Oral appliances have been used by dentists for several decades to treat snoring and obstructive sleep apnea. Although these devices are regulated by the Food and Drug Administration, most have undergone only sparse clinical testing for efficacy and safety. Most otolaryngologists are not well-versed in their applicability as treatment options. This review summarizes the historical development of oral appliances, the types of available devices, the current literature regarding devices, and pertinent regulatory issues as they relate to the ongoing debate over appliance use and potential misuse.