Are there any long term side effects to using a mandibular advancement splint?
It has been well-documented how the use of a Mandibular Advancement Splint (MAS) can treat mild to moderate sleep apnoea and can be more easily tolerated than other treatment options such as CPAP for many patients.
While this is becoming a popular choice for patients, we should remember to ask ourselves: are there any side effects? Would it hurt to put my jaw forward all night? Can this affect my teeth over a long period of time?
A recent study (Knappe, Bakke, Svanholt, Petersson, Sonnesen, 2017) looked into possible long-term side effects of MAS use following 3-years of sustained treatment. Their findings revealed some changes in the temporomandibular joint (TMJ), such as crepitus, as well as changes to oro-facial function such, for example: reduced overbite and increased jaw protrusion. These identified changes seemed to be less harmful than previously reported effects observed in other studies.
Another study (Fransson, Kowalczyk, Isacsson, 2017) looked at changes in teeth position following 10-years of sustained MAS treatment. The researchers in this study also found a decrease of the overjet and the overbite and changes in occlusion (the contacts between the top and bottom teeth). These changes in dentition can be favourable for some, whilst unfavourable to others and may continue to develop with continue MAS use.
It is important to remember a Mandibular Advancement Splint for the treatment of sleep apnoea or snoring is not simply a ‘mouthguard’ you should buy off-the-shelf to try. There are many different types that may or may not be appropriate. Long term therapy should be managed with Sleep Physicians, Dentists and Allied Health professionals to ensure the treatment is appropriately prescribed and side effects can be managed appropriately.
References
https://www.ncbi.nlm.nih.gov/pubmed/28094865
Oral Rehabil. 2017 Jan 17. doi: 10.1111/joor.12485. [Epub ahead of print]
Long-term side effects on the temporomandibular joints and orofacial function in patients with obstructive sleep apnea treated with a mandibular advancement device.
https://www.ncbi.nlm.nih.gov/pubmed/28057701
Eur J Orthod. 2017 Jan 5. pii: cjw081. doi: 10.1093/ejo/cjw081. [Epub ahead of print]
A prospective 10-year follow-up dental cast study of patients with obstructive sleep apnoea/snoring who use a mandibular protruding device.
Fransson AM1,2, Kowalczyk A3, Isacsson G4.
