Dental sleep medicine - therapeutic value of mandibular advancement devices

Obstructive sleep apnea syndrome (OSAS) and snoring occur due to the narrowing of the upper airway. While OSAS can lead to a variety of potentially serious health complications, snoring is not considered a significant medical problem. Mandibular advancement devices (MADs) work by widening the upper airway. In recent years, MADs have emerged as effective, widely accepted treatment modalities for OSAS and snoring. MADs are adjustable, custom-made appliances fabricated from dental impressions. In sleep medicine, MADs make it possible to advance and readjust the position of the mandible millimeter by millimeter over the entire treatment period. This capacity for controlled adjustment (titration) significantly increases the therapeutic effectiveness of these devices and prevents unwanted side effects. Successful MAD therapy requires close interdisciplinary cooperation between medical and dental professionals, and a dentist with a high level of knowledge and experience in the field of dental sleep medicine. The inherent interdisciplinary nature of this new field generates a variety of opportunities for dentists, extending their reach beyond MAD therapy into, for example, orthodontic treatment of sleep disorders in children. Dental sleep medicine is emerging as a wide-ranging and completely new field of dentistry. Keywords: sleep, sleep-related breathing disorders, obstructive sleep apnea syndrome (OSAS), mandibular advancement device (MAD), continuous positive airway pressure (CPAP), guidelines, titration