Mandibular advancement prosthesis: first-line alternative to surgery in snoring

Mandibular advancement prosthesis (MAP) is infrequently used in the UK at p resent for snoring. First-line measures include dietary and weight modifica tion for those that require it. Where such measures are unlikely to be usef ul or have already failed, surgery is sometimes utilized as a second-line t reatment modality. We evaluate the use of MAP as an adjunct to first-line m easures, with emphasis on efficacy, side-effects and patient compliance. Ca se notes of 30 snorers were reviewed and followed up with a questionnaire. Despite being useful in alleviating snoring, the prosthesis was poorly tole rated. Side-effects include increased salivation, temporomandibular joint p ain, intra-oral and myofacial discomfort. Patients who persevered with the prosthesis found the early side-effects resolved after a few weeks and snor ing reduced. MAP can be used in the initial management of snorers but patie nts need to be educated and encouraged, especially in the first few weeks.