The Dental Decade of Obstructive Sleep Apnea Treatment

It wasn’t a scientific survey, but if the level of discourse at the recent APSS meeting was any indication, sleep physicians are warming up to dental sleep medicine.

Flex with new logo The Dental Decade of Obstructive Sleep Apnea Treatment

The decade of dental of sleep medicine may have quietly kicked off in the halls of this year’s Associated Professional Sleep Societies’ meeting in San Antonio. In a marked change over last year, vendors have encountered acceptance where they had previously found reluctance.

SomnoMed, an Australia-based dental sleep medical com- pany and makers of the SomnoDent® MAS devices saw the subtle shift firsthand. It started with an overall tone of positiv- ity that quickly morphed into an infectious enthusiasm. At last year’s APSS in Seattle they were still getting questions about clinical data and people asking about white papers and publi- cations. This year, they heard totally different questions, such as: ‘Where do I find SomnoMed to work with?’.

The new line of inquiry amounts to a huge shift in a rel- atively short amount of time. A year ago, attendees wanted proof, but this year more are convinced. The new mindset is at least partly due to a concerted educational effort on the part of SomnoMed and others. Focused communication to the medi- cal market has hammered home the message that oral appli- ance therapy is backed by solid evidence, with more to come in the near future.

Ralf Barschow, CEO of SomnoMed agrees that medical acceptance is higher than last year, but he believes clinicians will ultimately embrace oral therapies on a much larger scale. Along with greater acceptance, Barschow noticed a lot more traffic coming to their booths this year, with serious inquiries outnumbering the casual fact finders. “We had more people taking contact details and networking than at any other time. I would characterize the interest as sensational.”

Next year’s APSS will be held in Minnesota and could be another milestone that mirrors the situation with home sleep testing. The analogy with works because just like that facet of sleep medicine, dental therapy has taken time to settle in and gain acceptance with certain segments of the market. Full polysomnograms were once considered infinitely superior to home tests, just as it was once considered unthink- able that oral appliances could be a better choice than CPAP.

Now people realize that patients are different and options are a positive development. SomnoMed’s latest innovation the RCMP (Remote Controlled Mandible Positioner) allows physi- cians in the PSG setting, along with a technician, to basically titrate throughout the night to determine whether the therapy will work, and to determine where the bite must be to get the optimal results.

“The unit is completely integrated into the software and the tech is already familiar with the oral appliance for titra- tion,” says Barschow, who’s company custom fabricates the SomnoDent® MAS, a mandibular advancement splint. “It plugs right into the channel and literally, instead of titrating to pressures, it is titrating to advancement in millimeter fraction increments—similar to the way our device can be advanced.”

As a company, it’s all part of SomnoMed’s effort to be viewed as more than just a therapy piece. Instead, the com- pany is looking for a way to determine efficacy, compliance and spread education. There is a SomnoMed Academy, which is an educational entity that generates continuing education credits for the dental and medical fraternity. It started out in the therapy market and the therapy arena.

who wish to get involved can contact the company and purchase a starter kit with collateral materials and three devices. Participating dental professionals may choose to reg- ister for an Awaken Seminar, which is a 2-day continuing edu- cation event that teaches how to prescribe oral appli- ance therapy. “We explain why and how they need to interact with the medical community to get a proper diagnosis,” says Barschow. “However, we have always maintained, and will continue to maintain that it is the physician’s role to treat the patient, diagnose the patient, and once oral appliance therapy is deemed appropriate treatment—it goes over to the dental arena for the fitting of the device. Patient care is for the physi- cian, and diagnosis is for the physician.”

Choice is Key
Like the burgeoning industry, SomnoMed is offering more options to customers. Currently, there are three MAS gold standard products which have been developed, each with dif- ferent clinical indications aimed at OSA sufferers. These in- clude the SomnoDent® MAS Classic, SomnoDent® MAS Flex, and SomnoDent® MAS Edent for the Edentulous patient.

The SomnoDent® MAS is a custom designed sleep apnea oral appliance and has been the subject of numerous strin- gent, evidence-based studies that satisfy the need for a safe and effective treatment for OSA. The SomnoDent® MAS has a number of design features such as: a streamlined design with minimal bulk, which maximizes the size of the lingual space and reduces gagging.

The company touts an excellent fit in both upper and lower arches with anterior and posterior contact for a stable occlu- sion, which prevents tooth movement and minimizes term- pero-mandibular joint discomfort and injuries. The MAS is constructed in two separate pieces that allow patients to open and close their mouths. This allows clear speech, yawning, and drinking without requiring patients to remove the appliance. The ability to communicate clearly while wearing the device is particularly appreciated by patients and their partners.

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