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Mandibular Advancement Splint Efficacy Studies

Sleep apnoea is a condition characterised by periods of reduced or arrested breathing during sleep. Obstructive sleep apnoea refers to the repeated episodes of upper respiratory tract blockage during sleep. During these episodes, breathing reduces or stops and then resumes with a snort, gasp or jerk.

A mandibular splint or mandibular advancement splint (MAS) is a device worn in the mouth that is used to treat orofacial disorders including: obstructive sleep apnoea (OSA) and snoring. The splint is customised to the precise shape of your mouth, and treats snoring and sleep apnoea by moving the lower jaw forward slightly, which tightens the soft tissue and muscles of the upper airway to prevent obstruction of the airway during sleep. The tightening created by the device also prevents the tissues of the upper airway from vibrating as air passes over them – the most common cause of loud snoring. The splint design helps to maintain an open and unobstructed airway which improves breathing and sleep patterns preventing daytime fatigue. It is usually recommended for patients who have trouble using a CPAP machine (continuous positive airway pressure device which consists of a mask connected to a pump that delivers pressurised air).

Your doctor will perform a sleep study and other diagnostic tests to evaluate your breathing patterns and the degree of apnoea. Mandibular advancement splints are usually designed by a dentist experienced in making these devices in collaboration with the sleep specialist. The splint is constructed on a mould made from a dental impression. The device is supported by the teeth and causes the lower jaw to protrude forward opening the airway. Further adjustments are dependent on the degree of mandibular advancement and the level of comfort. Sleep studies may be performed with the device on to assess the success of treatment.

Mandibular advancement splints are not recommended in individuals with severe or complicated form of sleep apnoea, stiff jaws or limited tooth support.

A well-fitted splint should be comfortable during use. Initially, some individuals feel discomfort but this tends to get better with prolonged use. You may experience a slight pain in the jaw due to the protrusion which usually disappears in the morning when the appliance is removed. Tooth tenderness and excess salivation are the other associated potential drawbacks.