Sleep Apnea Oral Appliances
Oral Appliance Therapy (OAT) using a Mandibular Advancement Device (MAD) is a proven, non-invasive treatment for obstructive sleep apnea (OSA) and snoring.
These custom-made devices gently reposition the lower jaw forward during sleep, helping to keep the airway open and reduce breathing interruptions. At Advanced TMJ Maxillofacial Pain & Sleep Center, we offer medically guided, dentist-fabricated MADs tailored to your airway anatomy and dental health—especially ideal for patients who can’t tolerate CPAP or are seeking a more comfortable alternative.
What are mandibular advancement devices for Obstructive Sleep Apnea
Mandibular advancement device for sleep apnea
Mandibular Advancement Devices are custom-fabricated oral appliances designed to treat Obstructive Sleep Apnea (OSA) and primary snoring by mechanically advancing the lower jaw (mandible) forward during sleep. This forward positioning increases the upper airway space, particularly the oropharynx, preventing airway collapse.
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Mechanism of Action:
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By advancing the mandible, MADs also reposition the tongue and associated soft tissues anteriorly.
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This reduces dynamic airway obstruction and improves airflow.
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MADs also improve muscle tone of upper airway dilator muscles (e.g., genioglossus) via a reflex mechanism.
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Indications:
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Mild to moderate OSA (AHI 5–30)
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Severe OSA in CPAP-intolerant patients (as per sleep physician recommendation)
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Primary snoring
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Positional OSA
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Patients with concurrent TMJ dysfunction and OSA (requires careful design by orofacial pain-trained dentists)
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Clinical Evidence:
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Studies show MADs reduce AHI (apnea–hypopnea index) significantly in mild-to-moderate OSA.
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American Academy of Sleep Medicine (AASM) & American Academy of Dental Sleep Medicine (AADSM) recommend MADs as first-line therapy for mild to moderate OSA and for patients intolerant to CPAP.
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Systematic reviews have shown improvement in oxygen saturation, snoring, and subjective sleepiness (Epworth Sleepiness Scale scores) with MADs.
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Considerations:
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Must be custom fitted and titratable
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Long-term monitoring for bite changes and TMJ symptoms is essential
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Not ideal for patients with few or no teeth, severe bruxism, or advanced periodontal disease
