The Georgia’s new legislation now says, “Depending on the diagnosis of the type and severity, one possible treatment option for obstructive apnea is the use of oral appliances.  The design, fitting, and use of oral appliances and the maintenance of oral health related to the appliances falls within the scope of the practice of dentistry.  The continuing evaluation of a person’s sleep apnea, the effect of the oral appliance on the apnea , and the need for, and type of, alternative treatment do not fall within the scope of dentistry.  Therefore, the prescribing of sleep apnea appliances does not fall within the scope of the practice of dentistry.  It is the position of the Board that a dentist may not order a sleep study. Home sleep studies should only be ordered and interpreted by a licensed physician.  Therefore, only under the orders of a physician should a dentist fabricate a sleep apnea appliance for the designated patient and conduct only those tasks permitted under OCGA title 43, chapter 11. (Adopted 4/1/2016)”

This is very disappointing for dentists in Georgia. Let’s look at the interpretation of this new law. Does it mean a dentist will no longer be able to titrate their appliance by using a home sleep test? It surely means a dentist cannot refer out to a sleep testing company such as Complete Sleep, Snap or Easy Sleep or hand out an HST to one of their patients and have a Board Certified physician do the read and diagnosis. To the ASBA this is horrible news and we will be fighting it with all of our resources. You will be pleased to know that just yesterday, ASBA Board Member and Diplomate Dr. Elliott Alpher was in Washington D.C. alongside Congresswoman Anna G. Eshoo discussing this very topic and transportation.

Dr. Elliott J. Alpher, Diplomate to and representing the American Sleep and Breathing Academy and Congresswoman Anna G. Eshoo (DCalif.), Ranking Member of the Energy and Commerce Committee’s Subcommittee on Communications and Technology for the 114th Congress met today to ask her support on proposed rulemaking for screening, diagnosing, treating and tracking compliance of Obstructive Sleep Apnea (OSA) in individuals occupying sensitive positions in highway and rail transportation.

The Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA) have requested data and information concerning the prevalence of moderate-to-severe obstructive sleep apnea (OSA) among individuals occupying safety sensitive positions in highway and rail transportation, and on its potential consequences for the safety of rail and highway transportation.

Many mental functions are reduced when an individual experiences fatigue and sleepiness. It is estimated that 20% of accidents are caused by drivers’ inattention and sleepiness, and the occurrence of drowsiness when driving is a major risk factor for dangerous accidents. Chronic excessive sleepiness and sleep-disordered breathing are common in commercial vehicles drivers.

“OSA is a prevalent disorder among workers, which increases the risk of occupational accidents and has a significant impact on public safety. Fortunately, many of these accidents could be prevented by screening and treating sleep-disordered breathing with the resources and technology available…we are grateful to have Congresswoman Eshoo’s support on this matter,” says Dr. Alpher.

Dr. Alpher, one of the District’s most experienced specialists for sleep and jaw disorders, on staff at George Washington University Hospital and Georgetown University Hospital, has been known as a leader in the treatment of sleep disorders and jaw pain for 25 years. Dr. Alpher has pioneered a conservative, non-invasive approach utilizing computerized and verifiable diagnostic methods to treat TMD, snoring and sleep apnea. This method of treatment has proven to be greatly successful and is highly regarded as the first method of choice by physicians and patients.

Dr. Alpher was also responsible for heading a delegation to the Medical Advisory Board (MAB) to introduce the new technology of compliance chips in oral appliances to treat and monitor sleep apnea and snoring of truckers and other transportation personnel. In addition, he earned the status of Diplomate of the American Board of Craniofacial Pain & Dental Sleep Medicine in October 2013 and serves as a board member. Dr. Alpher is a Diplomate of the American Academy of Pain Management, Life Member of both the American Dental Association and the District of Columbia Dental Society. Dr. Elliott Alpher says, “The ASBA is the only academy fighting for the dentists’ rights in the sleep apnea arena and the efforts will become stronger as the American Sleep and Breathing Academy grows. The more members we have the more firepower we’ll have. I am so pleased that I have joined this academy because this is the only academy making a huge difference in my humble opinion. We are so blessed to have former Congressman Marty Russo as our ally.” Dr. Elliott Alpher was elected to the ASBA Hall of Fame for his lifetime achievements in the field of dental sleep medicine. If you are a concerned dentist about your rights, join the American Sleep and Breathing Academy at americansleepandbreathingacademy.com.

Alan Hickey

Publisher of Sleep Diagnosis and Therapy Journal the Official publication of the American Sleep and Breathing Academy, the Journal is a clinical and technical publication for dental and medical professionals.

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