Exploring the Use of Speech Features to Determine Mandibular Position In Oral Appliance Therapy for Dental Sleep Medicine

• Author / Creator

  Ng, Enoch T

• This thesis assessed the use of speech characteristics to determine mandibular position for oral appliance therapy in dental sleep medicine. A review of the literature was completed indicating minimal research into this subject and no clear definition on appropriate use and application of the procedure. A retrospective comparison between patients treated with the anterior protrusive technique and the sibilant phoneme technique for mandibular positioning suggested there may be clinically relevant differences in target mandibular position worthwhile exploring. A questionnaire was created and validated to explore differences in patient experience in oral appliance therapy. An interdisciplinary expert panel was convened which reached a consensus definition for the use of speech characteristics to determine mandibular position in oral appliance therapy. A randomized crossover pilot study was conducted providing initial comparative data between the anterior protrusive and speech positioning techniques as well as initial efficacy data on the speech positioning technique for oral appliance therapy. The creation of the first validated questionnaire to measure patient experience in oral appliance therapy provides a foundational step in evaluating, understanding, and improving patient outcomes in dental sleep medicine. It also provides a roadmap for expanding patient experience research in continuous positive airway pressure. The formal establishment of an interdisciplinary consensus procedure for the use of speech characteristics to determine mandibular position for oral appliance therapy will allow for reproducibility in teaching clinicians and for future research. From the pilot study a crossover randomized controlled trial is feasible. Initial data also suggests patients may have more than one target therapeutic mandibular position in oral appliance therapy, with significantly less mandibular protrusion for the speech positioning technique necessary compared to the anterior protrusive technique. The speech positioning technique is a clinically viable alternative technique with the possibility of increasing the number of patients responsive to oral appliance therapy and for patients with limited mandibular protrusion.

• Subjects / Keywords

  • dental sleep medicine
  • oral appliance therapy
  • obstructive sleep apnea
  • speech
  • phonetics

• Graduation date

  Fall 2024

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/r3-6a31-b741

• License

  This thesis is made available by the University of Alberta Library with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.