It’s extraordinary to see how things have changed since I started in the field of oral appliance therapy for snoring and sleep apnoea almost 20 years ago.
Back then it was almost impossible to get sleep physicians to take oral appliances seriously as a treatment for snoring or sleep apnoea. CPAP had been invented in Australia and it seemed like that’s all they knew, or were interested in. To be fair there wasn’t a lot of good research validating oral appliances, and that’s the language of sleep physicians. So I had my work cut out for me getting referrals.
As the evidence built over the years, oral appliances became more and more accepted for snoring and mild sleep apnoea as an alternative to CPAP for moderate sleep apnoea. More recent studies demonstrate that oral appliances are almost as effective as the CPAP machine – even for severe sleep apnoea.
As a result the American Academy of Sleep Medicine, the world peak body in the field, has published guidelines recommending that sleep physicians should be offering oral appliances as an alternative to CPAP, even for severe sleep apnoea.
While CPAP is still unquestionably the treatment of choice for the severest forms of sleep apnoea, there are many patients in this category who, despite all the advances in technology, simply can’t tolerate it.
At our clinic we are now getting referrals of patients with extremely severe sleep apnoea. The following is one example of a referral of a patient for an oral appliance who has a disturbance in his breathing of 106 times an hour! Who could have imagined this 20 years ago?
As the times are changing there are now great opportunities for dentists trained and interested in providing this valuable service.
by Dr Harry Ball
BDSc LDS (Melb) M Counsel. (Lat.) Grad Dip Counsell. & HS (La.)
Past co-chairperson dental sleep medicine council of the Australasian Sleep Association.
Co-Director SleepWise Clinic
For details of the next Dental Sleep Institute training program: “Oral Appliance therapy for Snoring Sleep Apnoea & Bruxism” visit the program page here.