Peer reviewed articles have established that advancing the lower mandible forward is highly effective at maintaining an open airway and thereby reducing snoring. The medical issue is to advance the jaw enough to achieve the clinical result, but not beyond which could result in comorbidities like TMJ, ligament damage etc.
The best anti snore intra oral devices offer the ability to adjust in 1mm increments to the needs of the individual patient. The oral contours of every patient are unique so it is critical to be able to precisely select the degree of advancement. This process often requires multiple changes in the setting. Thus, the intra oral appliance should allow the patient the ability to unlock the current setting and select a new setting. Many patients after 8-10 months require a new setting, because their jaw has reset itself.
The other component to clinical effectiveness is patient comfort. If the patient does not like, or cannot tolerate the oral appliance, they will elect to not use it. I have found that when patients are able to select their ideal setting, they are far more comfortable and thus more compliant and likely to use their device every night.
It is often difficult to establish the degree of advancement selected. Devices that integrate a measurement system allows the patient to precisely identify the degree of advancement and hence a reference point to make further adjustments.
I believe the best designed devices do not employ hardware of any kind, or require tools. Because the jaw muscle is the strongest muscle in the body, it can assert enough pressure to break many devices. Many patients suffer from chipped and broken teeth from devices that employ hardware.
To summarize the features to look for when selecting a prefabricated intra oral appliance for the treatment of snoring are:
• Ability to adjust in 1mm increments
• Custom impression of the patient’s teeth
• No hardware of any kind
• An integrated ruler to display setting selected
Dr. Mandell is a member of the American Academy of Periodontology, The American Dental Society, The Massachussets Dental and Periodontal Societies and The International Association of Dental Research. Dr. Mandell received his dental degree from the Boston University Goldman School of Dentistry. Dr. Mandell is an advisor for SnoreRx.
