Dental sleep medicine · Cologne
Sleeping beside someone who snores can mean struggling to rest yourself. A custom-made mandibular advancement device can help reduce snoring when it is suitable. The starting point is understanding what is actually disturbing your nights.
Patient films · German
Understanding snoring appliances. This German-language film explains jaw advancement, medical assessment and follow-up.
Simplified teaching illustrations. Individual suitability, treatment and follow-up require a personal examination. The full German film text is available below.
Unterkieferposition, Atemweg und Abklärung.
Im Schlaf entspannen sich Muskeln und Gewebe. In verengten Abschnitten der oberen Atemwege kann die Luft weiches Gewebe zum Schwingen bringen, etwa am Gaumensegel. Das hörbare Geräusch kann den Schlaf beider Partner belasten.
Schnarchen allein beweist keine Schlafapnoe. Beobachtete Atempausen, Luftschnappen oder ausgeprägte Tagesschläfrigkeit benötigen ärztliche Abklärung. Vor einer Schienentherapie wird geklärt, welche Schlafatmungsstörung vorliegt und welcher Behandlungsweg dafür geeignet ist.
Eine angepasste Unterkieferprotrusionsschiene stützt sich auf den Zahnreihen ab und hält den Unterkiefer beim Tragen in einer eingestellten Position weiter vorn. Die Einstellung richtet sich nach Wirkung und Verträglichkeit.
Mit dem Unterkiefer werden verbundene Weichgewebe beeinflusst. Der Rachenraum hinter Zunge und weichem Gaumen kann sich erweitern und stabilisieren. Dadurch können Schnarchgeräusche abnehmen. Eine vollständige Schnarchfreiheit lässt sich nicht versprechen.
Vor der Versorgung werden Zähne, Zahnhalteapparat und Kieferfunktion untersucht. Nach der Anpassung können Druckgefühl, Speichelveränderungen oder Kieferbeschwerden auftreten. Auch Zahnstellung und Biss können sich verändern; deshalb sind regelmäßige Kontrollen wichtig.
Bei Schlafapnoe reicht weniger Schnarchen als Erfolgskontrolle nicht aus. Die Wirksamkeit wird ärztlich überprüft, gegebenenfalls mit einer erneuten Schlafmessung. Eine bestehende Atemtherapie sollte nicht eigenständig durch eine Schiene ersetzt werden.
Welche Behandlung infrage kommt, lässt sich erst nach einer zahnärztlichen Untersuchung und einem persönlichen Gespräch beurteilen.
Editorial source review: 2 October 2026.
Both partners’ sleep matters
Waking up again. Nudging your partner. Perhaps moving to another room. Snoring can significantly disturb a partner’s sleep and affect your shared well-being. Wanting quieter nights deserves to be taken seriously.
The throat muscles relax during sleep. As the airway narrows, passing air can make soft tissue such as the soft palate and uvula vibrate, producing the familiar sound of snoring. The position of the tongue also plays a role.
In obstructive sleep apnoea, the airway repeatedly narrows or closes enough to disrupt breathing. Snoring alone neither proves nor rules out sleep apnoea.
Loudness alone does not distinguish these situations. Medical assessment and an appropriate referral or request therefore come before making a device. Suitability for a device is then also assessed by a dentist.
Explained using a model
The model shows the principle of a mandibular advancement device. The three explanations cover its function, assessment and follow-up.
AI-generatedOne splint fits over the upper teeth and one over the lower teeth. In the model, they are joined by a plastic connector at the side. The splints hold the lower jaw slightly further forward during sleep. This can create more space in the throat; the position is adjusted individually.
Understand how the device worksSnoring alone does not show whether pauses in breathing occur. Medical assessment and a referral or request come before making a device. The dental examination assesses teeth, their supporting structures and the jaw joints.
Learn about the assessment processFollow-up visits check the device’s fit, the teeth and the bite. For sleep apnoea, medical checks also assess how night-time breathing responds to treatment. Quieter snoring alone is not enough.
What follow-up includesIllustrative teaching model, not a patient case. The illustration does not replace a dental examination.
What the device is intended to do
A mandibular advancement device, or MAD, consists of two custom-made parts for the upper and lower jaws. Connectors hold the lower jaw slightly further forward during sleep, also bringing the tongue forward.
Through the connected soft tissues, this can create more space behind the tongue and at the soft palate. The throat may become more stable and less likely to narrow. This can reduce vibration and therefore snoring. The device does not hold the soft palate directly.
The device is made to fit your dental arches and jaw position and can be adjusted. The appropriate design depends on the medical findings, retention on the teeth and how well your jaw joints tolerate it.
The appropriate amount of advancement is adjusted gradually and reviewed over time. More advancement is not automatically better. Whether snoring improves, and by how much, varies from person to person. For sleep apnoea, quieter snoring is not sufficient evidence: the effect on breathing must be checked medically.
A look inside the airway
The device changes the position of the lower jaw while it is worn. This simplified cutaway shows how that relates to the tongue, soft palate and snoring.
AI-generated
Potentially more space
Simplified illustration of the principle, with the device visible from the side. Anatomy, movement and airway width are not to scale. This is not a patient case or an individual treatment outcome.
01 · How the sound begins
Muscle tone decreases during sleep. If the upper airway narrows, passing air can make soft tissue vibrate — for example the soft palate, the flexible back part of the roof of the mouth. These vibrations can produce the sound of snoring.
02 · Position makes a difference
Muscles and tissues connect the tongue to the lower jaw. The position of its back portion helps determine the space in the throat. Snoring does not originate in the same place for everyone; the nose and other soft tissues may also be involved.
03 · Where the device acts
One splint fits over the upper teeth and one over the lower teeth. Their connection holds the lower jaw in an individually adjusted, slightly forward position and limits it from falling back. The large arrow shows the direction of this advancement; the stop marker represents holding the position while the device is worn. The amount of advancement depends on effectiveness and tolerability.
04 · The possible effect
Advancing the lower jaw also moves the tongue base and connected soft tissues slightly forward or puts them under tension. This can widen the space behind the tongue and soft palate and make the airway more stable. The green double-headed arrow marks this space behind the soft palate schematically, without indicating a measured width. Less tissue vibration means less snoring noise. Snoring can therefore decrease, although complete quiet is not achievable for everyone. With sleep apnoea, medical checks must establish whether breathing is also adequately treated.
The animation highlights anatomical areas. It does not simulate measured breathing or an individual treatment outcome.
Three practical features
How well a device can be worn depends on its fit, adjustment and individual tolerance. These three features can make it practical in daily life:
Both parts are made to match your dental arches. Retention and fit are checked when the device is fitted. The aim is a tolerable fit, not as much pressure as possible.
The device is worn inside the mouth. It needs no electricity, tubing or mask to work. Your findings still determine whether it is the right treatment; please do not stop existing CPAP treatment yourself.
With an adjustable device, the jaw position can be adapted according to the treatment plan. Effectiveness and tolerance are considered together.
Snoring quick check
What have you noticed about your sleep? These optional questions help prepare for a conversation. Each selection reveals general information about that topic; your answers are not assessed.
Without JavaScript, all general information remains visible. No assessment is made.
If medical assessment has not yet taken place or you are unsure, first discuss the snoring with a GP, ENT or sleep medicine professional. Bring existing findings and the referral or request to the dental consultation. Whether a device is an option is established through your individual care pathway.
Your selections remain on this page and are neither stored nor sent to us. The booking link does not transmit any answers.
From assessment to follow-up
A GP, ENT or sleep medicine practice can begin the assessment. A respiratory sleep study usually measures breathing and oxygen saturation, among other things, at home. Based on your symptoms and findings, the medical team decides whether additional polysomnography in a sleep laboratory is needed.
To make a device, we need the medical referral or request and the relevant findings.
We examine the teeth, gums, existing dental restorations, jaw joints and lower jaw movement. The device needs sufficient retention. Inflammation, loose teeth or certain joint symptoms may mean that immediate fitting is not appropriate.
After recording your dental arches and jaw position, the device is made individually. At fitting, we check its fit and starting position. We explain how to wear, clean and handle it. Adjustments follow the agreed plan.
We check the fit, teeth and bite. For sleep apnoea, the medical team also assesses the effect on night-time breathing. If it is insufficient, the setting or treatment must be reassessed together.
Using the device needs follow-up
Initially, pressure on the teeth, increased saliva, dry mouth or discomfort in the muscles and jaw joints may occur. Tooth position and the bite can also change in the long term. Dental check-ups are therefore part of device treatment.
Report pain, a change in how your teeth meet or a damaged device. Do not adjust or alter the device yourself beyond the instructions discussed with you.
Clean your teeth and device daily according to the instructions for your model. Bring the device to check-ups. The fit should also be checked after new fillings, crowns or other changes in the mouth.
Material, loading and care affect how long the device lasts. There is no fixed replacement interval for every device; wear and function are assessed at appointments.
Four tips for the early stages
A new sensation in the mouth can take getting used to. Ask how to approach adaptation and the first nights with your particular device.
Note how wearing the device feels and anything you notice about your sleep. Your partner’s observations can add to the discussion. They do not replace medical checks of effectiveness.
Pressure sores, persistent pain or a change in your bite should be discussed with the practice. Please do not simply advance the device further or modify the material yourself.
Even if nights seem quieter, checks of the device, teeth and bite remain important. For sleep apnoea, breathing must also be checked medically.
Costs & insurance
A device for simple snoring is usually privately funded. Before it is made, you receive an individual cost plan according to the German fee schedule for dentists (GOZ).
For adults with obstructive sleep apnoea requiring treatment, a MAD may be covered by German statutory health insurance under G-BA requirements if positive airway pressure treatment cannot be carried out successfully. Suitably qualified statutory health insurance doctors establish the indication and request treatment; dental suitability is also assessed. The diagnosis alone does not mean every device is automatically covered.
We clarify in advance which care and billing arrangements are possible in your case. People with private or supplementary insurance should have their insurer review the cost plan before starting. Whether and how much is reimbursed depends on the policy and findings.
Information to help you decide
Snoring and sleep apnoea need different assessments.
Observed pauses in breathing or marked daytime sleepiness should be discussed with a doctor. Before a device is fitted, it must be established whether a sleep-related breathing disorder is present and which treatment is appropriate.
The device needs suitable retention. Before fitting, the teeth, gums, dental restorations and jaw joints are examined and any preliminary treatment is discussed together.
Less snoring alone does not prove that sleep apnoea is adequately treated. The effect on night-time breathing must also be checked medically after fitting.
Pressure, joint symptoms or bite changes are possible. Dental follow-up therefore accompanies use and helps identify necessary adjustments in good time.
A device for simple snoring is usually privately funded. For sleep apnoea, possible statutory health insurance cover depends on additional medical requirements.
Frequently asked questions
A dentally fitted device may be an option. First, however, it must be established whether this is simple snoring or a sleep-related breathing disorder. We discuss the dental requirements and the necessary medical assessment pathway.
The device changes the jaw position while it is worn. A noticeable improvement may occur, but no particular timeframe or complete silence can be promised. Adaptation and gradual adjustment are often needed. For sleep apnoea, adequate effectiveness on breathing must be confirmed medically.
It is compact and individually fitted. This can make it easier to use, but does not mean everyone finds it comfortable immediately. Increased saliva, dry mouth or pressure on the teeth and jaw can occur, especially at first. Fit, adjustment and follow-up help assess tolerance.
Before making a MAD, we need the medical referral or request and the findings. Statutory health insurance provision for sleep apnoea also requires the relevant medical qualifications and treatment criteria. Depending on the findings, the necessary examination may take place at home or in a sleep laboratory. A prescription alone does not replace the assessment.
That can only be decided based on your sleep apnoea and previous treatment. CPAP is an established standard treatment. Do not stop it yourself because a device is planned; any change belongs in the medical treatment plan.
No. A bite splint to address the effects of teeth grinding has a different purpose. A MAD deliberately holds the lower jaw in an adjusted position. Existing splints and symptoms should be assessed together.
A ready-made device replaces neither diagnosis nor assessment of the teeth and jaw joints. The care described here involves making and monitoring a custom-made, adjustable device. Your findings determine the appropriate approach.
Its effect depends on wearing it during sleep. How treatment continues in the long term depends on symptoms, follow-up findings and tolerance. Regular checks remain appropriate even if you notice an improvement.
Clinical sources
This information explains general principles. The appropriate treatment is decided after medical and dental assessment.
Your appointment in Cologne
Existing sleep medicine findings, your medical referral or request, details of previous treatment and any existing device help us start in the right place. If medical assessment has not yet taken place, please mention this before booking.
We assess the dental requirements and discuss what the next step could be.
Discuss a mandibular advancement device
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