Permanent Tooth Movement from MADs
Mandibular advancement devices (MADs) are oral appliances used to reduce snoring and mild obstructive sleep apnoea. They keep the lower jaw (mandible) pushed slightly forward during sleep to help keep the airway open.
How MADs can move your teeth
A MAD rests on your upper and lower teeth and holds the jaw forward. This applies a steady force to the teeth and jaws while you sleep.
As a result, the teeth can shift over time. Common patterns include:
- Lower front teeth tipping forward (proclination)
- Upper front teeth tipping backward (retroclination)
- Changes in how the upper and lower teeth meet (occlusion), such as an open bite or deeper bite
- Slight widening of spaces between teeth
These changes are usually slow and may take months or years to become noticeable.
Why the teeth move
Teeth sit in bone sockets and are held by the periodontal ligament. The ligament is not rigid; it remodels in response to steady pressure.
A MAD applies force in a direction that is not part of your normal bite. Over time, the ligament and surrounding bone remodel, and the tooth can move.
What to do about it
- Get a dental check before starting MAD therapy. A dentist or orthodontist can assess your bite and the health of your teeth and gums.
- Have regular follow-ups while using a MAD. Early changes in tooth position or bite can often be managed before they become more pronounced.
- Report changes promptly. If your bite feels different, your teeth feel loose, or new gaps appear, talk to your provider.
- Consider alternatives if needed. If tooth movement becomes a concern, options such as CPAP, positional therapy, or surgery may be worth discussing.
Balancing benefits and risks
For many people, reduced snoring and better sleep outweigh the risk of slow tooth movement. The key is monitoring dental health and adjusting treatment with your healthcare team as needed.
Note: This article is educational and not a substitute for professional dental or medical advice.