Anti-Snoring Devices in the City of London: How a Mandibular Advancement Device Works
Snoring is easy to treat as a joke until it stops being one. Broken sleep, a partner in the spare room, and the particular fog of trying to hold your attention together through a full working day on five hours of poor-quality rest. For a lot of City professionals, that is the real cost.
What is less widely known is that one of the more effective treatments for snoring is fitted by a dentist, not bought from a chemist. It is called a mandibular advancement device, and this guide explains what it is, who it helps, and, importantly, when snoring needs a medical opinion before any device is considered at all.
What a mandibular advancement device is
A mandibular advancement device is a custom-made appliance worn in the mouth at night. It looks a little like a sports mouthguard in two parts, upper and lower, joined so that the lower jaw is held slightly forward of its resting position.
That small forward shift is the whole mechanism. By bringing the lower jaw forward, the device also brings the tongue and the soft tissues at the back of the throat forward with it, which opens the airway. A more open airway means less turbulence, and less turbulence means less noise.
Because it is made from impressions or a scan of your own teeth, it fits only you, which matters both for comfort and for how precisely the jaw position can be set.
Why snoring happens in the first place
When you fall asleep, the muscles that hold your airway open relax. In most people it stays open enough. In some, the airway narrows, and air passing through the narrowed space makes the soft tissues vibrate. That vibration is the sound.
Several things make it more likely: sleeping on your back, alcohol in the evening, nasal congestion, carrying extra weight around the neck, and simply getting older, as muscle tone decreases. Anatomy plays a part too: the natural set of your jaw, tongue and soft palate.
Snoring or sleep apnoea? Check this first
This is the most important section of this article.
Snoring on its own is a nuisance. Obstructive sleep apnoea is a medical condition in which the airway repeatedly closes during sleep, interrupting breathing and dropping oxygen levels. It is associated with daytime sleepiness, high blood pressure and cardiovascular risk, and it needs proper medical diagnosis and management, not a device fitted on the assumption that the problem is only noise.
Signs that warrant a conversation with your GP before anything else include: gasping, choking or pauses in breathing that someone else has witnessed; waking unrefreshed however long you sleep; persistent morning headaches; and falling asleep during the day, particularly if you drive.
If obstructive sleep apnoea is suspected, the route is a medical assessment and usually a sleep study. A mandibular advancement device does have an established role in managing mild to moderate sleep apnoea, but that is a decision made with a medical diagnosis in hand, and often alongside a sleep specialist, rather than something to self-select.
Who a mandibular advancement device suits
Where snoring has been assessed and sleep apnoea ruled out or appropriately managed, a device tends to suit people who snore primarily because of airway narrowing at the level of the tongue and soft palate, and who have enough healthy teeth to support and retain the appliance.
The assessment therefore covers more than the snoring itself. It looks at the health of your teeth and gums, how your jaw joints move and whether they are comfortable, and the condition of any existing dental work. Active gum disease or untreated decay is dealt with first. A device is worn nightly for years, and it should not be seated onto an unstable foundation.
If you have extensive restorations, crowns, bridgework or implants, a device can often still be made, but the design has to account for them.
What getting one fitted involves
Assessment. A discussion of your sleep and symptoms, an examination of your teeth, gums and jaw joints, and a check that a medical opinion has been sought where the picture suggests it should be.
Records. A scan or impressions of both arches, plus a record of the jaw relationship, so the device can be built to hold your lower jaw at a specific starting position.
Fitting. The device is tried in, checked for comfort and adjusted. You will be shown how to insert, remove and clean it.
Titration and review. This is the part people do not expect. Most devices allow the amount of forward positioning to be increased gradually over subsequent weeks. The aim is the smallest advancement that meaningfully reduces the snoring, because more is not automatically better. Comfort and jaw-joint health matter. Expect a review to check both the result and how you are tolerating it.
Living with the device
Most people adapt within a couple of weeks. In the early stage it is normal to notice increased saliva, a feeling of tightness, and some jaw or tooth tenderness in the morning that settles within an hour or so of taking the device out.
What should not be ignored is persistent jaw joint pain, or a bite that feels genuinely different during the day. Worn over years, these devices can produce small changes to tooth position and bite, usually minor, but real. That is why continued dental review while you are wearing one is part of the treatment rather than an optional extra.
Cleaning is straightforward: rinse and brush it after use with a soft brush and cool water, let it dry, and store it in its case. A well-cared-for device typically lasts a few years before it needs replacing.
Frequently asked questions
Will a mandibular advancement device stop my snoring completely?
It reduces snoring substantially for many people, and some find it resolves almost entirely, but no device can promise silence for everyone. How well it works depends on where in the airway the narrowing occurs and how much of the snoring is driven by other factors such as nasal blockage or alcohol.
Is it the same as the anti-snoring mouthguards sold online?
No. Shop-bought versions are made from a generic mould, so the jaw position is approximate and the fit is not matched to your teeth. A poor fit is not simply less effective; it can load your jaw joints unevenly and put pressure on individual teeth. A dentist-fitted device is made to your mouth and adjusted over time.
Will it damage my teeth or change my bite?
Long-term wear can produce small changes in tooth position and bite in some people. This is one of the main reasons the device is fitted and monitored by a dentist rather than simply supplied. Changes are picked up early at review and the design adjusted.
Can I use one if I have crowns, implants or dentures?
Often yes, though the design must be planned around existing dental work, and the device needs enough sound teeth to grip. Full dentures are usually not compatible. This is assessed at the consultation.
Do I need a sleep study before having one made?
Not always for simple snoring. But if there is any suggestion of obstructive sleep apnoea, whether that is witnessed pauses in breathing, choking or gasping, or heavy daytime sleepiness, a medical assessment comes first. Treating apnoea as though it were ordinary snoring risks leaving a serious condition unmanaged.
Speak to us about snoring near Bank
If snoring is affecting your sleep, or someone else’s, book an assessment at our practice at 77 Cornhill in the City of London, a short walk from Bank station. You will get an examination of your teeth, gums and jaw joints, a straight answer about whether a mandibular advancement device is appropriate for you, and a clear steer towards medical assessment first if that is what your symptoms suggest.
About the author
Dr Martin Zunde is a cosmetic and implant dentist practising at 77 Cornhill in the City of London, a few minutes from Bank station. He works with City professionals across general dentistry, implants, veneers, Invisalign and smile makeovers, with an emphasis on results that look natural rather than obviously treated. GDC No. 281866.
