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What is the difference between ready-made mandibular advancement devices (MAD) and MADs especially customised by dentists?

Cost

The cost of ready-made MADs ranges approximately between 45£ and 145£, whereas MADs customised by dentists are comparatively more expensive (ranging from 270£ up to 1800£).

Material & Comfort

MADs customised by dentists generally require less material, and are thinner than ready-made MADs. Additionally, the material is significantly harder and less flexible. MADs customised by dentists, therefore, tend to fit more firmly as well as more precisely. In order to use them, they literally clip onto the upper or lower jaw. The ready-made boil&bite MADs have a slightly softer surface and are therefore, very comfortable. The majority of MADs customised for patients by dentists use metal adapters to set the tensioning for the mandibular advancement, which some customers may find to be bothersome, as they may press against the inside of the cheek when sleeping on one’s side. Ready-made MADs generally use flat tensioning bands.

How soon can the MAD be used?

Ready-made MADs can be used immediately after the custom-moulded (this applies to both the customisation at home and at a doctor’s or dentist’s practice). MADs customised by dentists are produced in a dental laboratory by using individual bite impressions (taken by dentists). This requires two doctor appointments. The production time depends on the capacity of the dental laboratory.

Switching from a ready-made MAD to a dentist customised MAD (and vice versa)

Often dentists recommend that, in order to determine its overall suitability, one should first test a ready-made MAD. That is, one should first test a ready-made MAD in order to determine if one can sleep while wearing it and if it is effective. Only if this is the case, should one switch to a MAD customised by a dentist. This recommendation is certainly not wrong; however, it is based on technical prerequisites that, meanwhile, have become obsolete. The plastics technology of modern ready-made MADs is well-developed and of such high quality that these MADs are also well suited for sustained use. Furthermore, an increasing number of customers are switching from MADs customised by dentists to ready-made MADs, arguing that, subjectively speaking, they are more comfortable (due to softer material), far more affordable, and are ready for use after an easy customisation procedure un the comfort of their home.