My patient snores and wants me to make him an oral appliance. He hasn’t had a medical diagnosis or sleep study. Can I proceed?
No. Snoring may be a symptom of obstructive sleep apnea or other medical problems and as such a medical diagnosis is essential. This is the opinion of the R.C.D.S.O., your governing body, Professional Liability Program, your insurer, and the American Academy of Sleep Medicine and the American Academy of Dental Sleep Medicine.
What can I expect if I refer my patient to you to manage sleep disordered breathing?
The first visit is an examination and consultation appointment. The pathogenesis of SDB is explained and all appropriate treatment modalities are presented. If the patient has had a polysomnogram (sleep study) this is reviewed and OAT is discussed. If the patient hasn’t had a polysomnogram, medical referral is recommended so a proper diagnosis can be made. If your patient had had a study and wishes to proceed immediately, generally impressions and registrations are taken along with a Panoramic radiograh (a duplicate will be sent to you). Approximately two weeks later the OA can be inserted. Over time the effectiveness of the appliance will be monitored and adjustments made. If needed, ultimately your patient will be referred back to his sleep specialist and a follow up sleep study may be done to confirm OA efficacy. Your patient will also be shown appropriate morning exercises to minimize changes in occlusion. The importance of regular dental care is emphasized and of course your patient is referred back to you for continuing care.