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Dental Sleep Medicine
Four Part Treatment
Diagnosis – before you can be accepted as a patient for Oral Appliance Therapy (OAT), you must have undergone a standard polysomnography (laboratory sleep test) or a home sleep test that has been read and diagnosed by a qualified sleep physician. Snoring alone is a possibility, however obstructive sleep apnea (OSA) very often accompanies snoring and has to be ruled out before we can consider you to be a candidate for OAT.
If you have not been through the diagnostic process but think you or your loved one may have a problem of this nature, we would be happy to discuss it with you. Dentists are not allowed to diagnose such medical problems as OSA, however we can and do refer patients to sleep laboratories for sleep testing. We also have a home sleep testing device that we can send home with you to screen you for OSA. The data obtained by this home sleep test may be sent to a qualified sleep physician for diagnosis.
When you come to our office we will conduct an oral and radiographic evaluation of your teeth and jaws. We will also conduct an acoustic nasal (rhinometry) and oral-pharyngeal (pharyngometry) airway evaluation with a radiographic view of your airway to determine if you are a candidate for OAT and to have an idea if the treatment may have a reasonable chance of success.
The Appliance – Consideration is given to what kind of oral appliance best suits your needs based on your diagnostic workup. Once that has been determined we get to work making models of your teeth upon which the appliance will be constructed. The jaw position relationship in this treatment is crucial and we will take great care in deciding where to begin. The appliance will be constructed in a dental laboratory and upon its return to our office we will fit the appliance in your mouth making sure it is as comfortable as possible.
Therapy – Once your appliance is fitted and you have become accustomed to its use over several weeks, we will send you home with our home sleep-testing device to evaluate the efficacy of your oral appliance therapy. When we have determined that we have eliminated your snoring and OSA or improved it to the greatest degree possible, we will return you to your primary physician’s care for their own follow-up procedures which may include a laboratory sleep test to verify that your appliance therapy is effective.
Continued care – OSA is known to be a progressive disease, that is, it tends to worsen over time. With that in mind, it is important that periodically we re-evaluate you to make sure that your oral appliance therapy remains effective. During the first year following delivery of your appliance therapy, we will call you in on a six-month basis to evaluate you and your appliance. Thereafter, we will expect to see you at least once per year to for the same.
The saying goes that nothing lasts forever and even though oral appliances are made of very durable materials, we also understand that the oral environment can be very hostile to such materials… in other words, from time to time, repairs and/or remaking of the appliance may be necessary.