Factors Influencing Adherence to Therapy With Occlusal Splints-A Multicentre Questionnaire Based Study.

Abstract

Background: Occlusal splints are an established treatment option for temporomandibular disorders (TMD) and for preventing the consequences of bruxism. However, the effectiveness of this therapy relies on the patient's adherence influenced by various factors. Understanding these factors is essential for improving adherence.

Objectives: This study aimed to identify factors that promote and inhibit adherence to occlusal splint therapy in adult patients with TMD and/or bruxism, 4-8 weeks after insertion.

Methods: Between July 2021 and December 2023, questionnaires were sent to adult patients who had received a splint within the previous 4 weeks. Of the 275 patients initially contacted, 200 completed the questionnaires. Adherence was self-reported as the number of days the splint was worn per week and classified as high if worn at least 5 days or if dentists' recommendations were followed. Statistical analyses included the Chi-square test, Fisher's exact test, the Mann-Whitney U test, and logistic regression to identify significant influencing factors.

Results: 67% of the enrolled patients showed high adherence. Three factors were positively associated with adherence: a positive attitude towards splint therapy (OR = 1.6), perceived positive treatment effects (OR = 2.5) and regulated sleeping times (OR = 3.0). In contrast, lower adherence was associated with sleep impairment (OR = 0.3), respiratory impairment (OR = 0.1) and increased salivation (OR = 0.3).

Conclusion: Factors influencing adherence to occlusal splint therapy were identified during the critical early treatment phase. Patient-centred strategies offer promising approaches to improve adherence to splint therapy. Further research is needed to confirm these findings, explore causal relationships and develop targeted interventions.