What Is Dental Sleep Medicine? (Dentist Roles, Therapies, And Process)

Oct 28, 2019
What Is Dental Sleep Medicine? (Dentist Roles, Therapies, And Process)
If your sleep specialist has advised that you speak with a dentist who is board certified to practice dental sleep medicine, you probably have questions. Maybe you want to know, what is dental sleep medicine? What are the credentials that a dentist...

If your sleep specialist has advised that you speak with a dentist who is board certified to practice dental sleep medicine, you probably have questions. Maybe you want to know, what is dental sleep medicine?

What are the credentials that a dentist needs to practice dental sleep medicine? What exactly does dental sleep medicine look like?

Furthermore: how can a dentist play a role in improving your sleep?

Dental Sleep Medicine Definition

Dental Sleep Medicine is a specialty within general dentistry. Board-certified sleep medicine dentists are specially trained to use oral appliance therapy (OAT) to help treat certain sleep disorders or disordered behavior, most notably, snoring and obstructive sleep apnea (OSA).

An oral appliance for snoring or OSA is a medical device you wear in your mouth when you sleep. A qualified dentist would fit you for a sleep apnea mouthguard like apparatus that slides over your teeth and pulls your lower jaw forward slightly, creating additional room at the back of your throat for the tongue and loose soft tissue, which can sometimes cause airway obstructions that stop you from breathing normally.

A sleep medicine dentist can also fit you for a mouthguard-style device or splint to stop you from clenching and grinding your teeth in your sleep.

The official definition of what dental sleep medicine practitioners do, according to the American Academy of Dental Sleep Medicine (AADSM):

Dental sleep medicine is an area of dental practice that focuses on the use of oral appliance therapy to treat sleep-disordered breathing, including snoring and obstructive sleep apnea (OSA). Dentists work together with sleep physicians to identify the best treatment for each patient.

Dental sleep medicine is not a replacement for seeing a sleep doctor.

Normally, patients with sleep problems get diagnosed first by a board-certified sleep specialist. Depending on the severity of the patient’s symptoms and their individual needs, they may be referred to a sleep medicine dentist for an oral device in lieu of other therapies like CPAP (continuous positive airway pressure) therapy.

Oral appliance therapy is considered a first-line therapy approach to mild to moderate OSA. Increasingly, more and more sleep physicians are recommending it to patients because the compliance rate of this therapy is high, sometimes higher than CPAP compliance. What this means: patients who can use oral appliances tend to be more likely to stick with their therapy.

However, not everyone’s OSA will respond to oral appliance therapy. Severe OSA will most likely require the use of CPAP, or a BiPAP machine. Only a sleep doctor can tell you whether you’re a good candidate for a dental treatment approach.

Dental Sleep Medicine Credentials

Your sleep specialist will refer you to a dentist or dental practice certified to practice dental sleep medicine (like our practice, in Bellevue). This means your dentist will have specialized, post dental school training in sleep medicine. Dentists who practice dental sleep medicine have acquired the following:

  • Knowledge of sleep disorders, sleep-disordered breathing (such as airway issues) and sleep-disordered behaviors, such as obstructive sleep apnea and bruxism (tooth grinding and clenching).
  • The technical skills required to select the oral appliance that’s best for your issues; to measure your jaw and mouth for said oral appliance; to create a digital impression of your teeth or a mold; and to order and later custom-fit the resulting appliance to your mouth.

Dentists who practice dental sleep medicine have certification demonstrating their qualifications to treat sleep disorders with oral appliance therapy.

Such certification may come from an accredited non-profit organization such as the American Academy of Dental Sleep Medicine (AADSM) or the American Board of Dental Sleep Medicine (ABDSM).

These dentists also pursue continuing education in the field in order to stay up-to-date on new sleep disorders treatment breakthroughs and knowledge.

Dentist Roles and Therapies (How Dental Sleep Medicine Works)

The role of the dentist in the treatment of sleep apnea and snoring is collaborative. After you are diagnosed by a sleep physician, he or she may recommend that you see a sleep medicine dentist to get fitted for an FDA-approved oral appliance designed to help with snoring or OSA.

Sleep physicians frequently make these referrals for patients who have snoring without apnea, or a mild form of apnea that may respond to a dental appliance. (Many people find adjusting to a CPAP machine and mask to be difficult and uncomfortable and end up rejecting their therapy as a result; however, oral appliances are fairly easy to use—they are like wearing a retainer or sports mouth guard to bed.)

The sleep specialist and the dentist will coordinate closely to ensure that you’re provided an oral therapy device—a mouthpiece or splint—that’s appropriate for your needs. At your first dental visit, the dentist will review your file from your sleep physician and talk to you about the benefits of oral appliance therapy. A thorough exam will help the dentist understand the architecture of your mouth, jaw, and airway. You’ll learn about the benefits of this therapy and what kind of results you can expect.

Dentists work with doctors to treat your sleep-disordered breathing, but they can’t diagnose it.

It’s important to emphasize this fact: your sleep medicine dentist can treat sleep apnea and snoring, but they can’t diagnose a sleep condition. A sleep apnea diagnosis needs to be made by a sleep medicine specialist (a physician).

The process of getting diagnosed with sleep apnea

If you snore and you think you have obstructive sleep apnea, for diagnosis you’ll need to undergo a sleep study at a sleep center. There, qualified sleep technicians can monitor you while you sleep and collect data on how many times per night you’re waking up or experiencing apneas (cessations of breathing). Sleep techs are also able to tell from this sleep study whether your apnea is obstructive (involving an airway obstruction) or central (caused by the nervous system).

Dental sleep medicine can help only with the first type of sleep apnea, OSA—because the mechanical oral appliance will create additional space in the back of your throat, enabling you to breathe better when you sleep.

Making sure the oral appliance therapy is working

After you’ve been fitted with an oral appliance, and you’ve used it for a while, your dentist may refer you back to your sleep physician for a follow-up sleep study. The purpose of this study is to track improvement in your sleep while wearing the device. This follow-up enables the sleep physician and dentist to measure your improvements (or lack thereof) and determine whether this therapy is working for you.

If the oral appliance therapy isn’t improving your breathing and the quality of your sleep, you may need to try a different treatment—usually, CPAP therapy, which involves continuous airway pressure being delivered through the nose via a mask.

For some people, oral appliance therapy is a front line therapy that works for a while, but may not work forever. The key is to keep an open line of communication with your dentist, your sleep physician, and your regular doctor to ensure that you’re tracking your symptoms and getting adequate sleep.

Dental Sleep Medicine in Bellevue, WA

The dentists at Premier Sleep Associates are certified in dental sleep medicine by the American Board of Dental Sleep Medicine (ABDSM). Our facility is accredited by the American Academy of Dental Sleep Medicine (AADSM).

Premier Sleep Associates

Premier Sleep Associates

We offer patients Oral Appliance Therapy and Positional Therapy. We also work with counselors to help with insomnia therapy, weight-loss help, and other behavioral medicine.

If you have further questions about sleep medicine dentistry, obstructive sleep apnea, snoring, or other issues, call us for more information at (425) 698-1732.