Since the first decade of the twentieth century, orthododontists have been using devices to correct problems of the jaw. These function by positioning the lower jaw, or mandible. A number of patients fitted with such devices noticed an elimination of snoring.
Recently, orthodontists have designed specialized mandibular advancement anti snoring appliances, based on traditional orthodontic appliances, for the intention of managing snoring and mild sleep apnea.
Although the Continuous Positive Airway Pressure device (CPAP) is the gold standard for treatment of snoring due to sleep apnea, patients who suffer from snoring due to mild to moderate sleep apnea, aging, lack of muscle tone or other causes may find help in these oral devices.
Anti Snoring Appliances
Since snoring is related to contriction or obstruction of the upper airway, as well as soft tissues vibrating in the mouth/upper airway, the condition can be improved increasing the airway width and height and stretching the soft tissue more taut. Enter the orthodontic anti-snoring device.
Also known as a mandibular splint, the mandibular advancement device, (MAD), works by positioning the lower jaw and tongue forward approximately 5 millimeters. As the jaw is advanced, the tongue is brought forward, surrounding muscles and soft tissues are pulled forward, and the soft palate assumes a further forward position. Consequently, the airway is improved and kept open.
There are different types of snoring. If you are what is known as a Ã¢â‚¬Å“tongue base snorerÃ¢â‚¬Â, i.e., your tongue is dropping to the back of your throat causing an obstruction, a MAD may be effective for you. If you can make a snoring noise with your mouth both open and closed try this simple test: stick your tongue out as far as it will go and grip it with your teeth. Now try and make a snoring noise. If the snoring noise is reduced in this position then you are most likely a “tongue base snorer”, and should try an MAD anti-snoring orthodontics device. There may be some minor side effects, such as pain in the jaw, but many people use it with no problems.
There are three types available to choose from. The first is the least expensive. Known as Ã¢â‚¬Å“boil-and-biteÃ¢â‚¬Â splints, these are pre-formed devices made of thermoplastic which mold to the shape of your teeth after heating. They are placed in a pot of boiling water for 15-30 seconds, then you put them in your mouth and bite down on the softened plastic. After a short while you put them into a glass of cold water a few minutes so the impression sets.
A second type is the medium-priced custom-made MAD. These are made by an orthodontist taking impressions of the mouth and teeth, as well as a bite recording which places the bottom jaw as far forwards as comfortable for the patient. The splint is then custom-made and can be fitted a week or so later. These are far more comfortable than the bite and boil type.
If you really want to go all out for the maximum comfort, the third type is the adjustable custom-made splint. The primary benefit of this type is that the degree of advancement can be adjusted by the patient at any time to minimize any discomfort, thereby ensuring the device will be well tolerated.
Many studies have been done on Mandibular Advancement Devices to evaluate their effectiveness in snoring and sleep apnea patients. Most of these studies conclude that mandibular advancement devices do, in fact, reduce apneas and snoring and improves sleep quality in with obstructive sleep apnea, especially in patients with mild and moderate apneas. Below we list links to a few of these studies and their abstracts.
A thermoplastic mandibular advancement device for the management of non-apnoeic snoring: a randomized controlled trial M. E. Cooke and J. M. Battagel The European Journal of Orthodontics Abstract
Non-apneic snoring and the orthodontist: the effectiveness of mandibular advancement splints A. M. Smith and J. M. Battagel Journal of Orthodontics Abstract
Mandibular Advancement Devices in 630 Men and Women With Obstructive Sleep Apnea and Snoring: Tolerability and Predictors of Treatment Success M. Marklund, H. Stenlund, and K. A. Franklin Chest Abstract