Dental side effects of an oral device to treat snoring and obstructive sleep apnea

Study Objectives: Snoring and obstructive sleep apnea (OSA) are common and related conditions-with major social and health implications-which can be t reated successfully with dental devices that reposition the mandible. Despi te wide use, side effects of these devices have not yet been systematically evaluated. The purpose of the study was to evaluate side effects of a mand ibular advancement splint (MAS) previously described by the authors. Design: Questionnaire survey and dental examination of a consecutive case s eries of patients treated with the MAS Setting: Dental outpatient clinic Patients: Attempts were made to contact all 191 patients treated over a 5-y ear period. All had snored loudly and habitually with or without OSA prior to treatment. Measurements and Results: Of 191 patients treated, 132 agreed to complete t he questionnaire. All were scheduled to attend for dental examination and 1 06 underwent examination. Of the 132 interviewed, patient and partner repor t indicated that the device was well tolerated and controlled snoring satis factorily in 100 after 31 +/- 18 (mean +/- SD) months of use. Dental side e ffects were reported in 107 patients, although these were mostly minor, and only 10 patients ceased using the device because of them. Side effects inc luded excess salivation (in 40), xerostomia (in 30), temporomandibular join t pain (in 35), dental discomfort (in 35), myofacial discomfort (in 33) and bite changes (in 16). Of 106 patients examined, 30 had increased maximal o pening and 76 had no change compared with pretreatment records. Temporomand ibular joint noises were found in 9 patients, and occlusal changes (12 m my lar strip and wax bite, relative to pretreatment) in 15. None of these effe cts could be related to degree of opening or protrusion produced by the MAS . Conclusion: Dental side effects occur in a significant proportion of patien ts using the MAS. In most cases these are minor and their importance must b e balanced against the efficacy of the MAS in treating snoring and OSA.