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Sleep Med. 2013 Jul;14(7):656-61. doi: 10.1016/j.sleep.2013.03.009. Epub 2013 May 2.

Sleep bruxism, snoring, and headaches in adolescents: short-term effects of a mandibular advancement appliance.

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Faculté de Médecine Dentaire, Université de Montréal, CP 6128, succursale Centre-ville, Montréal, Québec, Canada H3C 3J7.



Sleep bruxism (SB) frequently is associated with other sleep disorders and pain concerns. Our study assesses the efficacy of a mandibular advancement appliance (MAA) for SB management in adolescents reporting snoring and headache (HA).


Sixteen adolescents (mean age, 14.9±0.5) reporting SB, HA (>1d/wk), or snoring underwent four ambulatory polysomnographies for baseline (BSL) and while wearing MAA during sleep. MAA was worn in three positions (free splints [FS], neutral position [NP], and advanced to 50% of maximum protrusion [A50]) for 1 week each in random order (FS-NP-A50 or NP-A50-FS; titration order, NP-A50). Reports of HA were assessed with pain questionnaires.


Overall, sleep variables did not differ across the four nights. SB index decreased up to 60% with MAA in A50 (P=.004; analysis of variance). Snoring was measured as the percentage of sleep time spent snoring. The subgroup of snorers (n=8) showed significant improvement with MAA (-93%; P=.002). Initial HA intensity was reported at 42.7±5/100 mm, showing a decreasing trend with MAA (-21% to -51%; P=.07).


Short-term use of an MAA appears to reduce SB, snoring, and reports of HA. However, interactions between SB, breathing during sleep, and HA as well as the long-term effectiveness and safety of MAA in adolescents need further investigation.


Headache; Mandibular advancement appliance; Pediatrics; Polysomnography; Sleep; Sleep bruxism; Snoring

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