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

Study background: Obesity is constantly increasing health problem worldwide and so are its detrimental consequences, including obstructive sleep apnea (OSA). Mandibular advancement devices (MADs) are proven to be efficient in treating mild to moderate OSA and snoring. We followed for two years 103 patients treated with a titrable MAD in a Community Dental Care setting. Methods: A follow-up questionnaire was mailed in 2012 to 124 patients who had participated in a survey 2010 and given their consent for further study. Results: Of all the 103 respondents 85% (n=88) still used MAD. Subjective tiredness (p<0.05) and the presence of any snoring (p<0.01) were reported more often in the long-term study than in the short-term study. In contrast, difficulty in initiating sleep with the device in situ was seen less often (p<0.05). According to the logistic regression, reduced loud snoring was significantly associated with the compliance of frequent wear of MAD (p<0.05). The majority (82%) of the patients also reported a positive impact of MAD in social (family) life due to reduced loud snoring. Conclusion: Titrable MAD is a noteworthy treatment modality for mild to moderate OSA and especially snoring. Compliance in using MADs and reported subjective health seem to remain at good level. General dentists could probably perform a great part of the care. However, possible worsening of OSA and side effects of MADs should be borne in mind.