effective than CPAP, which cannot lie flat.

2. Will TSA need to inspect my sleep apnea device?

No. Oral appliances are considered dental retainers. They do not contain metal that will set off scanners. They also do not need to be removed from your bag.

3. What if my oral appliance feels too tight while on a plane?

High altitude can cause slight swelling. If your device feels too tight, ensure that you are hydrated. If discomfort persists, remove the device for an hour and re-insert once you have consumed more water.

Dr. Devish Patel, DDS, provides comprehensive general and cosmetic dentistry at Enamel Dentistry in Austin, TX. With a focus on modern clinical care, he specializes in aesthetic treatments, alongside preventative and restorative maintenance. Dr. Patel is committed to delivering safe, evidence-based solutions that keep patients comfortable and informed at every step.

[1] Cavaliere F, Conti G, Costa R, et al. Exposure to noise during continuous positive airway pressure: influence of interfaces and delivery systems. Acta Anaesthesiol Scand. 2008;52(1):52-56. doi:10.1111/j.1399-6576.2007.01474.x

[2] Bagshaw M, Illig P. The Aircraft Cabin Environment. Travel Medicine. 2019;429-436. doi:10.1016/B978-0-323-54696-6.00047-1

[3] Johal A, Haria P, Manek S, Joury E, Riha R. Ready-Made Versus Custom-Made Mandibular Repositioning Devices in Sleep Apnea: A Randomized Clinical Trial. J Clin Sleep Med. 2017;13(2):175-182. Published 2017 Feb 15. doi:10.5664/jcsm.6440 

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