What is an Oral Appliance or MAD?

A Mandibular Advancement Splint is a small device, similar to an orthodontic retainer or a sports mouthguard that is worn over the tops of your teeth in the mouth when you sleep.  It is custom made to fit your mouth and is very discrete allowing you to close your mouth when wearing the device. You can open and close your mouth normally while wearing the appliance, and also eat and drink with the appliance in position.

How does an Oral Appliance or MAD work?

A Mandibular Advancement Splint gently and noninvasively adjusts the forward movement of your jaw, which in turn opens your airway to help you breathe easily and sleep restfully.

The appliance works by preventing the soft tissues at the back of the throat and the base of the tongue from collapsing back into the airway. These appliances take the lower jaw forward, bringing the tongue with it, thereby clearing the airway at the back of the throat.

How effective is an Oral Appliance or MAD?

There are recent studies that show oral appliances to be effective in treating mild to moderate Sleep Apnea.  We also know that there is a high level of compliance with patients using an MAD.

How do I get an Oral Appliance or MAD fitted?

At Sleep Centres of Australia, we have an experienced dentist who specialises in Dental Sleep Medicine to fit your device.  We receive referrals for oral appliance therapy for snoring and Sleep Apnea from specialist sleep physicians, GPs, ENT surgeons, and other specialist health professionals.

You can book an appointment with our sleep dentist by contacting us on 02 9252 6144. 

Your appliance will be custom made by the dentist to fit your teeth and mouth.  Adjustment mechanisms on the device allow you or your dentist to advance your lower jaw to the most effective and comfortable position.

What will the Dentist do?

During your initial appointment, the dentist will:

• Review the history of your sleep condition
• Complete a thorough examination of your teeth, mouth, head and neck
• Take dental impressions – models or casts of your teeth and mouth – that will be sent to the laboratory where the device will be custom made for you
• Take a bite registration to determine how far forward to move your jaw, whilst remaining comfortable for you

This appointment will take between approximately 45 minutes to complete.

Your complete Dental management at Sydney Sleep Centre will include:

- a choice of suitable oral appliances

- careful and sequential adjustment of the appliance over a few months

- several follow-up appointments as needed

- home sleep monitoring of your progress with a limited channel sleep study test if needed for optimal device titration *

- splint compliance monitoring using DentiTrac if needed *

- the Centre will organise a follow up sleep study to confirm full control of your sleep condition if needed *

Obstructive Sleep Apnoea can lead to serious health problems, and it is important that it be treated correctly. A thorough assessment and management approach as detailed above ensures this for you. This ability to comprehensively manage your oral appliance treatment is unique to Sydney Sleep Centre due to its multi-disciplinary and integrated nature.

* can be conveniently organised for the Centre's patients by the Sleep Dentist because of the Centre's unique multi-disciplinary Specialist care model. The ability of the Sleep Dentist and Sleep Physician to work together on your case in the one Centre to improve your outcomes is not available elsewhere.

Oral appliance therapy for sleep apnoea is completely non-invasive and pain free.

Which is the optimal Oral Appliance or MAD?

The most effective, comfortable types of appliances are those made from impressions and models of the patient’s own teeth. These customised appliances ensure a perfect fit and minimal dimensions.

There are a range of devices available, some of which are not custom-made or adjustable.   The “over the counter” and non prescription devices, available for sale over the internet and from some chemists, have not been proven to be effective and have potential for side effects such as teeth movement and jaw joint damage.

The customised and adjustable appliances that we use greatly enhance comfort, with clinical research backing its effectiveness.  They allow the dentist, and importantly the patient, to slowly bring the lower jaw forward to the ideal most comfortable position that opens the airway.

Sydney Sleep Centre's Sleep Dentist has a wide range of adjustable appliances from leading suppliers, enabling the Dentist to tailor the splint to your specific mouth/jaw shape and comfort needs.

Further Information

The following provide more information on the use of oral appliances for treating patients with Sleep Apnea: