Well, once again it has been too long since I’ve written in this blog. Recently, a patient form Farmington Hills who came in for some cosmetic dentistry mentioned he was using a CPAP and I remembered that I had neglected to follow up on my visit to the American Academy of Dental Sleep Medicine ( http://aadsm.org/index.aspx ) meeting in Baltimore in early June. I was privileged to be able to take part in 3 days of scientific sessions, classes and forums relating to the dental treatment of sleep disorders.
In a previous blog, I mentioned TAP and SOMNOMED appliances. In Baltimore, I had a chance to work with many other removable appliances such as the SILENCER, the HERBST appliance, the KLEARWAY appliance, the SUAD DEVICE, the EMA, the OASYS, and others. They all do essentially the same thing, that is move the lower jaw and floor of the mouth (tongue, etc.) forward slightly to open up the collapsed airway in the pharynx (throat) that causes the obstruction to breathing. In additon I had the opportunity to personally try out some sleep monitoring devices that provide a means of documenting the presence or absence of apneas (stopped breathing events during sleep) at home, such as the WATCH-PAT 100. the EMBLETTA, the Respironics STARDUST II, the ARES, and the MEDIBYTE. Although diagnosis of Obstructive Sleep Apnea Syndrome (OSAS) is best done by Polysomnography (PSG) done at a certified sleep clinic and interpreted by a pulmonogist, these are ideally suited to be used as follow ups to determine the effectiveness ot the dental appliances and to monitor treatment outcomes. The appliances are adjustable (titratable) and they may actually stop snoring but not stop apneas until the jaw is advanced further. These at-home diagnostic appliances can tell us if we are done titrating or need to advance the mandible (lower jaw) additionally to stop the sleep apnea.
More on this later. Until next time,
Mark W Langberg, DDS, MAGD