Mandibular Advancement Splints (MAS): Could a Dental Sleep Appliance Help You Sleep Better?

Snoring, restless sleep and waking feeling unrefreshed can sometimes be more than just an inconvenience. They may be signs that your breathing is being disrupted while you sleep.

For some adults, a Mandibular Advancement Splint (MAS) may form part of the management of snoring or Obstructive Sleep Apnoea (OSA).

But what exactly is a MAS, how does it work, and who may benefit from one?

At Sparkle Dental Joondalup, we take a comprehensive approach to dental health, looking beyond the teeth alone and considering how the jaws, oral structures and airway can influence breathing and sleep.

What is a Mandibular Advancement Splint?

A Mandibular Advancement Splint, commonly called a MAS, is a custom-made oral appliance worn while you sleep.

It looks a little like a mouthguard, but its purpose and design are very different.

A MAS is designed to gently hold the lower jaw in a more forward position during sleep. Moving the lower jaw forward can also help bring the tongue and surrounding soft tissues forward, which may help maintain space within the upper airway.

For suitable patients, this can help reduce airway obstruction during sleep.

What can a MAS be used for?

Mandibular Advancement Splints may be considered for adults experiencing:

Primary snoring
Mild to moderate Obstructive Sleep Apnoea
Difficulty tolerating CPAP therapy
A preference for an oral appliance where clinically appropriate
A need for an alternative treatment option following assessment by their medical and dental care providers

It is important to remember that snoring does not always mean you have sleep apnoea, and not everyone who snores will be suitable for a MAS.

Likewise, sleep apnoea is a medical condition and should be appropriately investigated and diagnosed.

What is Obstructive Sleep Apnoea?

Obstructive Sleep Apnoea occurs when the upper airway repeatedly becomes partially or completely blocked during sleep.

These interruptions can reduce airflow and cause the body to repeatedly move out of deeper stages of sleep in order to restore breathing.

Some signs that may warrant further investigation include:

Loud or persistent snoring
Witnessed pauses in breathing during sleep
Gasping or choking during sleep
Waking with a dry mouth
Morning headaches
Feeling tired despite spending enough time in bed
Daytime sleepiness
Difficulty concentrating
Restless or disrupted sleep

Because these symptoms can have many different causes, a proper assessment is important rather than assuming snoring alone is the problem.

How does a MAS work?

When we sleep, the muscles of the tongue and throat naturally relax. In some people, this contributes to narrowing of the airway.

A MAS holds the lower jaw slightly forward while you sleep. This forward position may help reduce the tendency for the tongue and surrounding tissues to fall backwards and compromise the airway.

Importantly, the appliance needs to be customised to the individual.

The amount of advancement required can vary considerably from person to person. The goal is not simply to move the jaw as far forward as possible, but to find a position that provides an appropriate balance between airway benefit, comfort and jaw health.

MAS vs CPAP: What’s the difference?

CPAP, or Continuous Positive Airway Pressure, uses gentle air pressure delivered through a mask to help keep the airway open during sleep. It is a well-established treatment for Obstructive Sleep Apnoea and may be particularly important for people with more severe disease.

A MAS works differently. Instead of using air pressure, it mechanically changes the position of the lower jaw.

Some patients find an oral appliance easier to incorporate into their lifestyle because it is small, portable and does not require a machine or electricity.

However, a MAS is not automatically a replacement for CPAP. The most appropriate treatment depends on your diagnosis, the severity of your sleep apnoea, your anatomy, your general health and other individual factors.

Why shouldn’t I just buy a snoring mouthguard online?

There are many over-the-counter products marketed for snoring, but a professionally prescribed MAS is different.

Before recommending an appliance, your dentist needs to assess factors including your:

Teeth and existing dental work
Gum and periodontal health
Jaw joints
Bite
Jaw movement
Oral anatomy
Relevant dental and medical history

A custom appliance is then designed specifically for your mouth and requires ongoing review.

This is particularly important because advancing the lower jaw places forces on the teeth, muscles and jaw joints.

Are there side effects?

Like any treatment, MAS therapy has potential side effects.

Some people may initially experience increased saliva, dry mouth, tooth tenderness, muscle discomfort or jaw joint symptoms.

Over longer periods, changes to the position of the teeth or bite can also occur in some patients.

This is one of the reasons why regular dental monitoring is an important part of MAS therapy. We want to ensure the appliance continues to fit appropriately while monitoring your teeth, gums, jaw joints and bite.

What does the process involve?

Your journey will depend on your individual circumstances, but it may include:

Assessment
We begin by looking at your dental health, bite, jaw joints and oral structures and discussing your sleep and breathing concerns.
If your symptoms suggest possible Obstructive Sleep Apnoea that has not yet been investigated, further medical or sleep assessment may be recommended.
Digital records
If a MAS is appropriate, detailed records of your teeth and bite can be taken to help create a custom appliance.
Appliance fitting
Once your MAS is ready, we check its fit and show you how to insert, remove and care for it.
Gradual adjustment
The lower jaw position can often be adjusted progressively. This process helps us work towards an effective position while keeping comfort and jaw health in mind.
Review and monitoring
Follow-up is important.

We review how you are adapting to the appliance and monitor your teeth, bite and jaw joints. Where a MAS is being used to manage diagnosed Obstructive Sleep Apnoea, appropriate follow-up sleep assessment may also be recommended to determine whether treatment is adequately controlling the condition.

Is a MAS right for me?

There is no single treatment that is right for every person who snores or has sleep apnoea.

The first step is understanding why your breathing is being disrupted and whether an oral appliance is appropriate for your individual situation.

At Sparkle Dental Joondalup, we believe in looking at the whole picture. Our approach considers your teeth and gums, jaw position, oral structures, breathing and sleep concerns alongside any medical assessment that may be required.

For the right patient, a custom Mandibular Advancement Splint can be a practical part of a broader approach to improving breathing during sleep.

Concerned about snoring or your sleep?

If you are regularly snoring, waking unrefreshed or have already been diagnosed with Obstructive Sleep Apnoea and would like to explore whether a dental sleep appliance may be appropriate for you, our team would be happy to discuss your options.

Contact Sparkle Dental Joondalup to arrange an assessment and find out whether a Mandibular Advancement Splint could form part of your care.

The information provided in this article is general in nature and is not a substitute for individual medical or dental advice. Obstructive Sleep Apnoea is a medical condition and requires appropriate diagnosis and management. Suitability for a Mandibular Advancement Splint varies between individuals.