Sleep medicine is evolving rapidly — and so is dental sleep medicine.
Over the past few years, patients have increasingly asked about “new” or “trending” treatments for snoring and obstructive sleep apnea (OSA):
- Tongue-tie (frenectomy) release
- Myofunctional therapy
- Arch expansion
- Laser procedures
- Airway-focused orthodontics
So when the American Dental Association (ADA) and the American Academy of Dental Sleep Medicine (AADSM) published a position statement in JADA reviewing emerging dental therapies for sleep disorders, it was a much-needed moment of clarity.
As a clinician who works exclusively in orofacial pain and dental sleep medicine, I believe this statement is important — not because it dismisses innovation, but because it reinforces something fundamental:
Evidence must lead treatment — not trends.
Let’s break down what this means for patients and dentists.
What Did the ADA and AADSM Actually Say?
The position statement reviewed the current evidence surrounding emerging dental therapies for obstructive sleep apnea and snoring.
The key takeaway:
No emerging dental therapy currently has sufficient evidence to replace established, guideline-supported treatments as first-line monotherapy for OSA.
Established therapies include:
- CPAP (Continuous Positive Airway Pressure)
- Mandibular advancement devices (oral appliance therapy)
- Surgery (in selected cases)
- Multidisciplinary evaluation
Emerging therapies may be considered:
- On a case-by-case basis
- As adjunctive treatment
- When evidence supports limited use
- Within ethical and informed consent frameworks
But they are not validated replacements for standard care. That distinction is critical.
Why Is This Statement Important Right Now?
Because the sleep space is noisy.
Social media platforms, short-form video content, and “airway-centric” marketing have amplified certain procedures — sometimes far beyond what scientific evidence supports.
Procedures like tongue-tie release in adults are being marketed for obstructive sleep apnea, snoring, TMJ pain, poor posture, fatigue and even facial aesthetics.
I routinely see adult patients who were advised to undergo frenectomy for TMJ pain or disturbed sleep without a comprehensive sleep evaluation.
The position statement reminds us that:
- Evidence for adult tongue-tie release in OSA is limited
- Data is inconsistent
- It cannot be recommended as a standalone treatment for OSA
In infants, frenectomy has specific indications — primarily feeding issues. Even there, recommendations are cautious and selective.
This is not about dismissing potential. It’s about respecting the hierarchy of evidence.
Are Sleep Disorders Just an Anatomical Problem?
No — and this is one of the most important concepts in modern sleep medicine.
Obstructive sleep apnea is often described as a “narrow airway” issue. But the reality is more complex.
OSA involves both:
Anatomical Factors– airway size, tongue volume, soft tissue collapse
Non-Anatomical Factors– Ventilatory control instability, Arousal threshold, Neuromuscular responsiveness, Sleep fragmentation, Obesity and metabolic health
Two patients with identical airway scans may have completely different sleep study results.
OSA is a multifactorial disorder. Any treatment claiming universal effectiveness based purely on anatomy should raise caution.
What About Myofunctional Therapy and Arch Expansion?
These therapies are frequently discussed in airway circles.
Myofunctional Therapy
It may improve tongue posture, nasal breathing habits, muscle tone.
There is some evidence suggesting it can reduce snoring and improve mild OSA metrics — but data is limited and it is not to be considered a replacement for first line modalitiesbut an adjunctive therapy.
Arch Expansion
In children, growth modification may positively influence airway development in select cases.
In adults:
- Skeletal expansion is complex
- Evidence linking it to predictable OSA resolution is limited
- Outcomes vary significantly
Again, this is about patient selection and honest communication.
Frequently Asked Questions
Can a tongue-tie release cure sleep apnea in adults?
There is currently insufficient high-quality evidence to support tongue-tie release as a cure or primary treatment for obstructive sleep apnea in adults.
Is myofunctional therapy effective for sleep apnea?
Myofunctional therapy may improve snoring and mild OSA in select patients, but it is considered adjunctive therapy — not a first-line replacement for CPAP or oral appliance therapy.
Are new dental sleep treatments better than CPAP?
No emerging dental therapy has demonstrated evidence strong enough to replace CPAP as first-line treatment for moderate to severe obstructive sleep apnea.
Why do some dentists recommend airway procedures?
Some clinicians are early adopters of emerging techniques. However, evidence-based guidelines recommend careful patient selection and transparent discussion of limitations.
The Real Risk: Oversimplification
The danger is not innovation. The danger is oversimplification.
When complex sleep disorders are reduced to:
- “It’s your tongue.”
- “It’s your jaw.”
- “Just expand your arch.”
- “Release the tie and you’ll breathe.”
This many lead patients to delay effective treatment, spend large sums on procedures with unclear benefit and continue living with untreated OSA.
The Bottom Line
The ADA and AADSM position statement is not anti-innovation. It is pro-evidence.
Emerging dental therapies for sleep disorders are promising in some contexts, but none currently replace established treatments as first-line therapy for obstructive sleep apnea.
As research evolves, recommendations may change. Until then, responsible clinicians must balance curiosity with caution. Because when it comes to sleep — patients deserve science, not trends.