New protocol of hygiene and motivation in the patient affected by OSAS in therapy with MAD

OBJECTIVES This study aims to evaluate a new oral hygiene protocol and the mandibular advancement device (MAD) in patients with Obstructive sleep apnea syndrome (OSAS). MATERIALS AND METHODS The study envisaged the recruit-ment of a sample of 40 subjects affected by OSAS and in therapy with MAD. During the first visit with the dental hygienist, the pa-tients informed of the purpose of the study filled in a paper questionnaire relating to oral hygiene habits and MAD. On this occasion, the professional motivated the pa-tients by identifying the V.A.K. (Vi-sual, Auditory, Kineasthetic) learn-ing model of the patients them-selves and issuing them two pro-tocols on the correct home oral hygiene techniques and mainte-nance of the MAD device. The questionnaire was recompiled at three months. RESULTS The answers to the questionnaire made it possible to compare the data regarding oral hygiene and the MAD device at T0 (first visit to the dental hygienist) and at T1 (after 3 months). After months, none of the patients claimed to have ever cleaned the device since the visit; patients who cleaned it twice a day went from 33% to 51%; the percentage of subjects washing the device with a toothbrush and surfactant in-creased to 65%; the majority (n = 33 at visit, n = 37 at follow-up) of patients stated that they kept the device in the appropriate container and the number of subjects who kept the container open increased from 9 to 29. Pa-tients who dried the device after use increased from 13 to 30; the number of patients who rated their home oral hygiene as excel-lent (score of 9 or higher) de-creased from 6 to 1, while the scores just adequate (scores of 5 and 6) doubled from 6 to 12; re-garding the cleaning of the MAD, the scores just sufficient (5 and 6) decreased from 16 to 6; the good scores (7 and 8) increased from 11 to 18, in particular the scores 8 almost tripled (from 4 to 11), the excellent scores in-creased from 9 to 12. CONCLUSIONS The experimental study conduct-ed on forty patients with OSAS confirmed how effective the mo-tivational approach used was. The protocol of home hygiene and the intraoral device has proved to be an excellent tool for implementing oral hygiene, if the patient has been sufficiently stimulated to comply with it. CLINICAL SIGNIFICANCE Demonstrate the importance of the role of the dental hygienist in the correct maintenance of the intraoral device called MAD. © 2023 EDRA SpA. Tutti i diritti riservati.