Why & When to Use a Mandibular Advancement Device (MAD) for Snoring

Snoring is a common sleep problem that disrupts many lives. As well as affecting the sleep quality of the individuals concerned, snoring also interferes with the sleep of their partners and anyone else who may be in earshot of the all that nocturnal grunting emanating from their throats.

Mandibular advancement device (MAD)

A mandibular advancement device (MAD) is one of several options available to people who want to get their snoring under control.

As well as having the potential to control normal snoring, a mandibular advancement device can also be useful for managing the symptoms of mild obstructive sleep apnea.

Sleep apnea is a dangerous sleep disorder. One of the symptoms is snoring. However, this article focuses on the value of mandibular advancement devices as a means of controlling normal snoring, not sleep apnea.

If you have sleep apnea or suspect you might, and are considering using a mandibular advancement device, it’s important to discuss the matter with a medical professional first.

For non-sleep apnea-related snoring, a mandibular advancement device could be a viable solution.

However, anti-snoring devices of this nature are not suitable for all. This article provides information that will help you to decide if a mandibular advancement device is likely to be a good option for you.

What Is a Mandibular Advancement Device?

A mandibular advancement device is an anti-snoring aid you place inside your mouth before going to sleep.

Devices of this nature have been around for a long time and used to be only available via dentists.

An anti-snoring device from a dentist? It’s not as crazy as it sounds. Somewhat wedge-type in shape, this type of device has to be molded to the upper and lower teeth.

As you may be aware, the mouthguards professional fighters and NFL players protect their teeth with are often custom-built by dentists.

You may also be aware it’s also possible to buy a “boil and bite” mouthguard that you can set-up yourself.

Dentists make custom-built mouth guards from the impressions they take of your teeth. This allows the mouthguards to be a perfect fit.

Boil and bite mouthguards are made from a special thermo-plastic. After they have been immersed in hot water, the plastic becomes soft enough to mold to the teeth.

The system makes it possible to get a perfect fit without having to pay expensive dentist bills.

The system is similar with boil and bite mandibular advancement devices. However, unlike the mouthguards used in sports, that only fit over the top teeth, mandibular advancement devices fit over the lower teeth as well.

As with mouthguards, custom-built dental mandibular advancement devices are very expensive, often costing upwards of $1,000. You can buy a high-quality boil and bite option for a fraction of the price.

How Does a Mandibular Advancement Device Work?

As already detailed, a mandibular advancement device fits over the upper and lower teeth. The fact that the plastic molds to the teeth ensures a nice snug fit. This is important because the device uses the teeth to alter the position of the lower jaw during sleep.

How Mad's work

Some mandibular advancement devices employ mechanisms that make it possible to move the lower tray forward in 1 mm increments.

With others, users purposefully advance their lower jaw during the boil and bite. Then, when the plastic sets, the device maintains the jaw position from the boil and bite stage.

An adjustable mandibular advancement device generally costs a little more than a normal boil and bite model. However, the increase in cost is not significant.

Regardless of the type you choose, the success of this type of anti-snoring device is due to the way they advance the lower jaw.

Snoring happens when the soft tissue at the back of the throat vibrates, producing noise. This vibration of flesh happens when obstructions in the airway cause air turbulence during breathing.

Several things can contribute to the obstruction that causes turbulence. However, the problem is partly due to the fact that the muscles in and around the throat relax during sleep. This makes the flesh more susceptible to turbulence.

The fact that the tongue often drops toward the back of the throat makes things worse. It reduces the diameter of the airway, increasing turbulence.

By moving the lower jaw forward, a good mandibular advancement device opens up the airway. This prevents the turbulence that causes snoring.

Why does this work? Because the tongue is anchored to the lower jaw and has to move forward with it.

Who Are the Devices For?

Mandibular advancement devices are a good option for most snorers. They may also be suitable for people who have mild obstructive sleep apnea but, where the condition is present or suspected, the decision to use a mandibular advancement device requires input from a medical professional.

Normal snorers only use this type of device to tackle the rowdiness in their throats. People who have obstructive sleep apnea use the devices to prevent their airways from closing up completely and arresting breathing.  This is a more serious issue. Hence the need for expert intervention.

Although many snorers find a mandibular advancement device works well for them, it’s not a viable solution for all. Devices of this type require strong teeth. If you have dentures, frontal crowns, or gum disease, a mandibular advancement device will not be for you.

Nor is this type of anti-snoring device suitable for people who wear retainers or braces during sleep.

Comfort Issues & Side Effects

Sleeping with something inside your mouth is an unusual sensation that may take a little getting used to. When you are using a mandibular advancement device, it can also take a little while to get used to the temporary repositioning of the jaw.

This shouldn’t be an issue for most people. Is it really so different from trying to get used to a new pair of shoes?

However, sleeping with the jaw in a slightly advanced position may initially cause some degree of jaw pain. The teeth may become a little sensitive too.

Fortunately, side effects of this nature are generally restricted to the early stages of use. As the jaw becomes used to the new positioning it adapts and the problems disappear.

Research published in the American Journal of Respiratory and Critical Care Medicine shows this. It also proves the value of mandibular advancement devices, both for snoring and obstructive sleep apnea.

Summary

A mandibular advancement device is an anti-snoring device you place in your mouth before going to sleep.  It fits over the upper and lower teeth in a way that forces the lower jaw to extend forward. This extension of the jaw moves the tongue forward, opening up the airway at the back of the throat.

By holding the tongue forward in the way that it does, the device can prevent snoring by reducing the turbulence that causes the flesh in the throat to vibrate audibly.

There was a time it was only possible to obtain a mandibular advancement device from a dentist. This is no longer the case. Modern boil and bite devices are cheap to buy and easy to set-up at home. Gone are the days when one of the best ways to stop snoring necessitated a dental bill of $1,000 or more.

Although some people may have dental issues that prevent them from using this type of anti-snoring device, it has proven capabilities. Using a mandibular advancement device is one of the most efficient ways to get snoring under control.

If you are thinking of buying and using a mandibular advancement device, it’s important to be aware using the device may entail a little discomfort. Any pain involved will likely be localized to the teeth and the jaw and should not last for long.

After you adjust to the nightly presence of the device in your mouth, any discomfort you felt should start to fade away.

The thing to remember is mandibular advancement devices have been around for a long time. They are popular and there is a good reason for that—they are an anti-snoring solution that works.

FAQ

Do mandibular advancement devices work for snoring?

Yes, but they are not the best option for everyone. However, if you have healthy teeth and currently snore, this is a good type of anti-snoring device to try.

Do mandibular advancement devices help with sleep apnea?

There are two types of sleep apnea. Central sleep apnea is a sleep disorder that causes breathing to stop because the organs of respiration don’t get the signal to breathe. A mandibular advancement device cannot help rectify this.

Obstructive sleep apnea happens when the airway becomes blocked. A mandibular advancement device may be able to prevent this from happening because it helps keep the airway open. However, due to the serious nature of the condition, if you suspect you have obstructive sleep apnea, you should share your concerns with a doctor. There is no substitute for professional advice.

How long does a mandibular advancement device last?

Unfortunately, there is no way to be certain how long the device will last. However, you should be able to continue using it for at least six months and, possibly, up to two years.

If you get a custom-built mandibular device from your dentist, it may last up to three years, but there are no guarantees. Even if you were to get a full three years, it can still be hard to justify the additional expense of buying this type of device entails.