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1 Dept of Thoracic Medicine, University College London Hospitals, 2 Dept of Orthodontics, Dental Institute, Royal London Hospital and 3 Royal National Throat, Nose and Ear Division, Royal Free Hospitals Trust, London, UK
CORRESPONDENCE: A.D. McGown, Dept of Thoracic Medicine, Middlesex Hospital, Mortimer Street, London, WIN 8AA, UK. Fax: 44 207 637 5809
Keywords: long-term compliance, mandibular advancement devices, sleep apnoea syndromes
Received: April 21, 2000
Accepted August 12, 2000
A mandibular advancement splint (MAS) may be an alternative treatment
for snoring and obstructive sleep apnoea (OSA). However, there is
little subjective or objective information concerning long-term effectiveness,
compliance and side effects.
A retrospective questionnaire was used to survey these issues plus patient
satisfaction and maintenance requirements in 166 patients who could have worn
a mandibular advancement splint for over a year.
One-hundred and twenty-six (76%) subjects returned
the questionnaire, (84 with OSA, 42 snorers), of whom 69 (55%)
reported still using the splint regularly, 47 (37%) every
night. The most common reported reasons for stopping use were discomfort (29/57;
52% of nonusers), and poor perceived efficacy (12 subjects).
Users reported more daytime symptoms, and they and their partners were more
likely to observe improvements with splint use. Side effects were reported
by 49 subjects, more commonly in nonusers. Sixty-five of 67 current users
and 23 of 41 nonusers reported less snoring with splint use (p=<0.001).
Long-term mandibular advancement splint usage appeared less satisfactory
than previously reported, however, splints were considered effective by 97%
of current users and even by over half of those who had stopped use. Reasons
for stopping use included side effects, social circumstances, dental treatment,
as well as lack of perceived efficacy.
This article has been cited by other articles:
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  A. M. Smith and J. M. Battagel Non-apneic snoring and the orthodontist: the effectiveness of mandibular advancement splints J. Orthod., June 1, 2004; 31(2): 115 - 123. [Abstract] [Full Text] [PDF]
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 A. Hoekema, B. Stegenga, and L.G.M. de Bont EFFICACY AND CO-MORBIDITY OF ORAL APPLIANCES IN THE TREATMENT OF OBSTRUCTIVE SLEEP APNEA-HYPOPNEA: A SYSTEMATIC REVIEW Crit. Rev. Oral. Biol. Med., May 1, 2004; 15(3): 137 - 155. [Abstract] [Full Text] [PDF]
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 M. Marklund, H. Stenlund, and K. A. Franklin Mandibular Advancement Devices in 630 Men and Women With Obstructive Sleep Apnea and Snoring: Tolerability and Predictors of Treatment Success Chest, April 1, 2004; 125(4): 1270 - 1278. [Abstract] [Full Text] [PDF]
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 D M Smith and J R Stradling Can mandibular advancement devices be a satisfactory substitute for short term use in patients on nasal continuous positive airway pressure? Thorax, April 1, 2002; 57(4): 305 - 308. [Abstract] [Full Text] [PDF]
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