What is a Mandibular Advancement Device and how does it work?
Mandibular Advancement Devices are small acrylic devices worn in the mouth during sleep and are somewhat similar to orthodontic retainers or sports mouthguards. There are numerous designs and these devices are customised and fitted to meet your individual situation. A device which is titratable (adjustable) is highly recommended. Over-the-counter devices (such as the "boil and bite") are not recommended as they do not work consistently and are typically uncomfortable. For a better treatment outcome, it is recommended you seek the care of a specialist who is experienced in the field of Dental Sleep Medicine.
Mandibular Advancement Devices assist breathing during sleep by repositioning and stabilising the lower jaw (mandible) and tongue in a forward position. This helps prevent the collapse of the tongue and soft tissues in the back of the throat and thus keeps the airway open during sleep. In turn, this promotes adequate air intake (oxygen) to prevent your airway from vibrating (snoring) and obstructing (sleep apnoea).
What conditions are Mandibular Advancement Devices suitable to treat?
- Mild and moderate obstructive sleep apnoea
- Severe obstructive sleep apnoea cases who are intolerant to CPAP
- As combination therapy with CPAP and/or upper airway surgery
- Easy to use
- Better compliance compared to CPAP
- Small and portable - may be used as a substitute for CPAP during travel and does not require a power source
- Non-invasive treatment unlike surgery
Possible Side Effects:
The Mandibular Advancement Device will be custom fabricated for maximum comfort. If the device is fitted correctly, it is typically well tolerated. However, there will be a short period of adjustment during which your mouth will adapt to the sensation of a device. As the device pushes your jaw forward, some patients feel discomfort initially, which typically resolves with prolonged use. Discomfort is usually at the jaw joint (in front of the ear) or jaw muscles. Also with prolong use, your bite may alter and this needs to be monitored carefully.
Most of the other side effects are minor and resolve on their own or with minor adjustment of the device. Long-term complications may or may not be fully reversible once therapy is discontinued. Given the potential for side effects and complications, it is recommended you seek the care of a specialist who is experienced in the field of Dental Sleep Medicine.