Do you or a loved one suffer from obstructive sleep apnea (OSA)? If so, your dentist may have recommended a mandibular advancement device (MAD), an up and coming alternative to the CPAP machine. Now you might be wondering, “What exactly is a device like this and how does it work?” We’re happy to answer these questions for you today. Dr. Mandanas has been successfully treating OSA patients with oral devices for years and her passion is helping people find a solution that works for them. Enjoy learning from her expertise!
Are you ready to get MAD about sleep apnea? Schedule an appointment with Dr. Mandanas!
What Is a Mandibular Advancement Device and How Does It Work?
The mandibular advancement device (MAD) is an alternative treatment to the CPAP machine for obstructive sleep apnea (OSA). It is a sturdy, plastic, oral device that fits over the upper and lower teeth much like a mouthguard with a hinge in the middle. It works by gently advancing the lower jaw (mandible) forward during sleep. Because the lower jaw is attached to tongue behind the chin, the MAD advances this tissue as well, preventing it from collapsing over the airway (causing obstruction), thereby preventing OSA.
For many years, the mandibular advancement device has been proposed as an effective alternative to the CPAP machine for treating mild to moderate cases of obstructive sleep apnea, especially when the patient is considered a “CPAP reject.” A CPAP reject is someone who cannot tolerate the CPAP machine, which is very common. The continuous positive airway pressure (CPAP) machine works by forcing air through the patient’s airway to keep it open throughout the night. The air is administered from the machine to the patient by means of tubing and a mask. Both the mask and the forced air can be very uncomfortable, causing patients to remove the mask.
The mandibular advancement device is often preferred by the patient and is historically better for treatment adherence than the CPAP machine. That said, whether or not the MAD can treat severe cases of OSA is still under study. One of the latest scientific articles regarding these studies was published in January of 2018. The article confirmed the growing body of evidence that the MAD is an effective alternative to CPAP (in large part due to patient adherence) and typically preferred by patients when given a choice. From the article:
“There is now a strong body of evidence supporting their (oral appliances) use in OSAHS and clinical guidelines now recommend their use in mild OSAHS and in more severe cases when CPAP fails.”– Journal of Thoracic Disease
“It seems that the higher efficacy of CPAP is offset by greater MAD compliance.“– Journal of Thoracic Disease
The factors that determine whether or not a dentist will recommend the mandibular advancement device include:
- The severity of your obstructive sleep apnea
- The structure of your upper airway
- Any other medical issues you may have
- Your personal preference
If you think the mandibular advancement device might be right for you or your loved one who suffers from obstructive sleep apnea, we would love to get you in for an appointment with Dr. Mandanas. The MAD has helped many patients who are “CPAP rejects” sleep deeply through the night and wake up feeling fully refreshed with energy throughout the day! Dr. Mandanas has a strong understanding of what makes someone a good candidate for the MAD. Please schedule an appointment with our office today.