Hi all,

Next week, I am seeing a dentist who is recommended by the British Society of Dental Sleep Medicine. I am hoping they can make me a mouthguard as I have been using CPAP for 9months now and the results have not been great. I recently saw a sleep specialist who advised a mouthguard may work for me since I have 'moderate' OSA (Pre-treatment AHI: 15).


I was wondering if anyone has any tips/tricks/questions I should ask the dentist before going ahead? I guess my concern is spending a lot of money for something that may not work. I want to make sure they have the best possible chance of success and that I find a dentist who actually does know how to make this work for sleep apnea.


Any info welcome!

The problem with this mandibular advancement device is that it can cause TMJ and causes further malocclusion. I am going through surgery instead(lower jaw advancement) with orthodontic treatment.

I was determined to have rest apnea and begun wearing the Herbst mandibular advancement gadget. At first it didn't encourage the wheezing and I couldn't quit slobbering from the gadget since I'm a mouth breather. After a few session with an ENT, I had nasal medical procedure to put in latera embeds in the nose to keep enhance my relaxing. My wheezing is relatively down to only I awaken at least at regular intervals am still extremely drained so not certain how to tell if the Herbst mandibular progression gadget is working.

You should do a follow up HST, OXY, or PSG while wearing the device, if you haven't already. Thats a pretty objective way to tell if it is working.

I'm on my second mandibular advancement device and can offer some thoughts based on my experiences.

The first one was fixed i.e. non adjustable. It did reduce my apneas by about 80%. The dentist was a specialist in TMJ and it additionally massively reduced my TMJ induced migraines and allows the TMJ muscles to relax. On the downside it totally destroyed by bite, I had 4 points of contact after using it for 6 months and my lower jaw had to do a dance back and forward whilst eating

I then switched to an adjustable one which aswell as bringing the lower jaw forward also slowly realigned the bite and is widening my jaw , I have increased in width by 6mm over 12 months and from the last 3D scan of my jaw and neck it has increased the airway by about 15%. Still another 6mm to go. Nice side effect is all my teeth are being straightened and spaced out at the same time. I also have control over the amount of lower jaw advancement

So questions to ask:
1: is the lower jaw advancement adjustable (either by you or dentist), this is very important
2: What will it do to your bite
3: What effect will it have on your TMJ's , specifically the gap and the muscles (they should be relaxed)
4: What is the long term benefit (some have none, some like mine have massive long term)
5: How long do you need to wear it each day if going for long term benefit