Mandibular Advancement Devices

What is a mandibular advancement device and what does it do?

Mandibular advancement devices (MADs) are oral appliances that you wear to keep your airway open while you sleep. It is the most common oral appliance for treatment obstructive sleep apnea (OSA) and snoring. It works by advancing the jaw and tongue away from the posterior wall of your airway and making it hard to collapse during sleep. There are custom-made MADs and OTC appliances. Research shows that custom-made oral appliances offer the best results for obstructive sleep apnea.

Does a MAD work for the most severe OSA cases?

Studies show that MAD is as effective as positive airway pressure devices (such as CPAP, APAP etc.) for patients with mild to moderate obstructive sleep apnea. For patients with severe OSA but cannot tolerate CPAP/APAP, MADs can be the alternative treatment option.

What are the risks of MADs?

The risks of MADs include:

Tooth pain, tooth damage, existing restoration damage
Temporary and/or permanently changing the occlusion
TMJ pain and/or dysfunction
Failure of MADs to prevent apnea and hypopnea events

To achieve the best outcome of MADs, your dentist and physician need to collaborate closely to determine that MADs is the best treatment for you. Before the appliance is made, a board-certified dental sleep medicine dentist will perform comprehensive oral/TMJ evaluation to prevent/manage TMJ complication. After the appliance is custom made, your dentist will titrate the appliance to achieve best treatment outcome and fabricate appliances to prevent unwanted teeth migration as a result of wearing the appliances.

Will my insurance cover the appliances?

With proper documentation, your medical insurance may reimburse the cost of MADs. Please consult with our insurance billing specialist for details.

References