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Original articles: C F Ryan, L L Love, D Peat, J A Fleetham, and A A Lowe Mandibular advancement oral appliance therapy for obstructive sleep apnoea: effect on awake calibre of the velopharynx Thorax 1999; 54: 972-977 [Abstract] [Full text] [PDF]

Electronic letters published:

Side effects of oral appliances

Murat Enoz   (31 March 2005)

Side effects of oral appliances 31 March 2005
Murat Enoz, Department of Otolaryngology, Head&Neck Surgery Istanbul University, School of Medicine, Turkey. Send letter to journal: Re: Side effects of oral appliances muratenoz{at}yahoo.com Murat Enoz	Dear Editor, Obstructive sleep apnea is an increasingly well-recognized disease characterized by periodic collapse of the upper airway during sleep. This leads to either complete or partial obstruction of the airway, resulting in apneas, hypopneas, or both. Interest in oral applicance therapy for snoring and sleep apnea has increased recently. Johson et al. Examined the effect of mandibular protrusion in 10 patients with documented sleep apnea [1]. They found that their patients were able to move their mandibles anteriorly an average of 6.9 mm. That led to an increase in posterior airway space (PAS) from the base of the tongue to the posterior pharyngeal wall of 56%. Mandibular advancement appliances, appear to have a somewhat different effect on airway dimension than voluntary forward movement of the mandible. One explanation is that it is possible that mandibular advancement devices both advance the mandible and may produce downward rotation of the mandible to varying degrees, opening up the vertical dimension. Oral appliance have many side effects [2](Box 1). Box 1 : Side effects of oral appliances. Excessive salivation Drynes of the mouth Transient discomfort may prevent early acceptance of the appliance TMJ or jaw discomfort (Long-term problems) Movement of the teeth However, oral appliances appear to be effective in patients with mild to moderate disease and are generally accepted more easily than nasal CPAP. Sincerely Dr. Murat Enoz References 1- Johnson LM, Arnett GW, Tamborello JA, Binder A. Airway changes in relationship to mandibular posturing. Otolaryngol Head Neck Surg. 1992 Feb;106(2):143-8. 2- Schmidt-Nowara WW, Lowe A, Wiegand L, et al: Oral appliances fort the treatment of snoring and obstructive sleep apnea: A review. Sleep 1995 ;18:501-510.