Bring on the Snorers: A Case for Entry-Level Sleep Disordered Breathing Products in the Dental Practice

by Patrick Tessier, MBA
Sleep disordered breathing (SDB) is certainly the most prevalent, under-diagnosed health issue of our time, affecting approximately 90 million Americans. Add in the second hand snore recipients and it’s difficult to find people who are unaffected by snoring or sleep apnea.
Most people that decide to take action to treat their sleep disordered breathing do not immediately think of their dentist to help them. They don’t go to their primary care MD. Most people first go online.
With over $10 million spent by pre-fabricated oral appliance manufacturers per year marketing to consumers, it’s pretty easy to find a potential solution. Our fellow citizens purchase somewhere in the range of 750,000-1,000,000 of these oral appliances and other SDB treatments every year. The DSM practices are delivering less than 75,000 custom appliances per year. This means that only about 10% of patients are obtaining treatment from a professional, 90% purchase something without any professional oversight.
Are they getting proper treatment? Would they be better off seeking out professional treatment? How do health care professionals reach these patients and get them engaged with their practices?
There are many questions and opinions about this subject. But, a couple observations are widely supported by research and literature:

  • Market demand for SDB treatment is huge and getting bigger.
  • People are willing to spend $100s for simple SDB products.
  • Very few professionals offer a low cost entry point for their treatment.

Like many of the professionals involved in treating SDB, our mission is get more people treated in a professional setting. The benefits to improving the lives of folks with SDB and their sleeping partners affects all of us. We need your help! The following lays out the health care and business argument to offering a low cost, entry point for SDB patients and their partners.

Health Care Case

The professionals engaged in treating SDB know the statistics. Only 10-20% of the population afflicted with sleep apnea have been diagnosed and been offered treatment.
Of the 90 million people in the US that have some form of sleep disordered breathing, including snoring, only about 1% find treatment every year. And less than 0.1% each year are professionally treated with custom oral appliances.
Since the great majority of patients are self-treating with pre-fabricated appliances or other devices, the easiest method to getting more patients into the professional practice is to offer low cost products directly to the patients.
Our research has shown that if the provider offers small steps, then the patient is more likely to complete the SDB process. For example: A Stop-Bang questionnaire is a good starting point, easy to administer and clinically validated. Using a pre-fabricated trial appliance can provide validation of the oral appliance treatment strategy. It’s not long lasting or comfortable compared to the custom device, but gets the patient to the next step of HST or PSG. This leads to an MD evaluation, potential diagnosis and Rx. Finally, we have all the steps needed to treat with the custom oral appliance. This is just an example, your protocol may be different.
One of the pioneers in oral appliance therapy, Airway Management, is promoting this method. They have developed a protocol called the TAP Method™, which calls for the delivery of a low cost trial appliance at the beginning of the process. Using the TAP Method™, patients are engaged early with a low cost solution. Once connected, the professionals can keep them engaged with the practice all the way through successful long term treatment.
Whether the low cost solution is professional grade or consumer grade pre-fabricated oral appliance, the result is the same. More people getting professional treatment for SDB.
If health care providers offer entry level treatments, they can help make the world a better place. Get the patients started and coming back for long term treatments.

Business Case

The business argument for offering low cost entry level SDB products is strong. Here is a simple breakdown of the advantages to those practices that offer low cost starting points.

  • Take advantage of the marketing spend from manufacturers of pre-fabricated oral appliances.
    • Over $10 million a year is being spent in TV, Radio, Internet and print ads.
    • This has been going up at least 25 -50% per year for the last five years.
    • Divert that business into your practice.
  • Dental practices are using low cost appliances to attract new patients.
    • This is a new market segment for dentistry.
    • Just like bleaching, cancer screening and Invisalign, treating SDB creates new opportunity to differentiate and expand a Dental Practice.
  • A cash based service of treating benign snoring with pre-fabricated products can create excellent margins.
    • The actual delivery of the appliance is a simple operatory procedure. Less than 15 mins.
    • The consumer market has shown it will pay between $250 and $750 cash for the appliance and delivery service.
  • If the patient purchases the pre-fabricated appliance from the DSM practice, they are much more likely to return for the custom appliance.
    • If they purchased the pre-fabricated appliance online, they are less likely to then move to a custom product from a professional.
    • Once they start treatment with a professional, they will stay with that professional.
    • To increase the conversion to a custom appliance, many successful DSM practices rebate the cost of the pre-fabricated appliance, if the patient accepts treatment using the custom appliance.


Dentistry is the ideal health care provider segment to serve the general public and get more people treated for sleep disordered breathing. Using pre-fabricated appliances with Dentist supervision is one of the best ways to get more people started on the path for successful treatment and life improvement.
“The man who moves a mountain begins by carrying away small stones.” – Confucius

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