Snoring and obstructive sleep apnea affect millions of people. Among the recognized treatments, the mandibular advancement device (MAD) has become the reference alternative to the CPAP machine. Here is everything you need to know before getting started: how it works, effectiveness, price, reimbursement and precautions.
What is a mandibular advancement device?
A mandibular advancement device (MAD) is a medical device made of two trays that fit over the upper and lower teeth. Connected to each other, they hold the lower jaw (mandible) in a slightly advanced position during sleep.
This forward shift of a few millimetres tightens the tissues of the pharynx and opens the upper airway. As a result, air flows freely, the vibrations that cause snoring decrease and apnea episodes become less frequent.
Who is it for?
A mandibular advancement device is indicated in three main situations: simple snoring, mild to moderate obstructive sleep apnea, and severe apnea as a second-line treatment when the patient cannot tolerate CPAP. Your sleep doctor or dentist confirms the indication after a sleep assessment.
It requires sufficient teeth for anchorage, and it is not recommended in case of unstabilized temporomandibular joint disorders.
Does it really work?
Yes, for the indications listed above. Clinical studies show that MADs significantly reduce the apnea-hypopnea index and snoring intensity in most patients. They are recommended by sleep medicine societies as an alternative to CPAP.
The BluePro® device, designed by sleep specialists, has been documented in 4 clinical studies covering the management of snoring and obstructive sleep apnea syndrome. See our publications.
Effectiveness depends on the adjustment: the advancement is set gradually, ideally under the supervision of a healthcare professional, until the position is both effective and comfortable.
How much does a mandibular advancement device cost?
Three main categories exist, at very different prices:
Over-the-counter mouthguards (€30 to €70). Self-fitted, often bulky, with a limited lifespan. A possible first try, but an unreliable fit.
Thermoformed devices fitted by a professional (€100 to €200). This is the category of the BluePro® device (€125): the practitioner takes a direct imprint of your teeth in a few minutes, with no dental laboratory involved. The most balanced effectiveness/price ratio.
Custom-made laboratory devices (from €459, excluding fitting fees). Made from impressions in a dental laboratory, on prescription, over several appointments — more than three times the price of a thermoformed device like BluePro® (€125), for the same principle of action.
Is the device reimbursed?
In France, coverage by the public health insurance exists for the treatment of diagnosed sleep apnea, on medical prescription and under certain conditions (severity of the syndrome, CPAP intolerance in particular). Devices bought over the counter for simple snoring are not reimbursed. Some private insurers offer an allowance: check with your practitioner and your insurer.
What are the side effects?
Side effects are usually mild and temporary: excessive salivation or dry mouth during the first nights, tooth sensitivity or jaw tension in the morning. They generally disappear as you adapt.
In the long term, slight tooth movements are possible: regular follow-up with your dentist is recommended. If jaw joint pain persists, consult your practitioner to adjust the setting.
Oral appliance or CPAP machine: which one to choose?
CPAP remains the reference treatment for severe apnea. But it is demanding: a mask, noise, dependence on a machine. The oral appliance is silent, fits in a pocket and needs no electricity — decisive advantages for travellers and for patients who give up on CPAP. For mild to moderate forms, the MAD offers comparable effectiveness with often better adherence: a treatment you stick to is better than a treatment you abandon.
How do I care for my device?
Rinse with cold water and brush gently every day. Avoid hot water, which can deform the material, and store the device in its ventilated box. A well-maintained device is replaced on average every 12 to 24 months depending on the model.
Key takeaways
The mandibular advancement device is an effective, discreet and recognized treatment for snoring and mild to moderate sleep apnea. For a reliable fit without the price of custom-made devices, a thermoformable device fitted by a healthcare professional is the best compromise.
The BluePro® device is thermoformable, CE marked, documented in 4 clinical studies and fitted in a few minutes by your dentist or sleep doctor. Discover the BluePro® device.