Overview

A mandibular repositioning appliance (MRA) is a dental device (appliance). It is similar to a gum shield.

We use an MRA to treat snoring and mild to moderate sleep apnoea. This is a condition where your breathing stops and starts while you sleep. You wear the MRA in your mouth when you are asleep.

An MRA holds the lower jaw forward and moves the tongue forward to clear the airway during your sleep. This can reduce or stop sleep apnoea.

An MRA also increases the amount of oxygen getting into your body. It usually reduces breathing noises and snoring.

The MRA is made of soft material and should not have any effect on moving your jaw.

Wearing your MRA

You need to wear your MRA for as long as possible at night. This should ideally be for 5 to 6 hours.

It takes time to get used to the MRA. Do not try to sleep with it immediately.

Try to get used to the MRA for increasing periods of time when you are not thinking about it. This could be when you watch TV or read.

Pain when wearing the MRA

Some people have slight discomfort where the teeth meet the gums (gum margin) when they wear the MRA. You can carefully adjust the MRA using a nail file or emery paper to help with this.

You may have discomfort if your gums:

• swell up when there is pressure on them
• become inflamed because of poor cleaning or dental plaque

The muscles involved in clenching the teeth might ache at first. This should settle within a few days.

The main area of discomfort is usually the jaw joint immediately in front of the ear. It can become very painful.

Your own dentist can adjust the MRA if needed.

If you have a lot of discomfort, remove the MRA and contact the dental sleep department. 

If your teeth ache after wearing the MRA, it is likely that you grind your teeth. Wearing the MRA makes the problem worse. If you cannot overcome this, you might decide not to wear the MRA anymore.

Looking after your MRA

Cleaning your MRA

If you soak your MRA in a special cleaner every day, it will last longer. You can use a cleaner like Retainer Brite® each day. You can buy this online or order it in large pharmacies.

You can also use a fizzy denture cleaner (such as Polident® or Steradent) 1 time a month.

Soak the MRA for 20 minutes in cold water. Then rinse thoroughly and store it somewhere dry or in plain water.

Replacing your MRA

If you use your MRA regularly, it should last about 2 years. After this time, the MRA might be hard and discoloured and not work so well. You might need to replace your MRA.

As you are no longer under our care, you need to ask your GP (not your dentist) for a new MRA. They can send us a letter asking for a replacement.

You do not usually need a follow-up appointment. However, if you have any problems, please contact us for an appointment.

Do not worry if a hole appears in the MRA. The most important thing is that the device as a whole works well. The suction (sucking air) effect of the MRA against the teeth is less important.

Looking after your teeth

Dental check-ups

It is important that you have a healthy mouth. This reduces the chance of the MRA causing any dental problems. Regular dental check-ups can help to keep your teeth and gums healthy.

If you get a new filling or crown, the dentist can adjust the MRA at the same time. They need to allow for the change in shape.

Cleaning your teeth

You need to clean your teeth carefully before putting the MRA in your mouth. With good dental care, the MRA does not affect your teeth.

Any gum problem or tooth decay could get worse. This is because the MRA covers the teeth and gums, and your spit (saliva) cannot reach them.

If you have problems

Over a long time, your lower jaw position can sometimes change and sit forward from its original position.

If you have any concerns or notice any change in how the teeth meet (the bite), stop wearing the MRA. Please contact the dental sleep department about this matter. 

You might only need to talk about the issue with the team and be reassured before you can wear the MRA again. 

If the MRA does not help you, you can stop wearing it. Please report this to the specialist treating your sleep disorder.