Not All Sleep Dentists Are Created Equally: Where to Find a Qualified Snoring- Sleep Apnea Trained Dentist

Snoring and apnea if left untreated or treated inadequately, can lead to serious medical problems. These problems can include increased risk of heart attack, stroke, daytime sleepiness and other serious illnesses. Even death can result from medical complications associated with apnea.  Increased rate of work-related and driving accidents can also occur from the excessive daytime sleepiness that some snoring and apnea patients experience.

When finding someone to provide you with a custom oral device, that is recognized and prescribed as a treatment for snoring and obstructive sleep apnea, here are some important points to consider:

1. Most dentists are NOT trained in dental sleep medicine,  the field of study within dentistry that focuses on snoring, apnea, sleep disorders and custom oral devices.  This area of dental practice is known as oral appliance therapy.
   In fact, snoring and sleep apnea treatment is NOT taught in most dental school curriculum. If oral appliance therapy is covered in a dental training curriculum, it is usually quite limited. Without this specialized education, poor or inadequate treatment can result in your therapy, and serious medical and dental issues can arise.
2. Those sleep medicine dentists that are trained, are not trained equally.
   Yay! You found a “trained” dentist, great news! Some sleep labs and manufactures, unfortunately, are profit based biased groups that are eager to get dentists working with patients with very limited training and this will result in shortcuts that will not benefit the patients.
3. Oral devices can often have side effects that only a trained dentist can prevent.
   Tooth and jaw pain can occur along with loose teeth and lisping.  Proper follow-up appointments are essential to guide patients to proper treatment if this should occur.
4. Untrained dentists lack the follow-up care knowledge that is needed with custom oral devices.
   It is not unusual to have an oral device fabricated, and the patient thinks it’s working great. These patients may experience reduced or resolved snoring issues, better energy, and YET may still have dangerous “oxygen dipping events.” Without proper follow-up care, these dips may not be uncovered, leading to serious medical issues.
   

The points above are so important that medical guidelines were readapted by a special task force made up of specialty trained sleep dentists and physicians to include details by outlining what a “qualified dentist” is. These guidelines were published to help the public find adequate snoring and apnea treatment with oral appliance therapy.

I’ll be summarizing the specifics of those medical guidelines in a separate article. To give you some direction now…

Here are some common characteristics of knowledgeable dentists that provide oral appliance therapy with dental devices for snoring and apnea:

• Adequate training in oral appliance therapy by a non-profit organization
• Appropriate knowledge of sleep disorders
• Experience with many different appliance types
• Has strong relationships with sleep physician and sleep testing facilities
• Provides adequate information when delivering the device as well as long-term follow-up care
• Is aware of the most current medical guidelines for the treatment of obstructive sleep apnea
• Is knowledgeable with a broad type of treatments for snoring and obstructive sleep apnea
• Guidance with medical insurance reimbursements

A Great Place to Start Your Search for a Sleep Apnea Dentist

So where do you find an adequately trained dentist? If you were in my family and lived in another state, this is what I’d recommend.  This is also what I tell all my patients that move away:

Go to the American Academy of Dental Sleep Medicine’s Find- A-Dentist tab and punch in your zip code.  Usually, the order of amount of knowledge of the dentist listed on this site ranks from most to least in this order:

• 1st choice-  Diplomate of the ABDSM (American Board of Dental Sleep Medicine): This is the highest credential a dentist can earn in dental sleep medicine. Diplomates of the AADSM  are required to demonstrate competency in dental sleep medicine and must pass a rigorous written examination
• 2nd choice- AADSM Accredited Facility: Accredited facilities must comply with the AADSM Standards for Accreditation, the gold standard for patient care in dental sleep medicine.
• 3rd choice -Qualified dentist: An AADSM qualified dentist is required to have completed at least 25 hours of recognized continuing education in dental sleep medicine provided by a dental sleep medicine focused non-profit organization or accredited dental school in the last two years.

If there are no providers of any sort listed on the AADSM website near you, I would consider this direction:

• Call a sleep specialist medical doctor is in your area.  Your primary care physician should be able to connect you with one. Ask him or her for a referral to a dentist that provides oral appliance therapy following the AASM (American Academy of Sleep Medicine)  medical guidelines for oral appliance therapy.
• Ask your general dentist for a referral, or possibly he has involvement in the dental sleep medicine area.
• Contact a credentialed sleep facility through the American Academy of Sleep Medicine and ask for a referral of a qualified dentist they have worked with.

Then consider asking these questions when contacting a dentist:

• How long has he/she been constructing oral devices for apnea?
• Does he/she make just one type or several different types? (More experienced docs have usually worked with or at last, tried several types.)
• What is their role in medical insurance reimbursement? (There are many great sleep dentists who do not work with insurance directly but will help guide you for reimbursement, many others do accept and file insurance.) Historically, getting oral appliance therapy paid through your medical insurance is often the trickiest part of getting an oral device. But in most cases, medical insurance does indeed cover this area of service, at least in part. The article Are Dental Devices That Treat Apnea Covered by Insurance may be of interest.

If you are outside of North America, here are several international organizations dedicated to dental sleep medicine:

• European Academy of Dental Sleep Medicine-  EADSM
• Australasian Academy of Dental Sleep Medicine
• British Society of Dental Sleep Medicine

 Once you are diagnosed with obstructive sleep apnea, or snoring (without apnea) and have decided to explore custom oral appliance therapy, finding a qualified dentist will help guide you through the process ahead towards healthy sleep.