Mandibular Advancement Devices

Mandibular Advancement Devices (also known as MADs for short) are one of the most popular and widely recognized types of anti-snoring devices.

MADs basically look like a mouthguard that you place in your mouth and use whenever you are sleeping. They really don’t look all that different from the type of mouthguard a football player or boxer would wear… but the truth is that there are actually a lot of differences.

Contrary to popular belief, you cannot just go to the sporting-goods store and buy a mouth guard to help you with your snoring. Mandibular advancement devices are specially designed for this purpose, and function a lot differently from a regular mouthguard.

Some MADs are adjustable, and many can be fitted at home using boil-and-bite technology. There are a few kinds that require a prescription to purchase and use… and a few that you need to go to the dentist to get fitted for if you want to use them.

How Are MADs Meant To Work?

MADs are meant to work by keeping the lower jaw slightly pulled forward during sleep. They accomplish this through their construction… or through a mechanism that keeps the lower part of the mouth guard advanced forward more than the top part.

How MADs work

Most snoring is caused by soft palate vibration in the airway. When you lay down and sleep, your muscles relax… and the soft tissues of your airway can collapse in and restrict the airflow. When this happens, the air that does go through results in vibration in the soft tissue… and this is what causes snoring.

But by keeping the lower jaw pulled forward, you can actually prevent this in a lot of cases… because this tightens the tissue and opens up the airway to allow for better breathing and less restriction.

Some MADs are adjustable, which allows you to customize the amount of advancement on the lower mouth piece. These tend to be a bit more expensive than regular types… but the concept is still the same.

Do We Believe That This Type Of Product Works?

Mandibular Advancement Devices are actually one of the best-documented types of anti-snoring devices, and have a fairly proven track record for treating not only snoring… but sometimes sleep apnea (depending on the specific device in question).

Obviously, different devices will give you different chances for success, as some are simply better than others. Some have also been clinically tested, while others have not. You actually have to be a little bit careful, in fact, when you buy devices like this… as some companies will make big claims about their product based on clinical trials performed on other products.

But… as a general rule, we do like these types of devices. They do have their downsides, but they do a pretty practical job of treating the root causes of snoring, and are one of the better types of devices on the market.

The Positives

Here is a list of the positives as they pertain to MADs…

  • They are relatively inexpensive
  • They do a pretty good job of treating the root causes of snoring
  • They have very few side effects
  • There have been quite a few clinical trials performed on these types of products

The Negatives

Here is a list of some of the downsides…

  • They are a little bit invasive since you have to have them in your mouth all night in order for them to work
  • If they break, you will have to buy another to replace it
  • It can take quite a bit of time to get used to them
  • Some people cannot use them (your teeth have to be in good condition, and there are a few other different conditions)

Who Should Use This Product, And When?

If you are 18 years of age or over, have healthy teeth, and don’t mind keeping a mouthguard in your mouth as you sleep, then a Mandibular Advancement Device may be for you.

As for when you should use it, you will need to use it all night, every night, in order for it to be effective. This is not a treatment that works when the mouthpiece is absent. So if you lose it or break it, you will need to replace it to continue to experience the benefits of its use.

Who Should Avoid Using This Type Of Product?

If you have problems with your teeth, these devices are probably not for you. You should also avoid using these types of devices if you suffer from sleep apnea, unless you can find one that is cleared for use to treat sleep apnea.

These devices are also not intended for individuals under the age of 18.

Top Scientific Studies on Mandibular Advancement Devices

There have actually been several studies performed on different types of MADs. Not every brand of MAD has been clinically tested, but there have been a number of studies done on the devices across the board… and we always take an interest in the science behind particular products when we write about them on the site.

The objective, of course, is to help our readers by delivering viable, useful information. And one of the best sources of information for anti-snoring products comes from clinical studies.

One study, titled ‘An update on mandibular advancement devices for the treatment of obstructive sleep apnoea hypopnoea syndrome,’ talks about how MADs are, for all intents and purposes, just as effective as CPAP therapy in most cases where mild to moderate OSA requires treatment. There is a lot to this study and we would recommend reading through it if it interests you—but the main takeaway is that CPAP is great at treating OSA, though it comes at a cost. There can be compliance issues… which basically means that people can have a tough time ‘sticking with’ their CPAP therapy.

MADs, on the other hand, often rate better on the compliance-end of the spectrum. This makes them virtually as effective as CPAP for treating OSA, though for slightly different reasons.

Another study, conducted back in 2015, followed 38 patients through a randomized, placebo-controlled, double blinded, crossover clinical trial on the effectiveness of MADs. This study was called ‘Efficacy of mandibular advancement device in the treatment of obstructive sleep apnea syndrome: A randomized controlled crossover clinical trial.’

Basically, this study ended up concluding that MAD could be an efficient treatment for both mild-to-moderate Obstructive Sleep Apnea and Roncopathy (chronic snoring).

And finally, in an older study (but a study that we still see as viable and relevant), titled ‘Non-CPAP therapies in obstructive sleep apnoea: mandibular advancement device therapy,’ which was published in the European Respiratory Journal in 2012, we find evidence for the fact that patients with moderate sleep Apnea are actually more likely to experience success when being treated with an MAD. We also find that MADs are a recommended treatment for patients with mild to moderate OSA, especially among those who do not tolerate CPAP treatment very well.

What Do You Need to Know Before Shopping for an MAD?

If you are thinking about trying an MAD for yourself, then there are more than a few things to think about. First of all, keep in mind that there are dozens of different devices on the market. We talk about some of our favorites here on the site, and even review some of them… but this is really just a starting point. Some people feel legitimately overwhelmed when they start to search for MADs online—but the reality is that you do not need to feel overwhelmed.

The first thing to keep in mind is that ordering something is going to be better than ordering nothing. If in doubt, just pick one and try it out. It might be a good idea to buy one that comes with a money-back guarantee to get started with, but that is not necessarily a big deal either if you are willing to take a risk on a product that could help you.

Secondly, a lot of people think that they need to buy the more expensive MADs to actually do it the ‘right way.’ You might feel like cheap mouthpieces are just gimmicks and imitations. But this is also a misconception. The simple truth of the matter is that MADs in all price ranges have the potential to help you.

Yes, MADs in higher price brackets might have better features or offer more value—but at the end of the day, the point is to help alleviate snoring problems. So a bit of experimentation is part of the process.

And third, a lot of people give up on MADs too quickly. We have heard countless stories of people who got discouraged because the device was uncomfortable the first night, only to end up deciding that MADs were just not going to work for them because of that one bad experience.

The truth is that MADs require some time and practice to use correctly. You also need to get used to them. Giving them a good week or two to really work for you is the best thing you can do. If you still can’t get it to work after two weeks, there is likely some kind of problem and that particular device may just not be the right device for you.

Note: An exception to this is if it causes you pain. A little soreness is one thing—but as a general rule, MADs should never cause you actual, legitimate pain. Never use a device that actually hurts you! That is certainly a bad sign!

There Are Rumors That MADs Are Gimmicks. Is This True?

There are more than a few rumors circulating online about how mandibular advancement devices are just gimmicks. Some people see them as cheap, non-medical-grade products, such as those you would expect to see in late-night TV commercials or on infomercials. And while there might be some lower-grade products out there, this is actually a broad misconception.

For one, MADs have not gotten a lot of ‘quality press’ since they first came on the scene in the mid-1980s. In other words, a lot of people have still not even heard about them… which is kind of surprising, but still true.

Secondly, many of these devices have not received much attention from a marketing standpoint. Since MADs have taken time to gain traction, it has also taken time for companies to catch-up on their marketing strategies. In the earlier days, MADs were advertised more like ‘serious medical devices,’ and this approach frightened some customers away. Nowadays, there are companies that are doing a better job of making them feel accessible to the average person—but there are still a surprising number of people who have simply never been properly informed about them.

Real Talk About Snoring

Let’s just take a minute to talk about snoring and sleep apnea. These two conditions are not necessarily always one-and-the-same… but far too many people suffer from snoring and/or OSA and never seek help for it.

Despite what people might believe, snoring is actually a very dangerous problem. It can lead to sleep deprivation for both the sleeper and their bed partner, which can further lead to a number of complicated health issues.

If snoring becomes bad enough that it leads to even mild OSA, then you can face an increased risk for…

  • High blood pressure
  • Enlargement of the heart
  • Heart attack
  • Stroke
  • Daytime drowsiness
  • Pulmonary hypertension
  • Chronic headaches
  • Obesity
  • And more

But the biggest problem of all is that people often just don’t take it seriously. Snoring is often thought of as a simple nuisance. It is not often thought of as a dangerous problem, but therein lies one of the most dangerous things about it. Through the use of devices like MADs, snoring and even mild to moderate OSA can actually be treated quite effectively.

But people are not usually as motivated to solve a problem that is not causing them immediate pain or misery. If you cut your hand, you are likely to go get stitches—because that seems like a big deal. There is blood, there is pain, and there is a physical cut that you can see with your eyes.

Snoring, on the other hand, tends to be rather invisible. But even when you are not thinking about it, it could still be putting you at an increased risk for all kinds of potential health risks.

Plus, not getting adequate sleep will keep you from living your best life and experiencing as much happiness as possible!

If you are a snorer, do not fall prey to the mentality that snoring is not a ‘real’ medical problem. It actually is—and there are ways to treat it. A visit to your doctor may not be a bad idea at all. But even if you don’t do that, you can still attempt to take methods into your own hands by finding a solution that actually works.

And MADs can actually work, depending on your specific situation.

MADs Are Not Miracle Products

As you saw in the upsides and downsides section of this page, MADs are not without their downsides. They are not perfect, and they do not help everyone. But the only way to know for sure if they are going to be a good fit for you is to give one a try.

There are plenty of affordable devices on the market. You don’t have to buy the most expensive one to give it a go. There are plenty of MADs that fall within an ‘affordable’ range that have awesome customer reviews.

Final Thoughts

If you are a snorer and want to try a device that is inexpensive, but proven to do a pretty good job, then

They do come with a few side effects. And as snoring remedies go, they are one of the more invasive types. Not everyone can get used to sleeping with an entire mouth guard in their mouth over the course of the night.

But… if you can overcome these obstacles, this is certainly one of our favorite types of anti-snoring products. Learn more about one particular MAD here.

Updated: 1.9.2019

Josh Sigafus Editor

Joshua Sigafus is just a writer trying to make the world a better place. You can find him on Facebook.