Are general dental practitioners effective in the management of non-apnoeic snoring using mandibular advancement appliances?
OBJECTIVE
This study assessed the effectiveness of general dental practitioners (GDPs) in the management of subjects with non-apnoeic snoring using a mandibular advancement appliance (MAA), following a one day training course.


METHODS
Sixty subjects suffering from simple, non-apnoeic snoring were treated by 15 GDPs, in three hospital centres, using a monobloc mandibular advancement appliance design. All GDPs attended a one day training course prior to the study which covered theoretical and practical training in the use of mandibular advancement appliances. Snoring and level of disturbance were assessed using a questionnaire completed by their sleeping partner before and after a three month treatment period. Daytime sleepiness was assessed by the patients using the Epworth sleepiness scale questionnaire (ESS) before and after a three month treatment period. In addition, patients completed an outcome questionnaire, to assess side-effects experienced from the MAA.


RESULTS
A success rate of 48% (95% CI 0.35, 0.61) was achieved in partner-assessed snoring and disturbance levels, following a three month period of MAA treatment. The median ESS score reduced from 9 to 7.5 (95% CI 0, 3). General dental practitioners experienced problems during protrusive bite registrations, with 10% being judged inadequate.


CONCLUSIONS
GDPs were not effective in the management of non-apnoeic snoring using a monobloc appliance after a one day training course. Further training and/or selection of a different design of appliance should be considered for GDPs to become highly competent in this area.
Manor Hospital, Moat Road, Walsall, West Midlands, WS2 9PS. s.church@nhs.net
S K J
SK
Church
S J
SJ
Littlewood
A
A
Blance
A J
AJ
Gowans
T M
TM
Hodge
R J
RJ
Spencer
A
A
Johal
D000328:Adult; D003761:Dental Impression Technique; D003796:Dental Service, Hospital; D003815:Dentists; D004498:Education, Dental, Continuing; D004739:England; D004867:Equipment Design; D005500:Follow-Up Studies; D005792:General Practice, Dental / Q000193:education; D006801:Humans; D007574:Jaw Relation Record / Q000379:methods; D019186:Mandibular Advancement / Q000009:adverse effects / Q000295:instrumentation*; D011446:Prospective Studies; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000175:diagnosis / Q000628:therapy*; D013663:Teaching / Q000379:methods; D016896:Treatment Outcome