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Has anyone tried the SomnoDent Mas and if so how successful was it? £1000 plus is a lot to pay unless it's guaranteed to work.
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We added a new, British based testimonial on the www.oral-sleep-therapy.co.uk website here, up top. You'll find more when Googling around.
The principle is guaranteed, as in, many clinical studies have verified that mandibular advancement works. As it's custom made, once it's made there are no refunds so it's not guaranteed in that sense. Luckily (well, not luck but by design really) feedback has been nothing but great. Especially people who have given CPAP a real go but couldn't get on with it find it a real saviour. -
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Mandibular Advancement Devices, alslo known as MRD's (mandibular repositioning devices) can be an alternative, althiough should not be considered as a replacement for CPAP. At best, it is something like 50 % as effective as CPAP in cutting out airway events like apnoeas and hypopnoeas. Also, like CPAP it has its own problems - you can get quite bad ongoing jaw pain because the device pushes the jaw unnaturaly forward; you can also drool like a dog because of a foreign object being in your mouth all night. A soaked pillow every morning.... niiiiice!
TBComment
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That's sort of correct if you take these splints as a whole but when you are talking about high-end, custom engineered splints like the SomnoDent, you'll find much better performance.
For starters, they are so small, full mouth closure is absolutely possible so drooling is a non-issue. Sure, with bulky ones it can be a problem, but not with this one.
Also, in mild and moderate OSA it is far more effective than the 50% you mention. In fact, plenty of decent-number trials have demonstrated MRDs/MADs/MASes to be as effective as CPAP in lowering the AHI to sub 5 in cases of mild to moderate sleep apnoea. Granted, in severe CPAP is still the top performer.
In Germany and the US, not quite underdeveloped countries medically, they now accept high quality, custom fit, adjustable MRDs as first line treatment. The UK, for now, takes the cautious approach and recommends always trying CPAP first if it's moderate or severe. Mild sufferers can go straight on a splint.
The jaw pain is also more of an issue with inferior splints. Titratable splints like the SomnoDent can be advanced over time so you start off with say 2mm advancement of the lower jaw and increase this advancement to the desired position over say 2 weeks. This slowly trains the jaw muscles and avoids discomfort.
Custom splints and especially those which can be moved in a 3d plane like this one, also have little to no occlusal change (change in bite). Inferior splints put too much of the various forces on too few teeth, causing them to change position or bite direction. When the forces are efficiently spread over all upper and lower teeth, like with the SomnoDent, discomfort and teeth movement gets virtually entirely eliminated. Of course, this also depends on the dental health of the patient, which is why a pre-fitting assessment is part of it.
So TB you're right if you talk about the average splint. You are wrong if you just look at high-end splints like SomnoDent, OASYS, TAP and one or two others.Comment
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