Key Project Outcomes
Obstructive sleep apnea (OSA) is a major health problem affecting roughly 10% of adults. It causes a significant increase in healthcare costs, morbidity and mortality. OSA leads to poor quality sleep, excessive daytime sleepiness, impaired cognitive function, and increased blood pressure. Continuous positive airway pressure (CPAP) has traditionally been the most effective treatment for OSA and while CPAP works very well, it often is not used very much or for very long by patients. Mandibular advancing Oral Appliances have been found to be a suitable alternative to CPAP for OSA treatment in some patients.
Although well tolerated, treatment with Oral Appliances has been demonstrated to lead to significant bite changes in the majority of patients, however with considerable variation between individuals. These bite changes are progressive in nature and tend to continue with ongoing Oral Appliance use. As a result, some long-term users of Oral Appliances have stopped treatment due to a decrease in quality of life caused by bite changes. Currently, it has become common practice to prescribe a repositioning splint, another type of oral appliance worn in the morning after a night of using an OSA Oral Appliance, as a means to prevent the side effects of tooth movement. However there is little clinical evidence to assess if morning splints work to prevent bite changes and tooth movement.
This study enabled the creation of a detailed group of patients that will be closely followed for years to come to directly address the question of the effectiveness of morning repositioning splints. The impact of oral health, the size of mandibular advancement, and treatment adherence all have on bite changes resulting from Oral Appliances are also outcomes reported by this study. Understanding the factors that influence these bite changes and finding ways to minimize or prevent them are essential for long term treatment effectiveness and was the focus of this study.
This research grant was supported by the American Academy of Dental Sleep Medicine and the AASM Foundation.