What is Herbst Sleep Appliance?

Herbst manufactures oral appliances intended to decrease snoring and other symptoms for people with obstructive sleep apnea (OSA). The appliances are custom-fitted mandibular advancement devices (MADs) that push the lower jaw forward and expand the breathing passages to promote stronger air circulation. 

Herbst anti-snoring appliances require a prescription and approval from a licensed dental provider. We’ll take a detailed look at how these devices work and where you can obtain one. 

Herbst Appliance in Orthodontics

Herbst manufactures a wide range of oral devices. In addition to anti-snoring mouthpieces, the company produces orthodontic appliances for treating conditions like jaw misalignment and TMJ. Traditionally, these appliances have been somewhat rigid and limiting for lateral and vertical mouth movements. Thanks to evolving technology, many Herbst appliances made today help align and stabilize the jaw while allowing more comfort and freedom of movement for speech and eating.  

Herbst Appliances for Snoring and Sleep Apnea

Herbst anti-snoring appliances are cleared by the Food and Drug Administration (FDA) for people with OSA, covered under Medicare and most insurance plans, and widely available through licensed dental providers. Most customized Herbst mouthpieces consist of top and bottom trays customized with dental impressions to fit your teeth like retainers. You can incrementally increase or decrease the advancement level by adjusting metal hinges or shims on the right and left sides of the device.

Using a Herbst Sleep Appliance

Herbst oral appliances are designed for people with OSA, a sleep disorder characterized by a physical blockage obstructing your airway. Heavy snoring is a chief symptom of OSA, and people with this condition may also choke or gasp for air in their sleep due to restricted airflow in their breathing passages. People with mild to moderate OSA symptoms, and those with severe symptoms who have not responded well to or cannot tolerate CPAP therapy, are strong candidates for Herbst devices. Talk to your dentist if you think a Herbst appliance might be right for you.

People with central sleep apnea, a condition caused by miscommunication between the brain and muscles that control breathing, should not use Herbst devices. The same is true for children and anyone with loose teeth or advanced gum disease.

How Does a Herbst Sleep Appliance Work?

As MADs, Herbst appliances physically advance your jaw forward to widen your airway. Snoring often occurs because the breathing passages are narrow, causing tissues to vibrate  as air passes through when a sleeper inhales and exhales. Your Herbst mouthpiece is customized using teeth impressions gathered by your dentist. Some devices feature metal shims and others have telescopic mechanisms, both of which can be adjusted by your dentist to change how far forward your jaw advances. 

Herbst appliances made with hard acrylic tend to be thicker and heavier but more durable. You can also opt for a soft material that feels gentler on the teeth as well as a thermal active material if you have dental characteristics that prevent the hard acrylic devices from fitting properly.

What Are the Pros and Cons?

As with any anti-snoring mouthpiece, there are pros and cons to using an Herbst appliance. Your dentist can help you decide if a Herbst device is right for you.

Pros
Cons
  • Each device is customized to fit your upper and lower teeth
  • Adjustable shims or telescopic mechanisms allow your dentist to change the advancement level
  • Herbst appliances are easy to clean
  • More expensive than over-the-counter MADs
  • Appliance may require an adjustment period before it feels comfortable
  • Device may cause jaw pain

Is It Comfortable?

You may need a few nights to acclimate to your Herbst appliance before it feels comfortable for sleep. This is especially true of devices made from hard acrylic, which feel heavier and more rigid than other models. If discomfort subsists, talk to your dentist about adjusting the appliance’s advancement level.

Are There Any Side Effects?

People wearing a Herbst appliance for the first time often report jaw pain, tenderness in the teeth and cheeks, excessive drooling, and soreness when chewing food. If you notice your teeth separating or jaw misalignment, consult your dentist immediately. 

What Herbst Sleep Appliances Are Available?

Herbst’s product line includes custom-fitted, anti-snoring MADs. These devices may carry different trade names, but they essentially belong to the same product line. Some Herbst mouthpieces can be adjusted by adding or removing metal shims from the hinge mechanisms that advance the jaw in 1-millimeter increments. Other models feature telescopic mechanisms adjusted in 0.25-millimeter increments. The latter may be more comfortable due to the more gradual adjustment. 

How Can You Get a Herbst Appliance for Sleep Apnea?

The process for obtaining a Herbst oral appliance usually begins with an OSA diagnosis. This may include an overnight sleep study. After being diagnosed, a dentist will take dental impressions of your upper and lower teeth. These impressions are used to create the custom-fitted mouthpiece. The turnaround time for completing the mouthpiece is about one week. Once the mouthpiece is ready, you’ll visit your dentist for a final fitting. You’ll also meet with them for subsequent follow-up appointments to ensure the device fits and works properly and to make any necessary adjustments to your appliance’s advancement level.

How Much Does a Herbst Sleep Appliance Cost?

The cost of a Herbst sleep appliance varies by model and provider, but the baseline price is about $300. This does not include the cost of your sleep study and other expenses related to receiving an OSA diagnosis. 

Herbst oral mouthpieces qualify for Medicare reimbursement. Additionally, most insurance providers cover at least some of the cost of your appliance.