MAD Sleep Apnea Treatment

MAD (Mandibular advancement device)

A potential treatment for snoring or sleep apnea (OSA) is to wear a Mandibular Advancement Device. An MAD, also known as a snore guard, is a customised mouth guard that pushes your lower jaw forward slightly. Wearing it at night creates more space behind the tongue, which allows breathing without vibration. Reimbursement of costs for a MAD can be requested on the advice of an ENT specialist, pulmonologist or neurologist. This is only possible for individual MADs that are manufactured from dental imprints at dental laboratories.

  • A simple solution for snoring and sleep apnoea
  • A good night’s sleep for you and your partner
  • Your health insurer often covers costs
  • NVTS-accredited MAD specialist

What is sleep apnea?

Apnoea is derived from the Greek word ‘apnea’, meaning ‘without breath. This is literally what happens to clients who suffer from sleep apnea. The breath falters during sleep, which sometimes causes clients to stop breathing for a few seconds or even full minutes. These pauses in breathing can happen several times an hour.

What are the risks of snoring and sleep apnea?

Snoring is primarily perceived as bothersome. However, sleep apnea also has a considerable effect on your health. Sleep apnoea can lead to chronic sleep disorders, fatigue, headache and high blood pressure, amongst other things. In addition, obesity and diabetes often occur in combination with sleep apnea.

Take the sleep apnea test

High risk of OSA: 3 or more points.
Low risk of OSA: fewer than 3 points.

  1. 1. Do you snore loudly?
  2. 2. Do you often feel tired, fatigued, or sleepy during the day?
  3. 3. Has anyone noticed that you stop breathing during the night?
  4. 4. Are you being (or have you ever been) treated for high blood pressure?
  5. 5. Is your BMI (Body Mass Index) above 35?
  6. 6. Are you over the age of 50 years?
  7. 7. Is the circumference of your neck (collar size) above 40?
  8. 8. Are you male?

Schedule a consultation with our MAD dentist if you scored 3 or more points on the abovementioned questions. Our MAD dentist will arrange a referral to an ENT specialist for a sleep study.

The treatment process

Initial appointment. An oral examination takes place at the initial appointment, including X-rays and illuminated photographs. You discuss the reason for the referral and the sleep study results with the MAD specialist. If the condition of your teeth allows, imprints of your upper and lower jaws are made, and your bite is registered. This information is eventually used to manufacture the snore guard in the dental laboratory.

Fitting. The dental technician needs 3-4 weeks to manufacture the MAD. We then schedule a short appointment of around 20 minutes to fit the mouth guard. In addition, the MAD specialist gives you advice regarding any symptoms and instructions for maintenance.

Check-up. One week after having the MAD device fitted, you return for a check-up to evaluate the mouth guard’s effect and make any adjustments. You subsequently return for annual MAD check-ups.

Types of snore guards

  • Adjustable snore guard
  • Non-adjustable snore guard

The type of snore guard that suits you depends on your general health and dental status.

Costs and reimbursement by your health insurer

The costs for all dental treatment are determined nationally by the Dutch Healthcare Authority on behalf of the government.

For full reimbursement of the cost of a MAD, it is important that your specialist is accredited by the NVTS or EADMS. You must submit a request to your health insurer before receiving the mouth guard. You also need a referral from an ENT specialist, pulmonologist or neurologist, as well as the results of the sleep study. Below is a summary of the procedures and costs involved in getting a MAD. Your MAD specialist will give you a personalised cost estimate at your initial appointment.

*There may be additional technical /material costs for these procedures.

Frequently asked questions

What is the best way to keep my snore guard clean? This depends on the kind of MAD. All kinds of mouthguards can be cleaned with Brite. It is very important that you do not use toothpaste. It contains a substance that is bad for your mouth guard.

I have dentures. Do I qualify for a snore guard? No, unfortunately, dentures offer insufficient anchorage. A MAD can only be worn if you have your own teeth or dental implants. You then qualify for OSA and receive a referral to an OMS surgeon for further treatment.

Does the snore guard come with a guarantee? Only the MAD has a 5-year guarantee. A snore guard comes with a 2-year guarantee. Exceptions to this are breakage caused by grinding, dropping, or bending. The guarantee on the MAD is also invalidated if the mouth guard no longer fits because of a change to your teeth or alterations made by third parties.

Could treatment with MAD cause complications? Wearing the MAD can cause a tendency to retch. This varies greatly from one person to another and is often temporary in nature. You may also suffer from excessive salivation, sensitive muscles and/or mandibular joints and temporary changes to your teeth. These complaints usually disappear an hour after removing the mouthguard.