Mandibular advancement device: how do you check that it works?

Does less snoring mean sleep apnea is controlled?

Less snoring, more refreshing sleep or better alertness are encouraging changes. They help to assess the benefit of treatment.

For sleep apnea, however, these improvements are not enough to confirm that breathing events are controlled. A sleep test with the appliance provides an objective measure of the result. 2 3

Comfort also matters: it helps you wear the appliance regularly, while the sleep test assesses its effectiveness.

Why are adjustments gradual?

The appliance holds the lower jaw forward during sleep. Its setting is adjusted according to your tolerance and the result sought.

Gradual progression gives you time to get used to the appliance. More advancement is not automatically more effective: the aim is to find a suitable therapeutic position that you can tolerate. 1

At Shalvina, Dr Chira Riahi-Boukhris supports this adaptation at scheduled adjustment appointments. Any adjustments at home follow the personalised instructions given at the clinic.

Why make the appliance part of comprehensive care?

The appliance is a treatment in its own right. To achieve the best possible result, the assessment also considers other factors that may contribute to your sleep apnea or interfere with treatment:

• Nasal breathing: nasal obstruction deserves assessment and appropriate treatment when present.
• Weight: in case of overweight or obesity, weight management support can complement sleep apnea treatment.
• Sleep position: when a positional component is identified, positional therapy may be considered.

These measures are chosen according to your situation: not every patient needs all of them. The aim is to consider the whole problem rather than the appliance alone, and then check the result of the chosen strategy. 4

When and how is the sleep test with the appliance done?

The check is organised after the adaptation and adjustment phase, at a time agreed with the professionals who follow you. The schedule reflects how treatment is progressing.

The doctor decides on the appropriate test, at home or in a laboratory. You sleep with your appliance in place according to the instructions given. 1 2

The recording examines in particular any remaining breathing events and oxygen levels during the night. It complements the information about your sleep, your comfort and your use of the appliance.

Bring the follow-up report and your initial test so that they can be reviewed in the context of your care.

How do the results guide the next steps?

The results are reviewed with your doctor, together with dental follow-up. They show how well sleep apnea is controlled and help decide whether to continue treatment or make further adjustments.

When the result remains insufficient, your doctor discusses the options suited to your situation with you. This decision takes into account the sleep data, your anatomy and the treatments already tried. 1

At Shalvina, support includes follow-up of the result, in coordination with your doctor.

Why continue follow-up after the first adjustments?

Follow-up checks comfort, the fit of the appliance, your dental health and how your teeth meet. It is also an opportunity to review how you use it and how your symptoms are evolving. 1

A return of loud snoring, fatigue or sleepiness should be reported. The professionals who follow you will decide whether an adjustment or a new check is useful.

Well-monitored oral appliance therapy therefore combines a suitable appliance, personalised adjustments and long-term verification of the result.

Would you like to know more about oral appliance therapy at Shalvina?

Learn about the dental assessment, the choice of Panthera device and the support provided with Dr Chira Riahi-Boukhris.

About Panthera oral appliance therapy

Scientific references

1. Levine M, Cantwell M, Postol K, Schwartz D. Dental Sleep Medicine Standards for Screening, Treatment, and Management of Sleep-Related Breathing Disorders in Adults Using Oral Appliance Therapy: An Update. Journal of Dental Sleep Medicine. 2025;12(2). doi: 10.15331/jdsm.7384. View the professional standards (PDF).

2. Caples SM, Anderson WM, Calero K, et al. Use of polysomnography and home sleep apnea tests for the longitudinal management of obstructive sleep apnea in adults. AASM clinical guidance statement. Journal of Clinical Sleep Medicine. 2021;17(6):1287–1293. doi: 10.5664/jcsm.9240. View the publication.

3. Ramar K, Dort LC, Katz SG, et al. Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: an update for 2015. Journal of Clinical Sleep Medicine. 2015;11(7):773–827. doi: 10.5664/jcsm.4858. View the AASM/AADSM guideline.

4. Department of Veterans Affairs / Department of Defense. VA/DoD Clinical Practice Guideline for the Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea. Version 3.0, 2025. Recommendations 20 and 21: weight management combined with other treatments in relevant patients, and treatment of positional sleep apnea. View the provider summary (PDF).