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I have a feeling that, within a short period of time, the mandibular advancement has become less effective, as my snoring has gotten worse. Is this possible, and what can be done about this?

While MADs do not cause permanent mandibular advancement of the jaw, it is, however, possible for the jaw to grow accustomed to the MAD and the mandibular advancement over time. In this case, we recommend you remould the MAD for an improved fit.

Another potential cause for this may be that the MAD was not properly moulded in the first instance. In this case, we recommend you remould the MAD.

Furthermore, prior to remoulding the MAD, it is important to smooth out the old dental impressions in the MAD, so that you bite into a smoothed surface during the remoulding. The moulding should not be based on 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, let it cool down and, finally, reheat the MAD. If you attempt to complete the “smoothing” and moulding in one go, there is the risk that the MAD may reharden too soon and the dental impression, therefore, may not being deep enough. Consequently, the MAD may fit too loosely.