This article deals with the question of whether the stabilization splint, which is commonly used for treating TMDs and bruxism, may pose a risk of worsening obstructive sleep apnea in patients with that condition. While a few earlier studies have touched on this matter, this is the first study to use quantitative measures to answer the question. All subjects had 3 recordings done in a sleep laboratory while wearing a splint and 3 recordings without it. Also, it is the first one to use a randomized format in which each patient is his own control; half of the patients wore a splint first and then slept without it, while the other half followed the opposite protocol.
The result was that there was a change in just one of the two variables studied. The variable affected, called AHI, which stand for Apnea-Hypopnea Index is a measure of obstructed airflow during sleep. If the index is higher than 5 events per hour and is accompanied by excessive daytime sleepiness, that qualifies for a diagnosis of obstructive sleep apnea. The second measure is called the Epworth Sleepiness Scale, which is a more subjective assessment of sleep disturbance.
In this study, the Epworth Sleepiness Scale was not different between the two conditions of wearing or not wearing a stabilization splint, but there was some difference in the AHI scores. While this difference was relatively small, it was in the negative direction of worse scores while wearing a splint. The researchers comment that this may not be clinically significant in the short run, and there are no long-run data. However, they caution dentists who want to make a stabilization splint for their patients to at least inquire about whether obstructive sleep apnea is a condition they may have.
The TMJ Association thanks Charles S. Greene, D.D.S., Clinical Professor, Department of Orthodontics, UIC College of Dentistry, Chicago, IL for this research summary.
Source: Effects of Occlusal Stabilization Splints on Obstructive Sleep Apnea: A Randomized Controlled Trial Authors: Maria Nikolopoulou, DDS, MSc/Jari Ahlberg, DDS, PhD/Corine M. Visscher, PT, PhD/Hans L. Hamburger, MD, PhD/Machiel Naeije, PhD/Frank Lobbezoo, DDS, PhD Journal of Orofacial Pain 2013; 27: (3) 199-205