Snoring is a life-long issue, impacting not only the snorer, but also their partner, family, and colleagues. Along with the unpleasant sound that snoring causes, people that suffer from this sleep issue may also see effects related to their energy levels, health, lifestyle, and work productivity.
Mandibular Advancement Devices or MADs are a possible solution to help ease or cure these symptoms. Before trying any anti-snoring method, it is important to do your research. Take a look below to gain a solid understanding of the MAD and how it works.
Mandibular Advancement Device
The mandibular (also referred to as the mandible) is a jawbone and the mandibular advancement device aims to advance or move it forward. It is the most widely used device for sleep apnea and looks much like a mouth guard used in sports.
How Does It Work?
There are many reasons why people snore. Most of these reasons are connected to the partial obstruction of the airway to and from the lungs by the tongue or throat tissue.
An anti-snoring device like the mandibular advancement device helps to diminish any restriction that occurs in the back of the throat by moving the jaw and tongue forward. By advancing them, the jaw and tongue move away from the back of the throat. This increases the size of the upper airway, thus reducing the air resistance that leads to snoring.
Typically, MADs fit within the mouth and are molded to your teeth to provide a platform. This platform allows the upper jaw to act as a fixed frame, while the lower jaw is pushed forward. The best MADs provide a mechanism that advances the jaw incrementally until the ideal balance between the back of the tongue and the soft tissue of the throat is reached. Once this happens, snoring stops.
3 Types of Mandibular Advancement Devices
- Boil and Bite MADs: These can be bought from pharmacies and online. The fit is achieved by softening the resin or silicone with hot water, then once cooled slightly, placing it in the mouth and clamping down to get a good fit. Some of these devices now include the ability to adjust to the user
- Semi-Custom Devices: These require the user to take a custom mold of their teeth. The mold is then sent away to be custom fitted. If a device doesn’t fit properly, it can be sent back to be fixed.
- Custom Dental MADs: These MADs are based on physician referral and custom made by dentists or sleep specialists. They offer a perfect fit and the ability to be refined by experts.
Each of the three mandibular advancement devices above have a cost/benefit outcome. Costs range from $40 for an off-the-shelf product to $2000 for a custom, dentist-fitted solution. While price is not the sole determinant of performance, a general guideline to follow is that the more you invest, the better chance you have of getting good results. And of course, in order to work properly, you have to wear a MAD while you sleep.
FAQs – Frequently Asked Questions
Are There Any Side Effects From Using a MAD?
Because this anti-snoring device causes the jaw to move forward for extended periods of time and is braced by fitting to your teeth, some discomfort may be experienced. This discomfort should only happen initially, but for some, it is enough to end usage. Some symptoms include a sore/stiff jaw, toothache, and teeth moving out of alignment. In extreme cases, there can be painful wear of the joints.
Clinical testing of mandibular advancement device users has also identified hyper salivation, mouth dryness, tooth discomfort, and jaw joint tenderness. However, users reported these effects to be relatively minor in comparison with the benefit of stopped snoring.
Can a MAD Be Used With Dentures?
No, it cannot. Most mandibular advancement devices are anchored by fitting to your teeth and will not advance the jaw unless anchored. Denture users should consider a Tongue Stabilizing Device or TSD.
Which is Better, a Mandibular Advancement Device or a Tongue Stabilizing Device?
Whether a MAD, TSD, or other anti-snoring device is best for you is somewhat a matter of trial and error. We recommend that you consult with your doctor or physician for advice on the best solution for you. At the same time, your medical practitioner or specialist can check for other sleep disorder issues such as sleep apnea.
How Much Does a MAD Cost?
Prices for MADs range from $39 to $2000. The majority of off-the-shelf devices range from$75 to $150. Custom devices are the most expensive, ranging from $1500 to $2000.
How Long Does a MAD Last?
Naturally, the frequency of usage and regular cleaning will have an impact on how long a mandibular advancement device will last. However, you should expect a minimum of six months and up to two years of effective life. Typically, you would renew your off-the-shelf MAD every year and custom MADs every three years.
Does Health Insurance Cover MADs?
Most medical insurance companies have policies that provide coverage for medical sleep devices. However, whether you will be covered will depend on the type of policy and depth of coverage. Please consult with your health insurance provider for an up-to-date opinion on the inclusion of MADs.
Do I Need to Get a MAD Professionally Fitted?
Fitting varies with the customization factor. Normally, an off-the-shelf MAD or one that is bought online, is a relatively straightforward device. Simply place the device in hot water, allow it to cool, place it in your mouth, and let the silicone mold to your mouth. Once fitted to your mouth, most MADs offer incremental adjustments.
Custom MADs are generally fitted by professional sleep doctors or dentists and have a comfortable fit that can also be incrementally adjusted.
Are MADs Adjustable?
The more modern and contemporary pharmacy or online-sourced solutions can include a basic adjustment. The very best mandibular advancement devices offer increments of 1.0mm or 1/16 of an inch. Custom fitted MADs also include micro-adjustment options.
Are MADs Painful to Wear?
Not usually. There may be some discomfort from having the device in your mouth, but experiencing pain would be highly unusual. If you experience pain in any way, you should stop wearing the device. It can take a week or so to get completely comfortable with the jaw being held forward with a MAD.
How Do I Keep My MAD Clean?
Placing your MAD in hot water should minimize any build up of bacteria or germs. Regular brushing with toothpaste or soaking in mouthwash will keep your mandibular advancement device fresh as well.
What If Snoring Persists?
Sadly, there is no guarantee that mandibular advancement devices will resolve your snoring problem. MADs don’t work for everyone, particularly if the snoring is in tandem with other health issues, but they do provide improvement for most users. Correct fitting is essential, as is ensuring the device is not damaged or worn out. A change or increase in weight and alcohol consumption can also have an impact on your snoring. If your MAD does not help you stop snoring, it is time to consider escalating to the next level of anti-snoring options. Here are a few of them.
- TSD’s – Tongue Stabilizing Devices
- Dental Appliances
- Positive Airway Pressure – CPAP Machines
- Bidirectional Positive Airway Pressure – BiPAP Machines
A mandibular advancement device can often be a good next step to help you or your partner stop snoring. They are relatively economical and because most can be adjusted, they can suit a wide range of snorers. If you’re thinking of purchasing this anti-snoring device, keep in mind that sleep physicians often recommend a sleep test prior to determining whether a mandibular advancement device is the best solution. For those that know this solution is best for their personal needs, take a look at our recommended list of anti-snoring devices that includes the MADs we have reviewed.