How mandibular advancement works
The lower jaw is the mandible, and advancement means bringing it forward. Two trays fit over your upper and lower teeth and connect so the lower one sits ahead of where it would otherwise rest. The tongue is anchored to the mandible, so moving the jaw takes the tongue with it and opens space behind it.
The trays are made from an impression or a scan of your own teeth, so they seat precisely and stay put. How far forward the jaw sits is adjustable, and that is what we tune. Too little does nothing, and too much makes your jaw ache for no gain. An appliance also has to hold on to something, so enough sound teeth, healthy gums and a joint that tolerates the position are all requirements. That is why the first visit is an examination.
What the process involves
From the first appointment to a confirmed result usually takes a few months, most of it adjustment rather than chair time.
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Examination and records
We check the teeth, gums, joint and how far you open, then take impressions or a scan of both arches. Crowns, bridges and loose teeth all matter.
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Fitting the appliance
The lab returns a device made for your mouth. We check that it seats without rocking, does not press on gum tissue, and lets you open and close.
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Titration over several weeks
You advance the jaw a fraction of a millimeter at a time, with days between changes so the muscles adapt. Rushing gets you a sore jaw and an appliance you stop wearing. We want the smallest advancement that works.
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A follow-up sleep test
Feeling better is encouraging and it is not evidence. Your physician arranges a repeat study with the appliance in place, to confirm the breathing events have come down.
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Ongoing checks
We see you periodically to inspect the appliance, confirm the fit and track your bite.
Side effects, the early ones and the one that lasts
Most people adapt within a few weeks. Several things are common early and settle. One matters for as long as you wear it.
- Morning jaw soreness. Normal in the first weeks and after each advancement, and it usually eases within an hour of taking it out.
- Tooth tenderness. Individual teeth can feel bruised early on. Tell us which ones, because it can mean the fit needs adjusting.
- Extra saliva, or a dry mouth. Both happen, sometimes to the same person on different nights, and both usually fade.
- Clicking or tightness in the joint. Report it instead of pushing through it. If it persists, see TMJ and jaw pain.
- Bite changes over years. Holding the jaw forward for eight hours a night, year after year, can gradually change how your teeth meet: front teeth touching less, back teeth touching more, none of it felt as it happens. Regular checks catch it early, which is why follow-up appointments are not optional.
Cleaning, care and lifespan
- Every morning
- Brush it with a soft brush and cool water. Skip toothpaste, which is abrasive enough to scratch the surface. Let it dry, then keep it in its vented case, away from hot cars and from dogs.
- Weekly
- Soak it in a cleaner made for dental appliances. No hot water, no dishwasher, no boiling and no bleach, all of which warp the material.
- How long it lasts
- Several years of normal use is typical, and heavy grinders wear through them faster. Cracks or a loose fit mean bring it in.
- When your teeth change
- A new crown, an extraction or a filling that alters a tooth can stop an appliance seating. Tell whoever does that work that you wear one.
Oral appliance questions
Will it stop my snoring?
It reduces or stops snoring for many people, and that is not the point. Snoring is the noise, apnea is the harm. The follow-up study tells you which one you fixed.
Can I wear one if I have crowns, bridges or missing teeth?
It depends what is left to hold on to. Several missing teeth or extensive bridgework may mean other work first, and a full upper denture usually rules it out. Teeth loosened by untreated gum disease are treated first.
Does it hurt to sleep with?
It feels bulky for a week or two and most people stop noticing. Morning ache is common early and after each adjustment. Pain that does not settle means coming in.
Do I have to wear it every night?
Yes. The airway collapses on the nights you skip, and consistent wear keeps the bite settled. It travels in a pocket, which is one reason people who hated hauling a machine stay with it.