Mandibular advancement device therapy for obstructive sleep apnea: A longitudinal study among patients treated in community dental care in Finland - Potential for the precision medicine approach

• Published in: Cranio Vol. 40; no. 3; pp. 268 - 273
• Main Authors: Vuorjoki-Ranta, Tiina Riitta, Kämppi, Antti, Aarab, Ghizlane, Tuomilehto, Henri, Pihakari, Antti, Lobbezoo, Frank, Ahlberg, Jari
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 04-05-2022
• Subjects: Community dental care; compliance; follow-up studies; mandibular advancement device; obstructive sleep apnea; snoring; obstructive sleep apnea; follow-up studies; mandibular advancement device; compliance; Community dental care; snoring
• ISSN: 0886-9634; 2151-0903
• DOI: 10.1080/08869634.2020.1752431

Objective: Obstructive sleep apnea (OSA) is an increasing health problem worldwide. The aim was to evaluate long-term mandibular advancement device (MAD) therapy outcomes in community dental care among OSA patients in Finland.
Methods: In all, 142 (77.2%) respondents of a questionnaire, with recently initiated treatment, were included in the study in 2010. Follow-up questionnaires were mailed in 2012 and 2017.
Results: Problems occurred with the device long-term. Orofacial pain was reported more often in 2012 than in 2010 (p < 0.01). Snoring (p < 0.01) and tiredness (p < 0.05) were also significantly increased. In 2017, 50 subjects were still continuing with MAD, 20 of them as a single treatment modality. Treatment modalities in combination with MAD were CPAP, nutrition counseling, and position treatment.
Discussion: Long-term MAD treatment may lead to a changing treatment-mix and set-backs. This may not only be a treatment adherence issue but also a lack of precision medicine approach regarding OSA.