A mandibular advancement device (MAD) is a custom-made oral appliance that treats snoring and OSA by expanding the airway through forward movement of the jaw. MADs are more comfortable and easy to use than CPAP machines.
Temporomandibular disorders can be aggravated by MADs, but long-term studies10,15 indicate that these problems can usually be remedied.
How It Works
Mandibular advancement devices (MADs) move the lower jaw forward to help prevent the tongue falling back into the airway and causing obstruction. These oral appliances have been shown to be effective for reducing snoring and treating mild to moderate sleep apnoea, as well as preventing teeth grinding and improving overall health.
MADs are non-invasive, and a great alternative to CPAP. They are also smaller and less obtrusive, which makes them easier to use and more comfortable. This leads to better compliance and improved outcomes, as patients are more likely to continue using the device.
MADs are the second most popular treatment option for obstructive sleep apnea after the continuous positive airway pressure machine. They are especially useful for people who are “CPAP rejects” because of discomfort with the mask and forced air. A MAD can be custom-fitted for your mouth and helps to keep the airway open allowing oxygen to pass into the lungs. This reduces snoring and improves overall health by reducing cardiovascular disease, depression and anxiety.
Benefits
Oral appliances are a popular sleep apnea treatment for patients who cannot tolerate or don’t want to use CPAP. Mandibular advancement devices are designed to treat moderate obstructive sleep apnea and snoring by moving the lower jaw forward to open the airway.
They are constructed of molded hard plastic that snaps over your lower and upper teeth, and feature metal hinges to move the lower jaw forward. They are not a one-size-fits-all device, and should be custom made by a dentist who has completed the necessary training in sleep medicine to ensure optimal comfort, fit, and effectiveness.
A mandibular advancement splint can significantly improve your quality of sleep and overall health. It may also help reduce the effects of obstructive sleep apnea in conjunction with other treatments, including myofunctional therapy, tongue and lip tie release procedures like laser frenectomy, and dental work such as orthodontics and tooth restoration. Long-term use of MADs may result in changes to the bite and temporomandibular joint (TMJ) pain.
Cost
MADs are available in a variety of price ranges. Cheaper devices can be purchased over the counter, but these are not as effective or well tolerated as those customised from an impression of the teeth and jaw. More expensive models are often custom-made, but this approach requires a high level of dental expertise and can be costly.
Studies have shown that MAS can reduce Apnea-Hypopnea Index (AHI) in patients with mild to moderate obstructive sleep apnea. However, it may be less effective for those with severe obstructive sleep apnea and/or specific anatomical challenges.
If you suspect that you have sleep apnea, it is important to consult with a medical professional to confirm the diagnosis and get the best treatment for you. A sleep study can help diagnose the condition, and our team can recommend oral appliances to treat your symptoms. In addition, we can help you navigate your insurance coverage and handle the paperwork to maximize benefits.
Side Effects
Mandibular advancement devices can be effective for treating sleep apnea and snoring. However, they can cause side effects including dental pain, temporomandibular joint (TMJ) problems, and tooth shifting. These side effects are generally easily managed by adjusting the position of the appliance or slowing its protrusion.
Several studies indicate that long-term use of MADs does not negatively impact TMJ function. The occlusal changes that occur with MAD use are mostly of a dental nature and include a decrease in overbite and overjet.
MADs are a relatively noninvasive treatment option for patients with OSA and snoring, but their effectiveness varies among patients and the exact mechanism remains unclear. Various associations with MAD efficacy have been identified, but these predictors only weakly explain MAD treatment response. Therefore, alternative prediction methods such as functional imaging may prove useful in patient selection for MAD therapy. MADs are contraindicated in patients with loose teeth, significant dental carries, periodontitis, severe bruxism, or upcoming orthodontic work.