A mandibular advancement device (MAD) is a custom mouthpiece worn during sleep. It holds the lower jaw slightly forward to help keep the airway open, which can reduce snoring and the breathing pauses of sleep apnea. Because snoring can come with sleep apnea, care starts with a sleep assessment by a physician, then a dental examination.
Snoring or sleep apnea?
Snoring is the sound of air moving past relaxed tissues in the throat during sleep. Sometimes it comes with obstructive sleep apnea, where breathing repeatedly stops and starts. Signs worth discussing with a physician include:
- Loud snoring most nights.
- A partner notices pauses in your breathing, or gasping during sleep.
- Waking up tired, or with a dry mouth or headache.
- Feeling sleepy during the day.
Why a sleep test comes first
Sleep apnea is diagnosed by a physician with a sleep test, which shows whether your snoring comes with sleep apnea and how severe it is. Your physician also explains all the options, including CPAP, a machine that delivers air through a mask during sleep. Our staff can help arrange the sleep assessment with physicians we work with, and the sleep test is paid directly to the hospital.
If you have already had a sleep test at another hospital or abroad, send us the report. A recent enough result can be used instead of a new test.
How the mouthpiece works
A MAD is made from impressions or a digital scan of your own teeth. It fits over the upper and lower teeth and holds the lower jaw slightly forward, which helps keep the airway behind the tongue more open. Results differ from person to person, so your physician reviews the effect on your sleep.
Snoring and sleep apnea appliance (MAD)
Who an appliance may suit
An appliance suits people whose physician recommends it after a sleep assessment, and whose teeth and gums are healthy enough to hold it. Your dentist checks your teeth, gums and jaw joints, and takes X-rays when needed. If you need fillings or gum treatment first, your dentist plans this with you.
Visits and travel
Plan for several dental visits: the examination, impressions or a scan, fitting, then one or more adjustment visits over the following weeks while the jaw position is moved forward step by step, followed by regular check-ups. If you are visiting from abroad, an appliance can be made during a stay of about one week, with two to three dental visits.
Living with your appliance
- Many people need a few nights to get used to it. The jaw or teeth may feel tight for a short time in the morning.
- Over months and years, the way your teeth meet can gradually change, so your dentist checks your bite at follow-up visits.
- Rinse and clean the appliance every morning with a soft brush, and keep it dry in its case.
A MAD is not a night guard
A night guard covers the teeth to protect them from grinding. A MAD holds the lower jaw forward to help breathing during sleep. If you both snore and grind your teeth, your dentist explains which appliance suits you.