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.