Mandibular advancement devices (MAD) are an alternative treatment for sleep apnea and can also alleviate snoring. The device typically consists of trays with moldable thermoplastic to fit the patient’s upper and lower teeth, and mechanisms such as hinges or elastic bands to adjust the advancement level. The goal is to pull the lower jaw far enough forward to prevent the tongue and jaw from falling backward, which obstructs airflow while the patient is sleeping. In addition, the advancement of the jaw keeps tension on the muscles, which will help reduce snoring as well. For people with obstructive sleep apnea (OSA), MADs can be a more comfortable and less invasive treatment option than CPAP therapy.
MAD can be semi-fitted or custom-fitted. Semi-fitted are available over the counter. Patient’s will heat thermoplastic in hot water and mold it to the teeth. Ones that are purchased over the counter can pose severe issues such as improper fit and patients therefore not compliant, jaw pain and changes in the patient’s bite due to jaw placement not being calibrated properly since it is not evaluated by a dental professional. It is advised that patients opt for a custom-fitted MAD. However, these can be a barrier for patients due to the cost and inconvenience of needing to see the dentist for multiple appointments. Custom-fitted ones can still result in jaw pain and changes in a patient’s bite; however, it is less likely compared to self-made ones since trained professionals are fitting the appliances, and patients are followed up with proper home care instructions.
