Dr. Robert Rogers

The American Academy of Dental Sleep Medicine celebrates its 30th Anniversary this year. To recognize this milestone, DSP called up the dentist who began it all, Dr. Robert Rogers.

DSP: We’re celebrating the 30th anniversary of the AADSM. What are your thoughts about that milestone? Do you think, back when the small group formed the sleep disorders dental society, it would grow like this?

Steve, it’s almost beyond words. What a rare occasion when one finds themself in a position so unique as to potentially impact the health of millions of people worldwide. In 1990, I took a course from the late Dr. Tom Meade in San Antonio and learned how to fabricate a boil and bite Snore Guard. No one was more surprised than I to discover that it was effective for my father-in-law who ceased snoring and felt refreshed for the first time in 30 years. I found a handful of other dentists across the country who had similar experiences and we formed a “study club,” with monthly phone conversations. Arthur Strauss, Michael Alvarez, Alan Lowe, Peter George and one or two others were part of this initial group. After a few months, someone suggested we form a “society” comprised of a membership of like-minded individuals. We placed an ad in the Journal of the ADA and surprisingly, 75 people responded, becoming the original founding members of the Sleep Disorders Dental Society (SDDS). I was chosen as the founding president, and we held our first annual meeting in Phoenix, AZ with an attendance of 25 dentists. It spanned little more than 24 hours with no vendors and only one speaker, albeit a great one, Alan Lowe. It was particularly challenging to grow our field in the absence of sufficient research, physician support, insurance reimbursement, and the leading-edge appliance designs we have today. This year, our 30th Anniversary Meeting will boast well over 1,000 participants, dozens of vendors, and world class speakers.

DSP: You and Mary Beth ran the society for over 10 years all by yourselves. What were some memorable events during that time?

Looking back, it’s hard to believe we managed the day-to-day operation of the SDDS (eventually the American Academy of Dental Sleep Medicine [AADSM]) for over 10 years completely out of our home with Mary Beth as the first executive director. I can remember Mary Beth being on the phone many hours each day fielding calls from our growing membership and organizing our annual meetings. A less pleasant memory involves being unceremoniously required to move our annual meeting out of the hotel that the physicians’ American Sleep Disorders Association had booked the same weekend because they viewed us as unqualified and somehow competing with them. My fondest memories are of the personal relationships I have established with the very many wonderful people who have stepped up to grow and develop our organization. I can honestly say that, outside of family, these relationships remain the most meaningful in my career.

Dentists’ responsibilities will expand and be more integrated with the medical team.

DSP: How did the presence of the AADSM help your clinic work in Pittsburgh?

The number of ways the AADSM has benefitted its members is exhaustive. It certainly has helped me over the years. Initially, when our organization dovetailed with physicians’ groups, we obtained much-needed professional guidance. This, I think, was critical and helped develop professional integrity and thus the support of our medical colleagues. Task forces were formed to create and update review papers, position papers, and practice parameters. Ultimately, a CPT code for oral appliances was created to allow us to work more efficiently with third-party insurance carriers. Presently the field of Dental Sleep Medicine has several magazines and professional journals. We have a board certification program for doctors. One of the most outstanding features of our Academy is the impressive annual meeting with the opportunity to network with the most committed colleagues in the country.

DSP: Today’s dentist treating sleep-related breathing disorders has a different relationship with physicians than in the early days. What do you think about the next 30 years? Or the next two to five years?

The roles of the dentist and the physician in treating sleep-related breathing disorders have certainly changed over the past 30 years. Our overall training and experience have evolved over the decades and oral appliance design has become advanced and nuanced. Many years of close collaboration with our medical colleagues has served us all well. I think it is easy to speculate that over time dentists’ responsibilities will expand, and we will become even more integrated with the medical team, taking a leadership role in appropriate situations. Dentists will be at the forefront of addressing and impacting the developing airway in children, leading to better breathing day and night.

DSP: Your accumulated clinical wisdom led you to develop the Medley, the oral appliance with more configuration options. That’s a daunting process, to introduce a new device. What problem were you trying to solve?

Over the past 31 years, I have treated in excess of 11,000 patients with oral appliances and have used most of the designs available today. I have been “around the track” as they say and have experienced remarkable success with many of them and at the same time have had more than my share of frustrations. Over time, it became apparent to me that no single appliance design is effective for every patient. With this in mind, I created a “universal” appliance that offers three different advancement mechanisms on the same base platform. Hence, the name Medley. In less than a minute, chairside, the Medley appliance (FDA cleared and PDAC approved) can transform from a rigid nylon link, similar to a Panthera, to an elastomeric strap in the style of the EMA appliance. And in another minute, take advantage of the Herbst rod/sleeve mechanism if indicated. The variable Medley design offers dentists and patients a quick, easy, and economical way to utilize three different advancement approaches without having to incur additional lab expense or waste valuable treatment time. Presently, the Medley is undergoing some improvements to take advantage of the newer digital approaches and will again be available by the end of this year.

DSP: I’m curious about your thoughts on the name “Dental Sleep Medicine.” Do you think it is still the right label for what dentists do?

I coined the term “dental sleep medicine” about 20 years ago during a lecture I gave to the Association of Professional Sleep Societies (APSS), the forerunner of the American Academy of Sleep Medicine (AASM). At the time, it was very descriptive and focused on a new, innovative approach to address sleep-disordered breathing. I believe it is well accepted, well recognized, and has held up very well over the years. However, with much of dentistry now becoming “airway focused” and with innovative ways to manage pediatric airways, the generic term “dental” may be misleading or limiting. I believe dentists can positively affect the upper airway during wakefulness as well as during sleep. While I think that “dental sleep medicine” is the right label for what we are predominantly doing now, it may not the best label for what we will be doing in the future.