If you have been recommended a Mandibular Advancement Splint by a sleep physician or your GP then please contact the team to discuss having a device constructed.
After a thorough examination of your mouth to ensure your suitability a splint can be custom fitted to help reduce snoring, or help manage sleep apnoea.
MADs are worn in the mouth during sleep to hold the mandible and tongue forward and therefore maintain upper airway patency. The device fits over the upper and lower teeth and creates forward placement of the lower jaw by approximately 8–10 mm (so the lower teeth end up in front of the upper teeth). Ideally, patients should have a follow-up sleep study to see if the device is working.
Tips & Challenges
IMADs have potential advantages over CPAP (the current first-line therapy for OSA). They are less obtrusive and more portable; they make no noise, are not reliant on a power source, and are often more acceptable to patients and families. However, they are not effective for every patient.
Patient acceptance of MADs is generally high. However, physiological, structural, and individual patient characteristics influence response to MAD therapy. Factors associated with better treatment outcomes include:
- lower OSA severity (i.e. mild to moderate)
- female gender
- younger age
- OSA is less pronounced when the patient sleeps on their side
- a face shape with a slightly receding jaw (retrognathic mandible).
Factors associated with poorer efficacy of MADs include:
- older age • obesity and greater neck circumference
- increased nasal resistance
- a very stiff jaw (which impedes advancement)
- dental conditions (e.g. TMJ disease, periodontal disease, insufficient dentition to hold the device in the mouth). Assessment for suitability may require assessment by a sleep specialist (and include a sleep study) or a dentist.
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