I experience pain and am left with pressure sores when wearing my mandibular advancement device (MAD) – will this improve with time or is the product simply not suitable for me?
This depends on the type of pain and when the pain occurs:
1. Mild pressure pain or the sensation of having a foreign object in one’s mouth may very well occur during the initial phase. However, once the jaw has become accustomed to the new position, such sensations will begin to subside. The duration of this acclimatisation period depends on the individual– it can last from only a few days to several weeks.
You should check if the mandibular advancement too extreme for you. Milder mandibular advancement generally leads to less pressure on the teeth. In the case of adjustable MADs (regularly bibloc), this can be easily changed: Reduce the mandibular advancement for 1-2 nights (per screw, spacer, or tensioning bands system) and check if the snoring reoccurs (e.g., with the aid of a snoring app, such as SnoreLab). In the case of monobloc MADs, this will require remoulding in a warm water bath
Additionally, you can counteract the feeling of pressure in the morning, by chattering your teeth after having removed the MAD. It can also be of help to flex the temporomandibular joint through subtle lateral movements. When experiencing pressure pain, you should refrain from eating solid foods, such as hard bread rolls, during the first half hour after you wake up.
2. Pressure sores on the gums can be an indication that the MAD has been poorly moulded.
a) In the case of the Boil&Bite MAD, we recommend that you remould the MAD. Prior to remoulding the MAD, it is important to smooth the old dental impressions in the MAD over, so that you bite into a smoothed surface during the remoulding.
The moulding should not be based on the old dental impressions (as this comes with the risk of the MAD fitting even more loosely). As far as the procedure is concerned, you should warm up the MAD as you would for an initial fitting, followed by smoothing the old dental impressions out, let it cool down and, finally, reheat the MAD. If you attempt to complete the “smoothing out” and moulding in one go, there is the risk of the material rehardening too soon and the dental impression, therefore, not being deep enough, Which may result in the MAD fitting too loosely.
b) Alternatively, you can also try to correct/remove the part that is causing the pressure with the aid of a knife.
3. Should you experience a severe pain to stabbing pain, please immediately stop using the MAD. Please contact us or your doctor to clarify the next steps.