A mandibular advancement appliance is described which is secured to a subjects dentition. The appliance may adjust a position of the subjects lower dentition relative to the upper dentition while maintaining a distance between the upper and lower dentition. The appliance may also allow for the free rotation of the lower dentition relative to the upper dentition for increased comfort. Additionally, the appliance may also be utilized with a tongue retention assembly for maintaining a position of the subjects tongue relative to the device for treating sleep disordered breathing.