Mandibular advancement orthosis: prescription
Obstructive Sleep Apnea Syndrome OSAHS , beyond causing significant discomfort in the patient – disturbed sleep, fatigue, drowsiness – is a risk factor for chronic diseases – diabetes, obesity , hypertension… In this context, the management of sleep apnea and snoring seems obvious. The patient for this must be able to justify a medical prescription.
The prescription of a mandibular advancement orthosis (OAM) involves the joint intervention of two health professionals: a sleep specialist on the one hand, a practitioner specialized in maxillofacial surgery on the other hand – dental surgeon or stomatologist.
Mandibular advancement orthosis: effectiveness determines the renewal of the prescription. The prescription for the mandibular advancement orthosis can be renewed every two years, provided that the effectiveness of the solution has been tested and proven to be sufficient.
Prescription of an OAM, for a custom-made mandibular advancement orthosis:
Holder of a prescription, the patient can use a mandibular advancement orthosis to remedy his sleep apnea and snoring at a lower cost, and in optimal comfort conditions. Designed in the laboratory, the mandibular advancement orthosis is indeed molded to measure: the device adapts perfectly to the patient's jaw, and in no way represents a hindrance for the patient. falling asleep.
Without a prescription, commercial dental splints:
Mandibular advancement splints are freely available commercially at low prices. Without a prescription, however, the patient cannot claim tailor-made: the gutter, if it can be effective, is rarely comfortable. But insofar as the prescription of a mandibular advancement orthosis is often the result of a long medical process, the adaptable commercial splint can be a useful solution in the event of significant sleep disorders.
Mandibular advancement orthosis: coverage and reimbursement.
The Haute Autorité de la Santé (HAS), under certain conditions, recommends the use of a mandibular advancement orthosis as a treatment for OSAHS . To this extent, the Health Insurance reimburses part of the tailor-made devices.
Support since 2008:
Previously, only treatment with Continuous Positive Pressure (CPP) was reimbursed by Social Security. Medical progress having demonstrated the effectiveness of the mandibular advancement orthosis, Health Insurance now covers part of its cost .
Please note: only certain brands benefit from reimbursement by the Health Insurance.
Mandibular advancement orthosis: reimbursement of the custom-made device and the medical act
After lengthy discussions, Social Security has granted reimbursement for the mandibular advancement orthosis and the medical act it entails.
Today, may result in partial reimbursement by Health Insurance:
- Custom design of certain orthoses: the basic reimbursement rate is €150.
- The taking of impressions, fitting and adjustment of said mandibular advancement orthoses listed on the LPPR. The basic reimbursement rate is €70.
To be reimbursed, the patient must have one of these two syndromes:
- 1st line: mild to moderate syndromes, without daytime sleepiness.
- In 2th line: moderate to severe syndromes, when the patient does not tolerate CPAP treatment.
Support accounts for approximately 65% of the overall bill.
Mandibular advancement orthosis: how it works
Intended to reduce the symptoms of snoring and sleep apnea, the mandibular thruster mechanically operated and very simple. The operation of the mandibular advancement orthosis is as follows:
- The device advances the lower jaw and tongue a few millimeters during the entire time of its use.
- The space at the back of the throat is then amplified.
- By widening the airways in the pharynx, OAM immediately reduces sleep apnea and snoring.
What does a custom-made mandibular advancement brace look like? Having a similar appearance to a protects -teeth, the mandibular advancement orthosis is divided into two parts connected by a lever: the first part is positioned on the upper jaw, the second on the lower jaw.
How to use the anti-snoring device? Used at night for more discretion, and in order not to interfere with speech during the day, the device medical must be worn regularly to be effective.
Mandibular advancement orthosis: side effects
Effective in reducing the symptoms of sleep apnea and snoring, and thus remedying their consequences on a daily basis, the mandibular advancement orthosis nevertheless has unwanted side effects.
Mandibular advancement orthosis: opinions differ. The side effects of the anti-snoring device encourage its early termination. In this context, its effectiveness is controversial.
Immediate adverse effects of the mandibular advancement orthosis
The patient may be confronted with a first side effect of the medical device, even when he uses it for the first time: discomfort. Although molded directly on the patient's dentition, this custom-made appliance remains cumbersome and paralyzing. Under these conditions, it requires perseverance on the part of the patient. Discomfort is indeed the first factor in abandoning the mandibular advancement orthosis, which reduces its effectiveness to nothing.
Another difficulty when wearing his OAM, the patient may hypersalivate or may on the contrary experience significant dryness of the mouth. These unwanted consequences are sources of significant discomfort. Also, possible tooth, muscle and joint pain as well as numbness in the oral area are among the side effects of the mandibular advancement orthosis . Suffering from one of these side effects, many patients do not tolerate wearing a mandibular advancement orthosis.
Mandibular Advancement Brace: Long-Term Side Effects
The tray, worn regularly, enclaves the dentition. For this reason, prolonged use of a mandibular advancement orthosis can have orthodontic consequences:
- The teeth move.
- The occlusion is changed.
- The sensitivity of the gums is accentuated.
Solutions other than the advanced mandibular orthosis
Not concerned by the indications for the advanced mandibular orthosis or too uncomfortable by its undesirable side effects, the patient has other solutions to treat sleep apnea and snoring. Beyond the device found on the market – thermoformable mandibular advancement orthosis in particular – the patient can resort to the following measures:
- Health and dietary measures: by adopting an appropriate lifestyle and an adequate sleeping position, the patient can reduce their snoring symptoms.
- Continuous Positive Airway Pressure (CPAP) is now considered the benchmark therapeutic solution for treating OSAHS.
- Surgery: very invasive and often disproportionate, it can treat sleep apnea and snoring.
- The radio-frequency.
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