Oral appliances are the second most commonly prescribed treatment for obstructive sleep apnea. CPAP is often recommended first due to its treatment efficacy, however, if someone is unable or unwilling to use the CPAP then next in line is the mandibular advancement device (MAD). It is a strong, durable custom built dental appliance that covers both the upper and lower teeth and is connected by some type of hinge either in the front or on the side. It functions by gently moving the mandible (lower jaw) forward while you sleep. By mechanically moving and supporting the jaw the MAD stabilizes all of the soft tissue as well, mainly the tongue and soft palate. This movement prevents collapse in the airway thereby treating snoring and sleep apnea.
Mandibular advancement devices are considered appropriate first-line therapy for the treatment of mild to moderate cases of obstructive sleep apnea by the American Academy of Sleep Medicine. They have a more than 30-year track record of success. They are also appropriate for the treatment of severe sleep apnea if the patient is intolerant of CPAP. Because a CPAP works by forcing air through a mask into the airway often patients struggle to wear the machine comfortably all night. In instances where patients are not well managed with a CPAP a dental device comes in to save the day.
The CPAP machine has historically had lower rates of treatment adherence, around 50%, compared to the mandibular advancement device, which people can tolerate upwards of 90% of the time due to its more compact and portable design. MAD allow more freedom to move during sleep which people appreciate. Now it is important to note when looking at treatment success CPAP works nearly 100% of the time while MADs are effective about 70% of the time. When comparing all factors it is generally believed that both therapies provide similar outcomes to overall health and quality of life improvement when looking at the combination of both treatment adherence and efficacy.
First your medical provider must diagnose and make a recommendation for treatment using either a CPAP or MAD.
Dental appliances must be fabricated and managed by a qualified dentist trained in sleep apnea management. Some factors that may impact the success of an appliance include:
- Your obstructive sleep apnea’s severity
- Your upper airway’s skeletal system
- Body weight and neck circumference
- Dental and gum health
- Any additional medical conditions you may have
- Your personal preference
If you are interested in learning more about a mandibular advancement device in Castle Rock or Denver, Colorado, we would be happy to schedule an appointment for you at Refresh Snoring and Sleep Apnea Center to see if it is the right treatment option for you or a loved one who has obstructive sleep apnea.