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The mandibular advancement device, or MAD, is one of the treatments for obstructive sleep apnea. Worn at night, it holds the lower jaw forward to allow air to pass through. It is prescribed by a sleep medicine specialist and custom-made in a laboratory. At the practice, Dr. Victor Zilioli, a dental surgeon, oversees the fitting and follow-up care.
The orthotic device consists of two thin aligners, one for the upper teeth and one for the lower teeth. They are custom-made based on impressions of your teeth and connected to each other by connecting rods.
While you sleep, the connecting rods hold the lower jaw forward. This position helps open the airways and may help reduce apnea and snoring.
The orthosis is worn every night, throughout the entire sleep period.
The device is only recommended after a diagnosis of obstructive sleep apnea, made by a doctor based on a sleep study. The doctor prescribes it based on the severity of the apnea and your overall health:
The signs and diagnosis of sleep apnea are detailed on the Sleep Apnea page.
The oral appliance rests on the teeth. Before making it, the dentist performs a comprehensive oral examination: condition of the teeth and gums, ongoing dental treatments, dental prostheses, and jaw joints.
Missing teeth, gum disease, or certain jaw joint disorders may limit the ability to wear an orthotic device. The examination allows for an assessment of each individual case.
If dental treatment is needed—for example, to treat a cavity or gum disease—it is performed before the orthotic device is fitted. If the orthotic device is not an option in your case, the dentist will explain this to you and refer you back to your sleep specialist.
Your sleep doctor makes the diagnosis based on a sleep study and then writes a prescription for the orthotic device.
At the office, Dr. Zilioli will examine your teeth and gums, then take impressions of both your upper and lower dental arches.
A laboratory will custom-make the orthosis based on your impressions. Please allow about three weeks.
During the fitting, Dr. Zilioli adjusts the orthotic device to fit your mouth. He then adjusts the jaw’s forward position, striving to find the right balance between effectiveness and comfort.
Your sleep doctor will assess the effectiveness of the orthotic device by conducting another sleep study within three months. Follow-up care will then continue with him and at the clinic.
You may experience some discomfort: sensitivity in your teeth or gums, discomfort in your jaw joints, increased salivation, or a dry mouth. Please report these symptoms to the office; an adjustment to the orthotic device may then be considered.
Over time, the orthodontic appliance may cause the teeth to shift. This is one of the reasons for the checkup at the office every six months.
The orthosis is not a substitute for monitoring your sleep apnea. Your sleep doctor remains your primary point of contact for assessing its long-term effectiveness.
At the Claude Monet dental practice, Dr. Victor Zilioli, a dental surgeon, fits the mandibular advancement devices prescribed by your sleep specialist. During your first appointment, he will examine your teeth and gums and determine whether the device is a suitable option for you. He explains how the appliance works and the steps involved, then takes impressions. You’ll receive a quote before the appliance is fabricated. During the fitting, he adjusts and fine-tunes the appliance with you to ensure both effectiveness and comfort. Follow-up care is then provided at the practice and in collaboration with your sleep doctor.
Yes. The orthosis is made based on a prescription from your sleep doctor, following your diagnosis. You will receive a quote before it is made; coverage depends on your circumstances and your supplemental health insurance plan.
These are two different treatments for sleep apnea. Your sleep doctor will choose one or the other based on the severity of your sleep apnea and your individual circumstances. A mouthguard may also be recommended if you cannot tolerate CPAP.
After the impressions are taken, the fabrication process takes about three weeks. If any dental work is needed beforehand—on a tooth or the gums—that is done first.
It depends on the number and condition of the teeth on which the orthodontic appliance rests. The evaluation performed at the office allows us to verify this before making any decisions.
Your sleep doctor will assess its effectiveness by conducting another sleep study within three months. Be sure to let them know how your snoring and daytime fatigue have changed.
Has your sleep doctor prescribed a mandibular advancement device? Dr. Victor Zilioli will see you at his office in Croissy-sur-Seine to assess your teeth and work with you to prepare your device. Schedule an appointment online or by phone at 01 30 53 13 68.
