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A patient told me this story last week.
He suffers from very severe OSA and uses a CPAP 6 nights a week. I made him a mandibular advancing splint(MAS) which he happily wears once a week as respite from CPAP, and for travel(At least once a month he flies to Asia for business). Recently, on a flight from Japan back to Toronto, he put in his MAS, as he planned to sleep for most of the ftrip. A Japanese businessman, also sitting in first class asked the flight attendant where he could plug in his CPAP and was told that regulations didn’t allow this. Fearing that he would stop breathing should he fall asleep, he became very agitated and disruptive, and needed to be restrained by the flight crew. When the airplane landed on Canadian soil, the Mounties were there to escort him away.

Cost of a round trip, executive first flexible from Tokyo to Toronto….$6781
Fee for oral appliance therapy…..$3000

Not being arrested by the Mounties and putting up bail……….PRICELESS!

In Ontario, any dentist is licensed to treat Sleep Related Breathing Disorders(ranging from snoring to severe obstructive sleep apnea) with oral appliance therapy, but it is suggested that any dentist doing so be appropriately trained. Before choosing a provider, find out the special education that they have had, their experience(approximate number of successfully treated cases), type of appliance that they will be using, their ability to interpret and explain your sleep study(polysomnogram), and communicate with your sleep specialist.
You may also wish to go to the American Academy of Dental Sleep Medicine (AADSM) website.

Why do physicians consider CPAP the gold standard of care? Its efficacy is 100%.  i.e. if a patient wears it , it can be adjusted to work every time.  However, if the patient can’t wear it, its effectiveness is zero.  An oral appliance may not be as efficaceous i.e. some residual apnea may still be present, but since the patient is more likely to continue wearing it because it is more comfortable, its effectiveness is often superior to CPAP.

View our recent Wylde on Health video clips:

• Wylde on Health – Clip 1
• Wylde on Health – Clip 2
• Wylde on Health – Clip 3