What is a Mandibular Advancement Device?

A mandibular advancement device resembles a mouth guard used in contact sports. It may be used to treat conditions such as snoring and obstructive sleep apnea, or OSA. Different types of mandibular advancement devices exist, but they generally consist of two plates which cover the upper and lower teeth. Mandibular advancement devices may be formed from hard acrylic or a soft elastomer material and, while some work by moving the jaw forward to open the airway, others position the tongue so that the airway is clear. They have been found to reduce snoring and promote restful sleep in people suffering from mild or moderate OSA.

Obstructive sleep apnea causes shallow breathing during sleep, and periods where breathing stops completely. Such periods typically occur several times in one hour and can last for a few seconds or may extend into minutes, ending in a choking or snorting sound when breathing resumes. Snoring often, but not always, occurs together with obstructive sleep apnea. Sleep is disturbed because each breathing pause moves the person into a lighter phase of sleep. In a person using a mandibular advancement device, snoring and sleep apnea often improve, leading to a reduction in daytime drowsiness and an increased ability to perform normal daily activities.

A collapsed or blocked airway is the cause of obstructive sleep apnea, and this can arise for a number of reasons, including being overweight or having enlarged tonsils. It is important to treat OSA because it can increase the risk of heart problems, strokes and high blood pressure. Research has shown that by using a mandibular advancement device sleep apnea can be effectively treated, providing an alternative to the treatment method known as continuous positive airway pressure, or CPAP. CPAP involves the use of a machine that blows air into the airway during the night, keeping it open. Patients have to wear a mask, connected to the machine by a tube, and many find an oral mandibular device easier to use.

There are some possible side effects associated with the use of a mandibular advancement device, and it is not yet known whether such devices are helpful for people who experience sleep apnea without any snoring. Possible negative effects include jaw pain, and in some individuals there may be movement of teeth which could alter the bite. For this reason, it is recommended that patients are followed-up closely when using a mandibular advancement device, as early detection of changes in the teeth can prevent more serious problems from developing.