Mandibular advancement device

A mandibular advancement device including:

• a lower part that is configured to be releasably attached to at least a portion of a lower jaw of a patient;
• a lower flange with a lower engagement surface extending upwardly from the lower part;
• an upper part that is configured to be releasably attached to at least a portion of an upper jaw of the patient;
• an upper flange with an upper engagement surface extending downwardly from the upper part;
• the lower flange being connected to the lower part by a lower one way ratchet means configured to only allow uni-directional posterior movement of the lower flange relative to the lower part, wherein the lower one way ratchet means includes a lower teeth rack on the lower part and a lower ratchet tooth or teeth on the lower flange, wherein the lower teeth rack includes a first end provided at a posterior region of the lower part and an oppositely disposed second end provided at an anterior region of the lower part, wherein the lower flange is configured to disengage the lower part by sliding the lower ratchet tooth or teeth along the lower teeth rack in the posterior direction until the lower flange slides off the first end of the lower teeth rack;
• and
• the upper flange being connected to the upper part by an upper one way ratchet means configured to only allow uni-directional anterior movement of the upper flange relative to the upper part, wherein the upper one way ratchet means includes an upper teeth rack on the upper part and an upper ratchet tooth or teeth on the upper flange, wherein the upper teeth rack includes a first end provided at an anterior region of the upper part and an oppositely disposed second end provided at a posterior region of the upper part, wherein the upper flange is configured to disengage the upper part by sliding the upper ratchet tooth or teeth along the upper teeth rack in the anterior direction until the upper flange slides off the first end of the upper teeth rack,
• the lower part being formed from a relatively hard lower shell, a relatively soft lower lining and a heat formable lower inner lining therebetween;
• and the upper part being formed from a relatively hard upper shell, a relatively soft upper lining and a heat formable upper inner lining therebetween,
• wherein, when the lower part and the upper part are fitted to the upper jaw and the lower jaw of the patient for use in sleep, the lower engagement surface and the upper engagement surface are configured to engage one another to cause anterior advancement of the lower jaw from a reflex path of opening.