Increasingly, I am getting a lot of requests for snoring mouth appliances from my patients. A mouth appliance for snoring is not a new concept. It is a however improved due to technology. They used to be very bulky and difficult to wear but are now better fitted and more tolerable in the advent of 3D scanning and printing. I will explain further.
An oral mandibular advancement device (MAD) is a small, custom-made dental appliance designed to help treat certain breathing and sleep-related problems, particularly obstructive sleep apnea (OSA) and snoring. By gently repositioning the lower jaw (mandible) forward, the device works to keep the airway open during sleep, improving airflow and reducing the risk of airway collapse.
For more Information about obstructive sleep apnea and snoring, you may check out the podcast with me and Dr Kenneth Oo (ENT specialist) below:
How the MADs Work
During sleep, especially when lying on the back, the muscles in the tongue and throat relax. In some people, this relaxation allows the airway to narrow or collapse, making it harder to breathe. This can cause loud snoring or repeated pauses in breathing (apneas).
A mandibular advancement device is worn over the teeth, much like a sports mouthguard. It moves the lower jaw slightly forward and sometimes also positions the tongue to prevent it from falling back. This forward posture increases the space behind the tongue and in the throat, allowing for smoother airflow.
Who Can Benefit
Mandibular advancement devices are most commonly recommended for:
• Mild to moderate obstructive sleep apnea. When a patient comes to me with snoring issues, I strongly recommend them to see a sleep specialist, who will assess your sleep activity and breathing.
• Primary snoring (snoring without significant apnea).
• Patients who cannot tolerate CPAP (continuous positive airway pressure) machines. There is a large pool of patients that cannot cope with the CPAP
• Individuals seeking a travel-friendly alternative to CPAP. They would instead travel with a MAD.
They are generally most effective for people with a healthy body weight, a mild to moderate condition, and in good dental health.
Custom vs. Over-the-Counter Devices
While over-the-counter (boil-and-bite) versions exist, dentists typically recommend custom-made devices. A custom MAD is fabricated from 3D scans, ensuring a precise fit for comfort and effectiveness. Custom devices also allow for adjustable advancement, meaning the dentist can fine-tune the jaw position for optimal results with minimal side effects.
Advantages
• Non-invasive – No surgery or major medical intervention
• Portable – Lightweight and easy to travel with
• Silent – Unlike CPAP machines, there’s no motor noise
• Easy maintenance – Simple cleaning routine similar to a retainer
Possible Side Effects
Although generally well tolerated, some users may experience:
• Jaw or tooth discomfort in the morning
• Excessive salivation or dry mouth.
• Minor changes in bite over time if not monitored
• Gum irritation if the device doesn’t fit properly
These side effects often improve with adjustment, gradual adaptation, or minor modifications by the dentist.
The Fitting Process
1. Consultation and evaluation – Your dentist or sleep specialist assesses suitability based on your symptoms, oral health, and sleep study results.
2. Impressions and bite registration – Molds of your teeth are taken to fabricate the appliance.
3. Fitting appointment – The device is tested for comfort and retention, and adjustments are made.
4. Follow-up visits – Regular reviews ensure continued comfort, effectiveness, and jaw health.
In Summary
A mandibular advancement device is a proven, user-friendly option for people with mild to moderate obstructive sleep apnea or disruptive snoring. It works by gently moving the lower jaw forward, keeping the airway open for better sleep and improved breathing. For best results, it should be custom-fitted by a dental professional and regularly monitored.
If you experience loud snoring, excessive daytime sleepiness, or have been diagnosed with sleep apnea, a mandibular advancement device may be an appropriate appliance to consider.
For further information, you may like to read this: