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Seeing is Believing

by Samuel E. Cress, DDS ”CBCT is useless in dental sleep because people don’t sleep sitting upright.” “CBCT is a wasteful expensive piece of equipment that unnecessarily radiates my patients.” You have probably heard these types of statements in lectures or on social media. Maybe you’ve even cast similar aspersions. I’d say it’s inarguable that a clearer understanding of the guest’s anatomical features for implant placement, endodontics, and dental sleep medicine (DSM) enables you to become a better clinician.  In …

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Treating Severe OSA – Versatility is Key

by Steven Olmos, DDS, DABCP, DABCDSM, D.ABDSM, DAIPM, FAAOP, FAACP, FICCMO, FADI, FIAO Sleep disordered breathing (SDB) is comprised of various structural and neural pathologies of the upper airway. Obstructive sleep apnea (OSA) is among the most prevalent forms of SDB. Regardless of disease severity, OSA has a host of metabolic and cardiovascular comorbid conditions. Mild and moderate apnea is often treated with positive pressure devices including APAP, BiPAP, and CPAP. However, 46% to 83% of patients are nonadherent if …

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Innovation at Arm’s Length

by Barry Chase, DDS Over many years of practicing dental sleep medicine, I have become a big proponent of the Herbst appliance to treat Obstructive Sleep Apnea. It is indicated for a wide swath of the patient population including bruxers, people with significant opening, and those with extensive protrusive ranges of motion. I’ve always felt that Herbst arms have been the “weak link” because they break, they don’t maintain position over time, and it’s been mind-numbingly difficult to accurately titrate …

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No More Porridge

by Mark T. Murphy, DDS, D.ABDSM Evolution refers to the gradual development or changes in something over time. Revolution means ‘a turnaround’; a sudden, complete, or radical change in something, occurring in a “staggeringly” short period of time. The ProSomnus® [IA] was unquestionably ‘revolutionary.’ As the first iterative design, first precision engineered platform, and first control cured, milled PMMA, it was met with skepticism, and a doubtful attitude that seemed to shout, “that will never catch on.” That was 2014, …

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Protect Dentistry with Panthera Sleep® Night Guard

by Diane Robichaud, t.d. Night guards, a sub-category of occlusal splints, are the most widely prescribed orthoses in dentistry. The recognized role of night guards is the protection of natural dentition and restorations from damaging parafunctional forces and, in some cases, headache relief and treatment of muscle soreness or TMJ pain. Night guards can be used as a permissive splint/muscle deprogrammer (Dawson) and as a muscle relaxation/stabilization appliance (Okeson).1,2 Splints can be placed on either the maxillary or mandibular arches …

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Building Physician Trust with Preferred OAT Designs

by Mark T. Murphy, DDS, D.ABDSM Earning physicians’ trust in OAT requires that we utilize device designs that demonstrate better efficacy, are within the designated precision tolerances, and have exceptional patient comfort and compliance. We could call that the ‘gold standard’ of OAT. A recent survey of prominent Dental Sleep Medicine clinicians exhibited a keen understanding of this. Device Fit, Size, Durability and Biocompatibility, the attributes most closely aligned with preferences of sleep physicians, all ranked significantly higher than attributes …

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Pending Restorative Work But Need Oral Appliance Therapy?

All practices, even full-time sleep practices, have patients that present for sleep apnea treatment while in the process of having restorative dentistry done. Doctors usually have a hard-acrylic sleep device made so they can retro-fit the device to the restorative work, once completed by their dentist at a later date. This is very labor intensive, distorts the integrity of the OSA device, and requires valuable chair time that could be spent with new patients. So, how do practices avoid or …

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