Division of Sleep Disorder Surgery

Oral Mandibular Advancement Devices for Obstructive Sleep Apnea

Oral Mandibular Advancement Devices are dental appliances used to treat patients with Obstructive Sleep Apnea (OSA) and Upper Airway Resistance Syndrome (UARS). They look similar to mouth guards used in sports. They may consist of upper and lower plates that are connected by adjustable hinges. One common device holds the tongue in a specific position to keep the airway as open as possible during sleep (called a Tongue Retaining Device, or TRD). Another increases the airway opening by forcing the lower jaw forward, and may be called a Mandibular Repositioning Device (MRD).

Efficacy of Oral Mandibular Advancement Devices

Studies indicate that oral mandibular advancement devices are more effective than surgery for normalizing sleep. They are most effective for patients with mild to moderate obstructive sleep apnea, and less effective for severe apnea. They work only when the source of obstruction is in the middle of the upper airway, however; if the obstruction occurs high or very low in the upper airway, oral devices will not be effective. While mandibular advancement devices improve sleep and reduce snoring, it is not yet clear if they help patients whose apnea is silent (without snoring). Patients tend to find oral devices easier to comply with than CPAP, and thus they are more likely to continue their use and derive benefit from mandibular advancement devices.

Adverse effects are minimal, and may include pain in the jaw.

 

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