by Joshua R. Oltmanns and Charles R. Carlson Orofacial pain often co-occurs with problems falling asleep, maintaining sleep, and waking too early that cause impairment in daytime functioning (Carlson et al., 1998; Porto et al., 2011). These problems are captured with the definition of insomnia (American Psychiatric Association, 2013; Edinger et al., 2004) and are also … [Read more...]
OSA – Dentist and Sleep Physician Working Together
by Teresa E. Jacobs, MD Patients enter the evaluation for sleep apnea from four primary sources: subjective symptoms, complaints of a bed partner, concerns of a doctor, or the observations of a dentist. Patients put off coming in for evaluation because they are apprehensive about spending a night in the laboratory. With increasing frequency, medical insurance companies … [Read more...]
Improving Management of Obstructive Sleep Apnea with Oral Appliance Therapy – A Sleep Physician’s Perspective by Jonathan S. Lown, MD, D.ABIM
The US and global impact of Obstructive Sleep Apnea (OSA) is staggering. An estimated 52 million Americans have sleep disordered breathing, with 1 in 5 having mild apnea, and 1 in 15 having moderate to severe apnea. To quote Dr. John Remmers, “Obstructive Sleep Apnea is the most common non-communicable disease in the western world with over 200 million apneics and approximately … [Read more...]
The Precision Medicine Paradigm for Dental Sleep Medicine
True partnership between medicine and dentistry must exist if we are to make any headway treating the exponential increase in breathing disordered sleep. The days where a one page medical history in a paper chart sufficed are long gone. It has been replaced by behemoth electronic/cloud based systems with digital forms compiling massive amounts of patient health data; … [Read more...]
Pushing Air or Pulling the Jaw: Which is better for which patient?
The “halcyon days” of CPAP Thirty years ago, nasal continuous positive airway pressure (CPAP) became established as standard therapy for obstructive sleep apnea (OSA). At that time clinicians were faced with horribly sick, massively obese folks having extremely severe OSA. They died regularly and often required a tracheostomy. That all changed in 1982, when Sullivan d … [Read more...]
Eeny Meeny Miny Moe: Selecting an Appropriate Appliance for Your Patients
by David B Schwartz, DDS, D.ABDSM When it comes to ice cream flavors I like chocolate, my wife likes vanilla, my kids like mint chip, you get the point. We have many choices in everything that we do in life as well as dental sleep medicine and until we have conclusive evidence that one oral appliance works better in our hands than another, we will be left selecting the … [Read more...]
Where Do We Start?
by Robert C. Williams, DDS, FAGD You just took a course in “Treating Sleep Apnea in the Dental Practice” and you are ready to start. Your patient is ready to start. Start where? You learned all kinds of terms and acronyms (AHI, RDI ...). You were shown this new device called a George Gauge – which you supposedly set at 60-70% of maximum protrusion, send to the lab, and deliv … [Read more...]
What Sets a Successful DSM Practice Apart?
Experts from Nierman Practice management discuss why some practices implement dental sleep medicine (DSM) quickly while others struggle to get going. Rose: We have helped thousands of practices acquire success in DSM treatment and notice some practices soar while others struggle to get going. You both work with all types of practices day in and out. What major differences … [Read more...]
Getting Connected by Robert R. Rogers, DMD, ABDSM
As I pen this article, I am amazed at the intense interest in dental sleep medicine and the widespread good it is doing for millions of patients worldwide. The efficacy of oral appliances is well supported in the scientific literature, physicians are actively seeking dentists to become part of the treatment team, insurance carriers cover a significant proportion of the cost … [Read more...]
Treating sleep disorders with oral appliances
Dr. Ronald Perkins discusses symptoms of sleep disorders and his treatment protocol An as an orthodontist since the early 1970s, I typically recommended the surgical removal of the enlarged tonsils and adenoids that caused airway blockage in young children. The results of this well-known surgical procedure were immediate: Parents reported that their children were … [Read more...]
