Role of dentists increase in treating sleep disorders

In somewhat of a first this year, the usual mix of physicians, technologists, scientists and industry representatives who attend the annual Australasian Sleep Technologists Association (ASTA) and Australasian Sleep Association (ASA) Scientific Meeting were joined by an interested group of dentists with an interest in dental sleep medicine. This marked a significant step in the recognition of the role that oral appliances play in the treatment options for treating sleep disordered breathing.

This event, the most significant domestic sleep specialist meeting held annually in Australia, included a very full program with a number of sessions and topics dedicated to this emerging discipline, including an entertaining hypothetical debate intended to assess the relative merits of treating mild obstructive sleep apnea (OSA) with oral appliances and CPAP.

Two of the sessions were of particular relevance to SomnoMed, Australia' leading manufacturer of mandibular advancement splints. Professor John Stradling, from Oxford University, who delivered this year's Helen Bearpark Memorial lecture, spoke about diagnostic and screening protocols for OSA. He argued that due to the prevalence of the disorder, simpler and lower cost forms of diagnosis are required and emphasized that an outcome-based gold standard be applied, where patients are measured in terms of their response to treatment. Professor Stradling's viewpoint indicates a potential shift towards a more open diagnostic pathway that may ultimately benefit the vendors of OSA and snoring treatment devices.

In addition to the dental sleep medicine presentations within the body of the conference, there was also a dental pre-course day, which was heavily oversubscribed. Those dentists, respiratory physicians and otolaryngologists who managed to gain entry to the postgraduate course were exposed to lectures on the pathophysiology, treatment options and comparative outcomes when using oral appliances to treat sleep apnea. In the afternoon, course attendees were able to interactively participate in a demonstration of how to select and achieve the optimum clinical outcomes with oral appliances. A number of SomnoMed staff attended this session and were able to provide course attendees with hands-on exposure to the SomnoMed MAS™. This practical component complemented the earlier theoretical lectures delivered by SomnoMed sponsored clinicians and key opinion leaders in the field of dental sleep medicine.

Key outcomes of the conference included:

• Dentists are becoming integrally involved in the clinical management of sleep disorders; a verification of SomnoMed's established inter-disciplinary protocol.
• There is increasing recognition among the sleep and respiratory specialist community of the role of oral devices and dental sleep medical practitioners in the management of snoring and OSA.
• There are calls from within the sleep professional community to simplify and reduce the cost burden of diagnosing OSA and snoring that adopts a multi-disciplinary approach.
• Simple snoring may exert the same negative effects on blood pressure and vascular disease as OSA.

Overall, the conference delivered a number of clear, positive messages for the clinical management of snoring and OSA and clear recognition of the growing role dentists will play in delivering treatment in this area.