A mandibular repositioning device (MRD) is an oral appliance, often resembling a mouthguard, designed to be worn during sleep. This dental device gently shifts the lower jaw forward, aiming to maintain an open airway throughout the night to address sleep-related breathing issues.
Understanding Its Purpose
The primary conditions an MRD treats are primary snoring and obstructive sleep apnea (OSA). Snoring results from vibrations of relaxed throat tissues during sleep, while OSA involves repeated episodes of upper airway obstruction. These breathing interruptions can lead to fragmented sleep, daytime fatigue, and may contribute to serious health concerns like high blood pressure, stroke, and heart issues.
MRDs offer a non-invasive treatment option for these conditions, especially for mild to moderate OSA. They are also an alternative for those who find other treatments, such as Continuous Positive Airway Pressure (CPAP) machines, uncomfortable or difficult to tolerate. Oral appliance therapy can improve symptoms like daytime sleepiness and concentration difficulties, leading to more restful sleep.
How the Device Works
A mandibular repositioning device functions by physically altering the position of the lower jaw during sleep. The device gently holds the lower jaw in a slightly forward and sometimes downward position relative to the upper jaw. This repositioning, often consisting of two parts for the upper and lower teeth connected by hinges or screws, creates more space in the back of the throat.
By advancing the jaw, the MRD pulls the tongue and other soft tissues, like the soft palate, forward. This prevents these tissues from collapsing backward and obstructing the airway, a common cause of snoring and breathing pauses in obstructive sleep apnea. The widened airway allows for consistent, unobstructed airflow, reducing noisy vibrations and breathing interruptions during sleep.
Types and Fitting Process
Mandibular repositioning devices fall into two main categories: custom-made, prescription devices and over-the-counter (OTC) options. Custom-made MRDs are fabricated by a dental professional and offer a precise fit, providing incremental adjustability for optimal comfort and effectiveness. These appliances are made from materials like hard acrylic or soft elastomer.
Obtaining a custom-fitted device begins with a consultation with a dentist specializing in sleep therapy. Dental impressions are taken and sent to a lab to create the personalized appliance. Once ready, follow-up appointments are scheduled for fitting and adjustments to ensure comfort and proper function.
In contrast, OTC devices, often “boil-and-bite” models, are less expensive and molded at home. While offering some adaptation, they do not provide the same precise fit or adjustability as custom devices, which can lead to discomfort or reduced effectiveness.
Important Considerations for Users
Users can expect positive outcomes, including reduced snoring and improved sleep quality. For individuals with obstructive sleep apnea, the device can alleviate symptoms, leading to more restful sleep and feeling refreshed upon waking.
An adjustment period is common, and users may experience temporary side effects. These include jaw soreness, particularly upon waking, changes in bite, or increased salivation. These symptoms usually subside as the mouth and jaw adapt to the device, often within the first week or two of consistent use.
Less common long-term effects can include persistent changes in bite or tooth position, though these are mild and manageable with professional oversight. Regular follow-up appointments with a dental professional are recommended for monitoring effectiveness, making adjustments, and ensuring continued oral health. Cleaning the device involves daily brushing with a toothbrush and cool water, and occasional use of a denture or retainer cleaner.