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Dr Joseph Paino · Melbourne

Snoring or
sleep apnoea?Explore a custom
dental appliance.

Find out whether a mandibular advancement splint (MAS) could suit you, with individual assessment and ongoing care at Enhance Dental.

Dr Joseph PainoPrincipal dentist · Enhance Dental
A woman stretching in bed in soft morning light
38+ yearsof clinical dental experience
Made for your mouthCustom oral appliances
Here in Melbourne566 St Kilda Road

Understanding your sleep

More than
a noisy night.

Snoring can happen on its own. It can also be a sign of obstructive sleep apnoea (OSA), when the upper airway repeatedly narrows or closes during sleep.

If these signs sound familiar, an assessment is a sensible next step. Symptoms alone cannot diagnose sleep apnoea.

Loud or persistent snoring

Especially when someone notices pauses in your breathing.

Waking through the night

Gasping, choking or waking without feeling rested.

Sleepy during the day

Morning headaches, tiredness or trouble concentrating.

Concerned about your sleep? Speak with your GP or ask us about assessment. If you feel sleepy while driving, stop driving and seek medical advice.

Custom mandibular advancement splints

Small appliance.
Considered design.

A MAS fits over your teeth and holds your lower jaw forward during sleep. This can help keep your upper airway open. You may also hear it called a mandibular advancement device, or MAD.

A 3D Sleep nylon mandibular advancement splint showing its adjustment tabs and dorsal fins
3D-printed nylon mandibular advancement splintEnlarge device image

Shaped to your teeth

Digital scans help create an appliance specifically for your mouth.

Fine-tuned with you

The jaw position is adjusted gradually, with attention to comfort and response.

No mask or power supply

A compact option for suitable patients, at home or when travelling.

A small shift in jaw position.
More room for breathing.

During sleep, soft tissues can narrow the airway. Holding the lower jaw forward can help maintain space behind the tongue. Follow-up sleep testing checks how well the appliance is working.

Conceptual comparison of a narrowed airway and a lower jaw held forward by a mandibular advancement splint
Conceptual illustration. Individual response varies; this is not a patient before-and-after result.Enlarge illustration

See how a MAS helps open the airway.

This short animation shows how moving the lower jaw forward can create more space behind the tongue. Your custom appliance holds the jaw forward during sleep.

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14-second animation by 3D Sleep / Modern Dental Pacific.Open video in a new tab

Is it right for me?

The right treatment starts
with the right assessment.

Oral appliances may suit adults with primary snoring after OSA is excluded, or selected people with OSA, including those who cannot tolerate CPAP or prefer an alternative.

CPAP usually controls breathing events more effectively, particularly in more severe OSA. Your sleep physician’s advice, sleep study and dental health guide the choice. Keep using prescribed treatment until your clinician advises a change.

Explore suitability questions ↓

Compare your options

Oral Appliance vs.
Traditional CPAP

A custom oral appliance can offer a compact, mask-free option for suitable patients. See how the practical benefits and everyday experience compare.

What matters to youOral applianceCustom mandibular advancement splintCPAPPressurised air through a mask
Mask & tubingKeep your face free. Worn inside your mouth, with no external mask or tubing.A choice of interfaces. Nasal pillows, nasal masks or full-face masks connect to the machine through tubing.
Travel & powerSmall case. No power supply. Easy to pack, with no electricity or batteries needed.Travel options are available. Requires a machine, mask, tubing and mains power or a compatible battery.
Night-time soundNo motor noise. The appliance works without a powered pump.Modern machines are generally quiet. Airflow or mask leaks can still create sound.
Fit & comfortMade for your mouth. Custom fitted and gradually adjusted, with time to get used to wearing it.A setup tailored to you. Mask choice, pressure settings and humidification can help improve comfort.
Daily careA straightforward routine. Clean your appliance as directed and attend regular dental reviews.Regular equipment care. Clean the mask, tubing and humidifier if used, and maintain filters as instructed.
Treatment effectivenessAn option for suitable patients. Can reduce snoring and obstructive sleep apnoea. Follow-up sleep testing checks your response.Strong control of breathing events. Generally more effective at controlling OSA, especially when it is severe.
Things to considerJaw or tooth discomfort and bite changes can occur. Ongoing dental reviews are important.Mask discomfort, leaks or dryness may occur. Adjusting the fit and settings can often help.

Mask & tubing

Oral appliance
Keep your face free. Worn inside your mouth, with no external mask or tubing.
CPAP
A choice of interfaces. Nasal pillows, nasal masks or full-face masks connect to the machine through tubing.

Travel & power

Oral appliance
Small case. No power supply. Easy to pack, with no electricity or batteries needed.
CPAP
Travel options are available. Requires a machine, mask, tubing and mains power or a compatible battery.

Night-time sound

Oral appliance
No motor noise. The appliance works without a powered pump.
CPAP
Modern machines are generally quiet. Airflow or mask leaks can still create sound.

Fit & comfort

Oral appliance
Made for your mouth. Custom fitted and gradually adjusted, with time to get used to wearing it.
CPAP
A setup tailored to you. Mask choice, pressure settings and humidification can help improve comfort.

Daily care

Oral appliance
A straightforward routine. Clean your appliance as directed and attend regular dental reviews.
CPAP
Regular equipment care. Clean the mask, tubing and humidifier if used, and maintain filters as instructed.

Treatment effectiveness

Oral appliance
An option for suitable patients. Can reduce snoring and obstructive sleep apnoea. Follow-up sleep testing checks your response.
CPAP
Strong control of breathing events. Generally more effective at controlling OSA, especially when it is severe.

Things to consider

Oral appliance
Jaw or tooth discomfort and bite changes can occur. Ongoing dental reviews are important.
CPAP
Mask discomfort, leaks or dryness may occur. Adjusting the fit and settings can often help.
The right fit for your sleep and your life.

Your sleep study, dental health and ability to use treatment consistently guide the choice. Dr Paino works with your sleep physician to assess suitability. Continue prescribed CPAP until your treating clinician advises a change.

Discuss your options at a consultation ↓

Further reading: AADSM: oral appliance therapy · Cleveland Clinic: benefits and suitability · Mayo Clinic: using CPAP

A woman smiling in a dental chair at Enhance Dental

Your first consultation

Time to understand
your sleep.

Your first visit is a chance to discuss your snoring, sleep symptoms and any difficulties with your current treatment. Dr Paino will review your sleep history and assess your teeth, gums and jaw to see whether a custom oral appliance may be suitable.

Bring any previous sleep study, your medication list and any retainers or nightguard you use. If you haven’t had a sleep study, we can arrange a home sleep test where appropriate.

You will have the opportunity to ask about the appliance, follow-up care and likely costs before deciding how to proceed.

Arrange a consultation
Questions about fees and rebates ↓

No sleep study yet? We can arrange one.

For suitable patients, Enhance Dental provides a WatchPAT 400 home sleep test, so you can complete your assessment overnight in your own bed.

The test fee includes the device loan and sleep physician review and reporting. Results are usually available within a few days after a successful test has been submitted for review.

Dr Joseph Paino will discuss the findings with you and explain the next steps, including whether a custom dental appliance may be suitable.

  1. 01Assess

    Talk & understand

    We discuss your sleep symptoms, health and previous treatment, then check your teeth, gums and jaw to see whether a custom oral appliance may suit you.

  2. 02Diagnose

    Home testing & physician review

    Need a sleep study? We can provide a WatchPAT 400 home sleep test, with sleep physician review and a detailed report included in the test fee.

  3. 03Fit

    Scan & personalise

    If suitable, digital scans and bite records guide your custom appliance. We check its fit, make adjustments and explain how to wear and care for it.

  4. 04Review

    Adjust & monitor

    We check your comfort, bite and progress, adjusting the appliance where needed. Reviews and follow-up sleep testing help assess your response and guide ongoing care.

Living with your appliance

Getting used to
your appliance.

Compact in your hand. Made for your mouth. Your white nylon MAS is individually made to fit your teeth and can be stored in a small case at home or when travelling.

A new appliance can feel unfamiliar at first. Your fitting visit and follow-up reviews help you build a routine and identify any adjustments you may need.

White nylon mandibular advancement splint resting in an open hand, showing its compact size
A nylon mandibular advancement splint (MAS), shown in a hand for scale. Size and fit are tailored to each patient.

At night

Wear the appliance as instructed. Adjust the jaw position only according to the plan you have been given.

In the morning

Clean your appliance as directed and follow any prescribed bite exercises or repositioner routine.

As treatment progresses

Tell us about ongoing soreness or bite changes. Reviews and follow-up sleep testing check comfort, dental health and treatment response.

Wearing and caring for your appliance ↓
Dr Joseph Paino, principal dentist and owner of Enhance Dental

Meet your dentist

Dr Joseph Paino

B.D.Sc. (Melbourne)
Principal dentist & owner, Enhance Dental

Joseph graduated from the University of Melbourne in 1988 and established Enhance Dental in 1995. He brings more than 38 years of clinical dental experience to his Melbourne practice.

His further training includes oral appliance therapy for snoring, sleep apnoea and bruxism. His approach is unhurried: time to listen, explain your options and consider your dental health alongside your sleep.

Talk to our team about an appointment ↓
More about Dr Paino ↗

Your questions, answered

Good questions.
Clear answers.

Find the information you need, or talk to our team about your own situation.

Getting started

Do I need a referral or a sleep study?

You can book an initial dental consultation without a referral. If you have already had a sleep study, bring the report. Suspected OSA needs medical assessment and sleep testing; the team can discuss an appropriate pathway with you.

How does the home sleep test work at Enhance Dental?

If you haven’t had a sleep study, we can assess whether a WatchPAT 400 home sleep test is appropriate for you. The device is loaned to you for overnight use at home, with instructions from our team.

The test fee includes the device loan and sleep physician review and an in-depth analysis report. Results are usually available within a few days after a successful recording has been submitted for review. Timing may vary if repeat testing or further assessment is needed.

The sleep physician provides the medical interpretation and recommendations. Dr Joseph Paino considers these alongside your dental assessment when discussing treatment options.

Already have a sleep report? Bring it along—another test may not be necessary.

Can you use a sleep study I’ve already had?

Yes. Bring your sleep study report and any recommendations from your sleep physician to your consultation. Dr Paino will review these alongside your dental assessment. Another test may not be necessary, although updated testing may be recommended if your symptoms or health have changed.

Is a MAS suitable for me?

Can an oral appliance replace my CPAP?

For some people, yes. A custom mandibular advancement splint may be an option if CPAP is difficult to tolerate, or if an alternative is being considered with your sleep physician. Suitability depends on your sleep study and dental assessment.

Continue prescribed CPAP until your treating clinicians advise a change. Any transition is coordinated with your sleep physician, with follow-up testing to check treatment effectiveness.

Will it work for everyone?

No. Your diagnosis, airway, teeth, gums and jaw health affect suitability and response. A mandibular advancement device does not treat central sleep apnoea. Follow-up sleep testing is important because quieter snoring alone does not confirm that OSA is controlled.

Can I wear a sleep appliance if I have crowns, implants or missing teeth?

Often, yes. Existing dental work does not automatically rule out treatment. Dr Paino will assess your teeth, restorations, gums and available support to determine whether an appliance can fit securely. If you wear dentures, suitability depends on your individual circumstances and the appliance design.

What if I wear retainers after Invisalign or other orthodontic treatment?

Bring your retainers to your appointment. Dr Paino will consider both your sleep treatment and the need to maintain your tooth alignment. Your appliance and retainer routine need to be planned together, with input from your orthodontist where appropriate. A sleep appliance should not automatically be considered a replacement for your prescribed retainers.

Is it the same as a nightguard for grinding?

No. A standard grinding splint does not position your jaw to treat OSA. Tell Dr Paino if you use a nightguard, orthodontic retainer or other dental appliance so they can be considered in your treatment plan.

Is an oral appliance suitable if I breathe through my mouth?

Mouth breathing does not necessarily prevent you from using an oral appliance. Your breathing pattern, nasal symptoms and appliance design will be considered during assessment. If you regularly have a blocked nose, let Dr Paino know, as this may also need attention from your GP or an ENT specialist.

Wearing and caring for it

How soon will my custom appliance be ready?

Manufacturing usually takes around two weeks after your digital scans and bite records are completed. We will confirm the expected timing and arrange a fitting appointment. Further adjustments and reviews help establish a suitable jaw position once you begin wearing it.

What does the appliance feel like, and how long does it take to get used to?

It may feel unfamiliar at first, and the adjustment period varies. Dr Paino will explain how to build your routine and adjust the appliance as prescribed. Contact the practice if soreness persists or your bite feels different.

Are there side effects or changes to my bite?

Possible effects include sore teeth or jaw muscles, dry mouth, extra saliva and changes in how your teeth meet. Tooth movement and lasting bite changes can occur. Regular reviews matter, and persistent discomfort should be assessed.

What is a morning repositioner, and why might I need one?

A morning repositioner is a small device used after removing your sleep appliance to help guide your teeth back towards their usual bite. Dr Paino will explain how to use it as part of your morning routine. It does not guarantee that long-term bite changes will be prevented, so regular dental reviews remain important.

How do I clean and store my appliance?

Clean it each morning using a soft brush and the recommended appliance cleaner. Avoid toothpaste, which the manufacturer advises against. Follow the supplied instructions for periodic soaking, and store the appliance dry in a ventilated case away from heat. We will explain the cleaning routine when your appliance is fitted.

How long should my appliance last, and is there a warranty?

The manufacturer indicates an average lifespan of around five years, although this varies with wear, care and changes to your teeth or dental work. The 3D Sleep appliances we provide carry a three-year manufacturer warranty, subject to its terms. Regular reviews help identify when adjustment, repair or replacement is needed.

Fees and rebates

How much does treatment cost?

Contact the practice for current consultation and appliance fees. Ask for a written treatment plan explaining the device, fitting, reviews and any separate sleep-testing costs. Private health rebates depend on your policy; confirm cover and limits with your insurer before proceeding.

Can I claim a rebate through my private health insurance?

A rebate may be available under your extras cover, depending on your fund, policy and remaining limits. We can provide the relevant dental item numbers so you can check your entitlements before proceeding. Ask your insurer about any waiting periods and the amount you would need to pay yourself.

Let’s talk about your sleep

Your next step
starts here.

Arrange a snoring and sleep apnoea consultation with Dr Joseph Paino. Tell our team whether you have had a sleep study or currently use CPAP.

Please bring a current medication list and any sleep reports you already have. Haven’t had a sleep study? We can arrange a home sleep test where appropriate.

On St Kilda Road.
Here for you.

Level 2, Suite 219
566 St Kilda Road
Melbourne VIC 3004
Get directions ↗
Monday
8.00 am - 7.00 pm
Tuesday - Thursday
7.30 am - 4.00 pm
Friday
7.30 am - 12.30 pm

Office hours; clinical appointment times may vary.

Coming by car?
Designated patient parking is available on Queens Lane, behind the building. Look for the Enhance Dental spaces.

Appliance detail