What to look for in an ideal Mandibular Advancement Splint (MAS)?
The Mandibular Advancement Splint used as an anti-snoring appliance or to treat sleep apnoea, can be highly successful. These splints push the lower jaw into a forward position, to create a clear airway behind the tongue. The amount of forward position and the comfort of the mandibular advancement splint determine the success.
5 factors that make a successful Mandibular Advancement Splint (MAS):
- The MAS must be titratable – you must be able to gradually move the lower jaw forward after the initial set position. The appliance requires an adjustable mechanism contained within the structure to gradually move the lower jaw forward. Fine calibrated movements as low as 0.1mm are even better at making an accurate fully customised splint. This is very important in those who suffer jaw joint pain.
- The upper and lower jaws are best NOT connected together. I have found patients who I have switched from connected to disconnected splints, report a significant increase in comfort levels and compliance. If the splint is not connected, there is a degree of free jaw movement which enables swallowing and also prevents the lower jaw dropping out of the appliance during the night.
- The material the splint is made from will perform best as a rigid material rather than a soft flexible material. A rigid material will provide far more stability and comfort. I have seen bruxing (teeth grinding) patients chip and break crowns even after being separated by 10mms of soft material.
- Mandibular advancement splints (MAS) made from material of a higher end manufacturing process and not low quality will fit far more comfortably. They will require far less adjusting than cheaper materials. Cheaper materials present a greater challenge to fit and will not give the years of service expected for the investment.
- Splints should be made to minimise the separation between the teeth. Obviously a degree of separation is required to fit the splint. If the mouth is forced open too far, a lip seal will be difficult to achieve. A dry mouth every morning can be very uncomfortable. Minimal thickness of material is very important along with minimal extension over the soft tissues. If splints extend below the gum line and dig into the soft tissues the desire to wear the appliance dramatically decreases. The amount of adjustments at the dentist also increases significantly.
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Next time you explore the many treatment options on the market, this check list will help. We are experienced in the gold standard Somnodent an effective anti-snoring treatment
Snoring can be hiding more serious health problems such as obstructive sleep apnoea (OSA).
OSA occurs when your airway closes partially or completely, while you are sleeping, stopping you from breathing and creating restless sleep. This can happen hundreds of times during the night with each period of no breathing lasting between 10-60 seconds. This occurs because the muscle control in the throat collapses and you must partially wake up to restore the muscle control. These interrupted breathing patterns result in fragmented and poor quality sleep leaving you with daytime sleepiness and fatigue.
It can be likened to drinking through a paper straw with the straw being your throat. As the walls of the paper straw collapse (similar to a loss of muscle control) it becomes harder to drink through the straw, and the more you suck through the straw the greater the effort required to draw the liquid. During sleep, in an attempt to overcome the obstruction to the airway, you breath harder using your chest walls and muscles, but the harder you breath the more the walls of the airway collapse.
OSA should be properly diagnosed generally by your GP ordering a sleep study, which can be done in your own home or in a sleep facility. The trigger for presenting to your GP is usually you noticing very low daytime energy levels and alertness and an increased likelihood of falling asleep in the day, or a partner complaining about your snoring.
Depending on the severity of the sleep apnoea it may be advised to use a CPAP machine or be fitted with a mandibular advancement splint. This device fitted in the mouth, prevents the airway from collapsing during sleep by holding the jaw forward.
On referral from your sleep physician or your GP we can provide you with a mandibular advancement splint.
Whilst there are many brands available on the internet, the most reputable and highly researched brand is provided by Somnomed and is called the Somnodent. Other devices can cause you to simply become a mouth breather with drying of the mouth a very uncomfortable side effect. The Somnodent is designed to prevent this from occurring. It works by advancing your lower jaw into a comfortable forward position via incremental adjustments, to suit your personal comfort level. This should then effectively reduce snoring and sleep apnoea and allow a comfortable night’s sleep.
Somnodent Appliance by Somomed -www.somnomed.com