Homeostasis. It may be my favorite word. The more I learn about how the body works, the more impressed I become by the exquisite interconnection and fundamental perfection of the systems. It’s amazing to learn how a disruption such as interrupted breathing patterns during sleep will cascade into the variety of disease that we observe in our patients. Science is increasingly adept at connecting the dots but cause-and-effect links remain elusive due to human variation. It’s becoming difficult to look past the growing body of evidence that giving the body the ability to move air with the least restriction possible, at all times, simultaneously minimizes destructive stress and maximizes the regenerative process. Restore best conditions and health returns. Of course, there are many health issues that affect humans ‘unrelated’ to sleep and breathing and thus are not directly responsive to restoration of the patent airway. It is safe to say, however that no person ever suffers from a good night’s sleep, with quiet, unstressed breathing.
Dentists who seek their place in this worthy endeavor are constantly curious about what’s next in the advancement of the field. Origin stories help us all know how we came to be where we are. Part of knowing how to chart a course for the future involves understanding where we were before, what lessons were learned, and who has been willing to accompany us on the journey. I’m fascinated by these tales of discovery. Dr. Thomas Meade was one of those pioneers – smart, dedicated and fearless dentists trying to find novel ways of impacting the health of their patients beyond the typical range of dentistry.
Navigating these new areas required making connections outside our offices, with medical professionals, government regulatory bodies, unfamiliar lab requirements, medical researchers, and frighteningly different third-party payer relationships to contend with. Pioneers paved the way, demand and response kept the pressure up, and research came around for support, resulting in acceptance of oral appliance therapy by most, but not all, the gatekeepers.
This young profession thrives on the dedication of pioneers and the insights of dentists new to the field
Mandibular Advancement Devices. As if the posture forward was all that mattered, or happened, in the course of stabilizing the airway. It’s far more complex than that, with serious, simultaneous consequences of therapy that must be dealt with, as they might be the least impactful choice available to the patient. Not only does this require us to be adept at discovery and management of the patient’s emotions related to therapy, but our own, as well.
Like several readers of this magazine, and seen with increasing frequency across the profession, I have transitioned my practice to focus exclusively on dental sleep medicine, a career move wholly unanticipated when Dr. Keith Thornton started badgering me to treat sleep problems in the early 1990’s. Who knew where any of us would be from those days?
As if ‘those days’ were far in the past – of course, they are not. This young profession thrives on the dedication of pioneers and the insight of dentists fresh from the latest introductory course – it’s all of us together that build the foundation of wisdom from which to launch the innovations of fresh ideas. Human physiology demands simple-to-describe yet hard-to-achieve benchmarks to achieve homeostasis. Good thing there are so many of us working on it.