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The main purpose for the Mandibular Advancing Devices (MAD) is to treat Obstructive Sleep Apnea (OSA), snoring and other sleeping dysfunctions affecting proper breathing during sleep. It was created to reduce sleep apnea frequency & duration of apnea, Hypopnoea and simple snoring. It was demonstrated oral devices can significantly improve oxygenation of patients’ blood using a mandibular advancing device, thus improving overall health, including social implications and noise from  snoring.

MAD is recommended for patients suffering from mild to moderate apnea  and /or simple snoring. It is also recommended to patients with severe apnea who don’t respond well or can’t tolerate the Continuous Positive Pressure device (CPAP). MAD can be used alone to treat apnea or in combination with CPAP, or with other treatment methods for a better control of the condition.  MAD works by repositioning and stabilising the tongue and  lower jaw forward allowing for a better airflow to reach the upper air passages during sleep.

The mandibular advancing device (MAD) is a custom-made oral appliance produced with manual and /or electronic measurements of the patient’s oral structure. It’s made of a bio compatible composite material that is attached to the mandibular portion and the maxillary.  It works by moving gradually the lower jaw forward by only 1 mm at a time or less, permitting a reversal of the protrusion of the lower jaw if required. MAD has to be easily installed in the mouth and removed by the patient or health professional. An properly constructed oral device can withstand 3 to 5 years of normal use.

Please take notice: Dentists producing mandibular advancing devices (MAD) must have been trained in Sleep Medicine techniques and temporomandibular dysfunctions. Patients must have semi-annual follow-up appointments with dentists to ensure proper tension of oral device, oral health and maxillary articulations.

Furthermore, an evaluation of all follow-up appointments and the results of apnea condition following final adjustment of oral device will be produced to determine the efficiency of the MAD. The patient will then be informed to return to his physician or pneumologist .

The Canadian society of Thoracology recommends:

Snoring:

• First line of treatment = oral devices

Light and moderate Apnea:

• First line of treatment = oral devices
  First line of treatment = Continuous Positive Airflow Pressure (CPAP)

Severe Apnea:

• First line of treatment = Continuous Positive Airflow Pressure (CPAP)
  Second line of treatment = Oral devices together with continuous Positive Airflow Pressure (CPAP) or on its own in situations where the oral device isn’t well tolerated.

When severe obstructive apnea is diagnosed the Continuous Positive Pressure device (CPAP) can be used together with the mandibular advancing device (MAD) to allow for a reduced airflow produce by the (CPAP).  The oral device shifts the lower jaw forward which keeps the airway open, allowing for a continuous airflow sent from the CPAP device but at lower rate.