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Mandibular advancement device, a bespoke oral device for snoring and mild to moderate sleep apnoea.

A custom-made dental appliance worn at night that gently holds the lower jaw forward - opening the airway to reduce snoring and treat mild to moderate obstructive sleep apnoea.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What mandibular advancement device fitting and its alternatives cost.

Indicative ranges across UK private providers.

In short

Bespoke MAD in our UK network: £600–£1,500, fitted within 4–6 weeks.

Procedure Indicative range
Bespoke MAD (SomnoDent, ProSomnus etc.) £600–£1,500
Bespoke MAD + follow-up sleep study package £800–£2,000
Dental sleep consultation £200–£450
Digital scan and bite record £250–£500
Device titration review £150–£350
Annual device review £120–£300

Prices vary by clinic, by which consultant does the case, and by whether preoperative investigations are included or billed separately.

The problem

A bespoke device, a specialist dentist, a follow-up sleep study.

A cheap boil-and-bite device rarely works; a bespoke device from a specialist dentist often does. The difference is the diagnosis, the fit and the titration.

  • Right diagnosis first

    A sleep study before or after fitting - so treatment is judged on data, not on the bed-partner alone.

  • Specialist dentist

    Formal dental sleep training and access to multiple device brands, not a general practice sideline.

  • Titration and review

    Small forward adjustments over weeks, with a follow-up sleep study at three months to confirm efficacy.

When it helps

When mandibular advancement device fitting is the right step.

The situations that fit mandibular advancement device fitting - and the red flag that means an urgent assessment first, not a booking.

  • Loud, disruptive snoring

    Relationship-changing snoring without significant apnoea - often the fastest win with a MAD.

  • Mild to moderate OSA

    AHI 5–30 on a sleep study - a MAD is a first-line alternative to CPAP.

  • Positional apnoea

    Apnoea worse on the back - a MAD combined with positional therapy often works very well.

  • CPAP intolerance

    Where CPAP has been tried and cannot be worn, a MAD is often the next best answer even for moderate OSA.

  • CPAP travel back-up

    Regular CPAP users who want a compact option for travel - a MAD is small enough to fit in a wash bag.

  • Combination therapy

    Combined with CPAP in some severe cases to allow lower CPAP pressures.

  • Preference for a non-electronic device

    Patients who prefer a fabric-and-plastic solution over a machine and mask.

  • Red flag: severe OSA on its own

    Severe OSA (AHI over 30) with excessive sleepiness usually needs CPAP first - a MAD may not be enough on its own.

Treatment options

A MAD is one of several answers for snoring and mild to moderate OSA.

What each option is - and which fits which pattern of snoring, apnoea and CPAP tolerance.

  • SomnoDent Flex

    A two-piece adjustable device - probably the most commonly fitted premium MAD in the UK.

  • ProSomnus (US)

    A single-piece milled device, very compact, popular with patients who dislike bulky appliances.

  • Narval CC

    A lightweight CAD/CAM device with a wide range of movement - good for larger jaws.

  • Somnowell

    A metal-framework device, extremely durable, made in the UK.

  • Off-the-shelf "boil-and-bite"

    Cheap and available online - a poor substitute for a bespoke device. Poor fit, higher failure rate.

  • CPAP

    The most effective treatment for moderate to severe OSA - often the right first-line answer.

  • Positional therapy

    A pillow or vest to keep you off your back - pairs well with a MAD in positional apnoea.

Safety and recovery

What to expect, honestly.

A bespoke MAD is a low-risk oral appliance that many patients wear happily for years. The important things to plan are the adjustment period, the review schedule and the small long-term bite changes.

  • Custom device only

    A bespoke device from a specialist dentist is the standard. Off-the-shelf gum-shields have poor fit and high dropout.

  • Adjustment period

    Two to four weeks of jaw stiffness, extra saliva or dry mouth in the morning is typical - settles as you adapt.

  • Bite changes

    Small permanent bite changes are possible with long-term use - the dentist reviews this at every visit.

  • Not for severe OSA on its own

    Severe OSA usually needs CPAP as first-line. A MAD is sometimes combined with CPAP, or used when CPAP is not tolerated.

  • Dental health matters

    You need enough healthy teeth to anchor a MAD. Missing teeth, gum disease and TMJ dysfunction may rule it out.

  • Snoring may improve first

    Bed-partner snoring reports usually improve within the first week; the full apnoea effect takes weeks to titrate.

  • Device lasts 2–5 years

    Devices wear over time. A biennial to five-yearly replacement is typical, depending on grinding.

  • Insurance sometimes covers

    Some UK insurers fund a bespoke MAD where OSA is documented - many still consider it a self-pay dental cost.

  • Red flags

    Severe morning jaw pain, tooth movement or new bite problems - call the dentist within a week.

Reading your procedure note

Your MAD fitting note in four parts. Read the last one first.

Whichever consultant does the procedure, the note you receive keeps to the same shape.

A UK consultant reviewing a patient's procedure note

A quiet reminder

Clinical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the note before your review, just ask.

  1. 01 Header

    Diagnosis and device chosen

    The sleep diagnosis (snoring, mild or moderate OSA), the device brand and the starting protrusion.

  2. 02 Technique

    Scans, bite and titration plan

    How scans and the protrusive bite were recorded, and the planned titration schedule.

  3. 03 Findings

    Dental status and any limitations

    A note on dental health, missing teeth, gum condition and TMJ status that guides the plan.

  4. 04 Impression

    Ongoing review and repeat testing

    Read this first: the review schedule and when a follow-up sleep study will confirm efficacy.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Some UK insurers fund bespoke oral appliances where OSA is documented - many still consider it a self-pay dental cost.

Frequently asked

Everything we get asked about mandibular advancement device fitting.

Quick answers on effectiveness vs CPAP, cost, boil-and-bite devices, side effects and insurance.

  • How does a mandibular advancement device work?

    It gently holds your lower jaw a few millimetres forward while you sleep, which pulls the tongue and soft palate away from the back of the throat and opens the upper airway. That reduces vibration (snoring) and can prevent airway collapse (apnoea).

  • Is a MAD as effective as CPAP?

    For mild to moderate OSA and snoring, a well-fitted MAD is often as effective as CPAP in real-world use because patients wear it more consistently. For severe OSA, CPAP is usually more effective; a MAD may be used alongside or when CPAP is not tolerated.

  • How much does a bespoke MAD cost in the UK?

    A bespoke device from a specialist dental sleep clinic costs £600 to £1,500, or £800 to £2,000 with a full programme including a follow-up sleep study. Off-the-shelf devices are cheaper but usually much less effective.

  • Are boil-and-bite devices any good?

    They can help with light snoring for a few weeks but they fit poorly, are less durable and have a high dropout rate. For anything more than occasional snoring, a bespoke device is worth the investment.

  • Are there side effects?

    Jaw stiffness, extra saliva or a dry mouth in the morning are common in the first two to four weeks and usually settle. Small permanent changes to the bite can happen with long-term use - the dentist reviews this at every visit.

  • Is a MAD covered by insurance?

    Some UK insurers fund a bespoke MAD where OSA is documented on a sleep study - many still consider it self-pay dental treatment.

Related

Looking for something else?

In practice, in the UK

Where a MAD sits in a private UK sleep pathway

Snoring, mild to moderate OSA or CPAP that cannot be worn - a bespoke MAD from a specialist dentist is often the answer.

A bespoke MAD means a specialist sleep dentist takes proper scans, chooses the right device, titrates it over weeks and confirms efficacy with a follow-up sleep study.

Everything runs to CQC and GDC standards; the choice is about a specialist dentist and a proper follow-up sleep study - not an online gum-shield.