Mandibular advancement devices hold the lower jaw forward during sleep to open the airway. They work best in mild to moderate obstructive sleep apnoea, and in patients who are not severely obese.
They need enough healthy teeth to anchor the device and a jaw that moves forward comfortably. Temporomandibular joint pain, active periodontal disease and few remaining teeth are relative contraindications. Side effects include jaw and tooth discomfort and, over years, changes in bite, so dental follow-up is part of treatment.
- Best suited to mild to moderate OSA.
- Check dentition and jaw movement before referral.
- Avoid in significant temporomandibular joint disease or advanced gum disease.
- Arrange dental review to monitor bite changes over time.
- Repeat a sleep study on the device to confirm benefit.
Why it matters
A device fitted to the wrong mouth fails as surely as an unused CPAP machine.
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