First of all, I was having a discussion with a lovely patient today who was surprised to learn that I had a blog stream. I had to admit that it had been a while since I had written, but I had no idea that it had been this long! Lots has happened since the last post, but I’ll start with the most relevant and pledge to be more faithful.
I had been listening to patients talking about sleep disorders and how much they both needed and disliked the CPAP appliances, so I thought that it would be a good thing to investigate that more fully. At the recent ADA meeting in New Orleans I attended several classes on dental sleep medicine. They helped to navigate the sea of different oral appliances, indications for each, how to tailor the needs of my patients to match them up with the right appliance, etc. Most of these appliances are laboratory fabricated, so the impression technique and bite registration is the major area of focus for the Dental office. Let me run through a basic flow chart of how to proceed if you think you may suffer from sleep apnea and/ or snoring.
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The first stop should be a consultation with your primary care physician (PCP) who would then refer you to a facility for a sleep study. The results are sent back to the PCP and then in consultation with the patient will decide which avenue to pursue – CPAP appliance or oral appliance for sleep apnea, and probably oral appliance for snoring with NO sleep apnea issues. I won’t discuss CPAP therapy, since it is out of my expertise and I think most people have some understanding of what that is all about. My personal experience with CPAP was not good, and I opted for a surgical correction after discussion with my PCP. At that time there wasn’t an oral appliance option, and I’m sure I would have sought that option if it had been. In fact several people who are CPAP non-compliant have been successfully treated with oral appliance therapy once they were aware that it was an option.
If you suffer from snoring only, or if you are a second-hand snoring sufferer, Airway Management Lab introduced an appliance at the meeting called a my TAP 1000 which looks like it will be a great addition to the practice. It will be much more immediate since it can be fabricated chairside, but is still sophisticated enough that it can be adjusted during a follow-up sleep study to maximize benefits if necessary. Most of the appliances will be eligible for consideration by medical insurance as long as the PCP writes a prescription for them, so that makes them more affordable for most people. If you would like more information on this please contact our office and we will be glad to discuss this with you further.