Following a precise diagnosis, this discipline allows the individual treatment of various problems such as bruxism, neck pain, jaw locks, joint noise, headaches and orofacial pain.
Gnathology is the branch of dentistry that deals with cranio-mandibular disorders. Gnathology (from the Greek gnathòs, mandible) highlights and treats all dysfunctions related to the temporomandibular joints: articular noises when opening and closing the mouth, headaches, orofacial pain localized in the ear area, cervical pain and mandibular blocks.
Following a precise diagnostic phase (including digital recording of mandibular movements), this discipline allows the customized treatment of various problems.
Through the aid of different treatment protocols, the most common of which involves the use of occlusal bites, a neuromuscular balance of the stomatognathic apparatus is restored.
Bite
The bite, or gnathological occlusal plate, is a custom-made medical device built in the laboratory according to the patient’s specific clinical needs. Like a tailor-made suit, the rigid transparent resin plate perfectly covers the teeth of an arch and allows for improved cranio-mandibular relations during the night, in order to cure pain symptoms and prevent tooth wear due to clenching and bruxism.
Self-moulding bites purchased in pharmacies, which are soft, are very often useless or even counterproductive for the management of any articular or occlusal pathologies and should therefore never be considered as a ‘cheap’ or simpler alternative to custom-made splints following a careful functional assessment of the patient’s mouth.
MAD
Mandibular advancing devices (MAD) are modern, sophisticated dental appliances to be worn during sleep that, by changing the position of the mandible, increase the patency of the airways and reduce the resistance to the passage of air. This leads to an improvement in airflow, blood oxygenation and sleep quality.
These aids are particularly effective in selected patients (mild to moderate obstructive sleep apnoea syndrome or OSAS, with a positional component), and in those who are intolerant of CPAP ventilatory therapy.
It must be borne in mind that obstructive sleep apnoea is an extremely disabling condition, with significant symptoms and whose management can really change the patient’s quality of life.
It is an innovative treatment that can non-invasively solve obstructive sleep breathing disorders according to the most current international guidelines. The same guidelines also recommend that mandibular advancement devices (MAD) must be prescribed, designed and operated by a dentist experienced in sleep-disordered breathing disorders. Therefore, not all dentists have the necessary training or experience to provide competent assistance not only at the delivery of the MAD but in the follow-up afterwards, as it is important to perform regular checks of both the mouth situation and the effectiveness of OSAS treatment over time.
Treatment with MAD is very well accepted by patients: it is non-invasive, if the right indications and oral conditions exist it can be ready quickly, it is a viable alternative to CPAP in intolerant patients, it has a small footprint and can thus be transported everywhere easily, and the positive results of the therapy are appreciated by the patient within a short time.
