Snoring and obstructive sleep apnea can be serious medical problems.Obstructive sleep apnea can increase the risk for heart attack, stroke, diabetes and other serious illnesses. Choosing a sleep-disorders dentist who is qualified to work with your physician is essential to your health or the health of a loved one.
The dentist you choose to treat your problem with sleep disordered breathing must be properly educated and with adequate experience. Legally, any dentist can treat snoring and/or sleep apnea with an oral appliance, however, that does not mean that every dentist has the necessary experience and training to provide proper therapy. As snoring and sleep apnea can be deleterious to your health it is imperative that you choose a dentist with the special and necessary qualifications.
Dentists cannot legally make the diagnosis of primary snoring, upper airway resistance syndrome or obstructive sleep apnea. This means that the dentist you choose must be able to work closely with your physician to determine an appropriate treatment regimen.
A qualified sleep-disorders dentist must:
- Be willing and able to work closely with physicians and other health care professionals
- Have appropriate knowledge of sleep medicine as well as jaw joint function
- Have adequate training/education in oral appliance therapy. Oral appliance therapy for snoring and sleep apnea is not yet generally taught in dental schools. It is your responsibility to ask the dentist you choose for proof of adequate professional continuing education courses from reliable, accredited sources. Dentists are provided with Certificates of Attendance from courses and are required to keep records of the continuing education taken
- Be able to treat effectively with different appliance types since no one appliance can solve the problems of each individual patient
- Have a solid relationships with local sleep labs and sleep physicians
- Have a team approach with other professionals. Management by a dentist should always involve interaction and communication with your family physician, cardiologist, pulmonologist and/or endocrinologist and others as necessary.
- Have a proven follow-up system to ensure healthy results long-term
- Have an in-depth knowledge of oral appliance research
- Provide statement of informed consent that fully explains all possible contraindications and potential side effects
- Not represent that oral appliance therapy treat any medical condition unless that claim is based upon published, peer-reviewed, scientific research
- Realize that oral appliance therapy is not always the most beneficial treatment and should suggest alternate therapeutic modalities (CPAP, surgery) when appropriate
Several caveats - Beware of dentists who claim they have a "secret" process or an "exclusive appliance" or an appliance that they "invented" and that only they have access to.
The Code of Ethics of the American Dental Association states:
"Except for formal investigative studies, dentists shall be obliged to prescribe, dispense, or promote only those devices, drugs and other agents whose complete formulae are available to the dental profession. Dentists shall have the further obligation of not holding out as exclusive any device, agent, method or technique if that representation would be false or misleading in any material respect."
Ask about diagnostic and oral appliances that will be used and about the scientific research that supports their use. All effective and FDA approved appliances are available to ALL dentists with no restrictions as to their use.
Be careful about selecting a dentist from a site that advocates a single appliance or technique
There are well over 80 different appliances and many diagnostic and monitoring devices. Most qualified dentists use 3 or 4 different appliances depending on the particular needs of the individual patient. Since it is not legal for a dentist to make a diagnosis of sleep apnea, most of the "diagnostic" devices are used by dentists to measure response to oral appliance therapy before referring the patient back to the sleep physician for a final sleep test. There is no device or technique as yet that can predict the response to oral appliance therapy.
Nota Bene: Treatment of snoring and sleep apnea with an oral appliance is not covered by dental insurance, but rather by medical insuranc .Insurance coverage for oral appliance therapy requires a prescription from a physician that oral appliance therapy is appropriate and medically necessary. The dental office you select for treatment should be able to discuss all insurance options with you and assist you in receiving benefits but no one can "guarantee" coverage either by private insurance companies or Medicare.
