Mandibular Advancement Device Therapy in Obstructive Sleep Apnea and Snoring in Community Dental Care: Two-year Follow-up Study on Self-reported Sleep Quality, Side Effects, and Compliance

Vuorjoki-Ranta, Tiina-Riitta; Lobbezoo, Frank; Tuomilehto, Henri; Könönen, Mauno; Pihakari, Antti; Ahlberg, Jari

doi:10.4172/2167-0277.1000180

Cited by 9 publications

(9 citation statements)

References 30 publications

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“…According to our previous study, treatment of OSA with MAD was well tolerated and its compliance remained good over a 2‐year follow‐up period . This is also supported in other studies .…”

Section: Introductionsupporting

confidence: 82%

“…Also, within a decade, it seems that the awareness of oral appliances has also increased among dentists, comparing the results of Bian (55·0%) and ours (69·6%). This may well be due to the overall increased number of publications in sleep medicine in dentistry .…”

Section: Discussionmentioning

confidence: 99%

“…The use of mandibular advancement devices (MAD) in the treatment of OSA and snoring has increasingly become an alternative treatment modality for continuous positive airway pressure (CPAP) in patients with mild to moderate OSA . In these patients, clinical studies have shown equal efficacy between both modalities on ambulatory blood pressure, daytime sleepiness and quality of life, among other things .…”

Section: Introductionmentioning

confidence: 99%

“…In our study, MAD was found to markedly reduce loud snoring. Also, the occurrence of early morning awakenings (EMA) and non‐restorative sleep (NRS) remained at low levels among respondents in the follow‐up period .…”

Section: Introductionmentioning

confidence: 99%

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Treatment of obstructive sleep apnoea patients in community dental care: knowledge and attitudes among general dental practitioners and specialist dentists

Vuorjoki-Ranta¹,

Lobbezoo

Vehkalahti

et al. 2016

J of Oral Rehabilitation

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Obstructive sleep apnoea (OSA) is an increasing problem worldwide. Yet, a large number of patients may remain undiagnosed. Dentists could suspect OSA, but little is known about their knowledge and attitudes towards the topic. An email questionnaire was sent to dentists working in Helsinki Health Centre, Helsinki, Finland (n = 226). It consisted of demographic data, items on dentists' overall knowledge of OSA and factors associated with it, and their possibilities and willingness to take part in the recognition and treatment of OSA patients. Altogether, 70·9% (n = 134) of dentists eligible for the study completed the questionnaire. Of them, 79·1% (n = 106) were general practitioners and 20·9% (n = 28) dentists with specialty training. Continuous positive airway pressure (CPAP) (99·3%) and weight control (99·3%) were both generally acknowledged as effective methods to treat OSA. Regarding the efficacy of other treatment modalities, significant differences were found between general practitioners' and specialists' opinions. For example, mandibular advancement devices (MAD) were less often reported by general practitioners (69·8%) than specialists (89·3%) (P < 0·05). The possible risk factors, signs and symptoms, and consequences of OSA were overall well recognised regardless the years in dental profession, but specialists saw more often that nocturnal sweating (P < 0·01) and snoring (P < 0·05) may signify OSA. Dentists could play an important role in suspecting OSA, but they may need more education to cope with that.

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Section: Introductionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment of obstructive sleep apnoea patients in community dental care: knowledge and attitudes among general dental practitioners and specialist dentists

Vuorjoki-Ranta¹,

Lobbezoo

Vehkalahti

et al. 2016

J of Oral Rehabilitation

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“…OSA, and resultant sleep fragmentation and oxygen desaturation, have been associated with daytime sleepiness, cognitive impairment, type 2 diabetes, cardiovascular disease, stroke, increased risk of motor vehicle accidents and can have significant effects on quality of life (Chen et al, 2008;Cunali et al, 2008;Sutherland et al, 2014;Vuorjoki-Ranta et al, 2014). It can affect 4% to 9% of the middle-aged population, and some studies report an incidence as high as 34% in men (Clark et al, 2000;Cunali et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Temporomandibular Disorders in Patients Undergoing Mandibular Advancement Device Therapy for Obstructive Sleep Apnea: A Systematic Review

Nguyen¹,

Balasubramaniam²

2016

AJOM

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Background: Mandibular advancement device (MAD) therapy is a popular and effective treatment for snoring and obstructive sleep apnea (OSA). However, there have been several reports in the literature of patients developing temporomandibular disorders (TMDs). Objective:The objective of this review is to evaluate the prevalence of TMD, both in the initial phase of therapy and at follow up appointments, amongst patients wearing a MAD for OSA. Methods:The authors conducted a systematic review of published articles in which the presence of TMDs in patients undergoing MAD therapy for OSA was investigated. Eligible studies met the following criteria: a diagnosis of TMD following mandibular advancement using a custom-made and titratable MAD using either the Diagnostic Criteria for TMD (DC/TMD), Helkimo Anamnestic Dysfunction Index or reproducible clinical signs/symptoms. Of the thirty-six articles published in this area, eleven were included in this review. These were assessed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results:The average prevalence of TMD during the initial phase of MAD therapy was found to be 25%. The prevalence of TMD reduced in the follow up periods. The adherence to MAD, especially long term, appears to be variable and from our results, it appears an average of 20% of patients discontinue MAD therapy over six to one hundred and twenty months, and this number has been reported to be as high as 62.5% (over 58 months). Conclusions:There was some difficulty in comparing the studies due to the differences in follow up time, methodology, sample size and diagnostic criteria. Longer clinical follow-up studies, with an objective method of monitoring patient adherence such as home monitoring devices, and preferably with a larger sample size Amanda Phoon Nguyen and Ramesh Balasubramaniam / American Journal of Oral Medicine (2016) Vol. 2 No. 1 pp. 26-42 27 are needed to evaluate the long-term effects of MADs on the TMD. The authors consider it prudent for clinicians to counsel patients that a small number will experience signs and symptoms of TMD with MAD use. However TMD is usually transient and the long-term risk appears small. In patients who develop TMD during MAD therapy, treatment of their TMD is recommended to prevent discontinuation of MAD therapy. In a few patients, persistent TMD may result in discontinuation of MAD therapy. Patients should be cautioned of this possibility and subsequently referred to consider other treatment options for their OSA.

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Association of allergic rhinitis with obstructive sleep apnea

Cao

Wu²,

Zhang

et al. 2018

Medicine

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Mandibular Advancement Device Therapy in Obstructive Sleep Apnea and Snoring in Community Dental Care: Two-year Follow-up Study on Self-reported Sleep Quality, Side Effects, and Compliance

Cited by 9 publications

References 30 publications

Treatment of obstructive sleep apnoea patients in community dental care: knowledge and attitudes among general dental practitioners and specialist dentists

Treatment of obstructive sleep apnoea patients in community dental care: knowledge and attitudes among general dental practitioners and specialist dentists

Temporomandibular Disorders in Patients Undergoing Mandibular Advancement Device Therapy for Obstructive Sleep Apnea: A Systematic Review

Association of allergic rhinitis with obstructive sleep apnea

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