We update our pages on a regular basis to incorporate product changes, tester feedback, and refinements to our rating criteria.
December 13, 2022 Expert Tested
years treating sleep issues
unique testing team members
We know that getting quality sleep comes down to more than just the mattress you choose. That’s why we’ve partnered with veteran sleep doctor Michael J. Breus to devise the perfect sleep system for you—including tips, habits, products, and behaviors for better sleep.
The Elastic Mandibular Advancement (EMA) sleep appliance is a customizable mouthguard designed to reduce snoring. Chicago-based dental manufacturing company Myerson originally developed the appliance. Today, the company evaluates dental labs and authorizes these locations to produce the device.
The EMA sleep appliance physically pushes the lower jaw forward to expand your breathing passages and promote more airflow. Owners can adjust the mouthpiece with interchangeable elastic straps of different strengths and advancement levels.
The EMA is intended to help people who snore due to obstructive sleep apnea (OSA). To obtain the device, you’ll need approval from a licensed dental provider and a prescription.
As a mandibular advancement device (MAD), the EMA oral appliance is designed to minimize OSA-related snoring by pushing your lower jaw forward while you sleep. This widens your airway and helps prevent tissue vibrations that produce snoring when air passes through your breathing passages. The appliance received clearance from the Food and Drug Administration in 1997.
The EMA’s upper and lower retainers are made of thermoplastic material that has been custom-molded to fit your teeth. Elastic straps connect the trays at both ends to give you freedom of movement. The appliance comes with straps ranging from 13 to 21 millimeters in length. Each length has four strength levels — soft, medium, firm, and extra firm — giving you 36 different strap options.
The array of straps gives users a wide range of jaw advancement distances. For example, the longest 21-millimeter strap advances the lower jaw a minimum of 4 millimeters. On the other end of the spectrum, the shortest 13-millimeter strap maxes out at 14 millimeters of jaw advancement.
As with any anti-snoring mouthguard, the EMA appliance has benefits and drawbacks for wearers.
The EMA appliance is intended as a noninvasive treatment for snoring. The device is primarily designed for people who snore due to OSA, but those who have not been diagnosed with sleep apnea may still be good candidates.
Ask your dentist about the EMA if you think this mouthguard may be right for you. If your snoring is severe or you think it may be a symptom of a more serious condition like sleep apnea, speak with your doctor or a sleep specialist. They may recommend an overnight sleep study to properly diagnose your condition and recommend treatment options.
Who Is It Ideal For? Who Should Avoid It?Snoring occurs when your airway narrows during sleep, causing soft tissues to vibrate as air passes through. Conditions like obstructive sleep apnea can further constrict the airway to exacerbate your snoring. The EMA appliance moves the jaw forward to expand your breathing passages, creating more space for air to flow without interacting with surrounding tissues.
The EMA features top and bottom retainers customized to fit your teeth. You can adjust how far your jaw advances by swapping out the elastic straps connecting the retainers. The straps are color-coded to help you differentiate between the strength levels, and their lengths range from 13 to 21 millimeters. The shorter the strap, the farther your jaw advances.
The EMA dental appliance is designed to treat obstructive sleep apnea and snoring by expanding your airway while you sleep. While the EMA may be effective for people who need mandibular advancement between 4 and 14 millimeters to reduce snoring, those who need more or less advancement may need to seek out a different device.
The EMA consists of flexible thermoplastic retainers custom-molded to fit your top and bottom teeth. Latex-free elastic straps connect the retainers on each side. The device is FDA-cleared.
If properly cared for, your EMA appliance should last at least two years. The elastic straps typically last two to six weeks before needing replacement, though they may need to be replaced sooner when you first start using the device.
You should replace the straps if they stretch at least one-eighth of an inch longer than their original size, or if their circular holes become misshapen. Replacement strap sets are available without a prescription. If you need a new set of retainers, talk to your dentist.
If you clean the EMA each morning, the device is relatively easy to maintain. The inventor of the device recommends brushing it with a denture brush, cool water, and a mild denture toothpaste. Some dental practices suggest using liquid soap instead of denture toothpaste. A travel-friendly storage container is usually included with your purchase.
The EMA’s top and bottom retainers are made of moldable thermoplastic material. This material becomes soft when heated, at which point it can be custom-molded to fit your teeth. The customization is based on bite impressions you make during a dental appointment, which are then sent to the manufacturer.
Once the molding process is complete, the retainers are cooled and the thermoplastic hardens. Talk to your dentist if the device doesn’t fit properly, as this may necessitate a new impression.
The EMA appliance is not available over the counter. To obtain the device, you’ll need approval from a licensed dental provider. This involves an in-person visit and evaluation.
Speak with your doctor if you think your snoring is a sign of obstructive sleep apnea. Common symptoms of OSA include daytime sleepiness as well as gasping, choking, or loud snoring during sleep. Alternatively, your dentist may perform a sleep apnea screening and refer you to a doctor or sleep specialist if they suspect you have OSA. In some cases, a physician may recommend an overnight sleep study.
If you are approved for an EMA device, your dentist will act as an intermediary between you and the dental lab that produces your custom-fitted appliance.
Trial, Warranty, and Shipping PoliciesAvailability
The EMA is exclusively available to licensed dental providers. Talk to your dentist if you’re interested in obtaining this appliance.
Estimated Cost
Since the EMA appliance is sold through dental offices, cost varies by location. Prices typically range from $500 to $1,000 before insurance coverage or Medicare reimbursement.
Eligibility Requirements
Purchasing an EMA appliance requires a prescription. You’ll also need an appointment with your dentist to take a set of teeth impressions, which is used to customize the retainers.
Processing Time
On average, an EMA device is produced within five days after the customization lab receives your teeth impressions.
Warranty and Replacements
Warranty coverage for the EMA depends on the lab that produces the device, but most cover the appliance for six months to two years.
About The Author
Alison Deshong Profile Image" width="167" height="167" />
Staff Writer, Product Testing Team
Alison is a health writer with ample experience reading and interpreting academic, peer-reviewed research. Based in San Diego, she is published in the journal PLOS Genetics and the Journal of Biological Chemistry and has been a copywriter for SmartBug media. With a master’s degree in biochemistry from the University of California, Davis, she has nearly a decade of academic research experience in life sciences. She enjoys helping people cut through the noise to understand the bigger picture about sleep and health. Alison likes to stay active with rock climbing, hiking, and walking her dog.
Have questions about sleep? Submit them here! We use your questions to help us decide topics for articles, videos, and newsletters. We try to answer as many questions as possible. You can also send us an email. Please note, we cannot provide specific medical advice, and always recommend you contact your doctor for any medical matters.
