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Inside Dentistry
November 2019
Volume 15, Issue 11

Take the Plunge

Now is the time to jump into dental sleep medicine

Kent Smith, DDS

About 30 million Americans suffer from obstructive sleep apnea (OSA), yet 80% of cases remain undiagnosed.1 That means an astounding number of people are not only sleep deprived but also possess a greater risk of experiencing car crashes and on-the-job accidents as well as developing serious medical conditions, including obesity, hypertension, heart disease, diabetes, and stroke.

Furthermore, during the next 40 years, the subset of Americans aged 65 and older-an age group that is at high risk for developing OSA-is projected to exceed 98 million.2 The sheer volume of this problem is massive, and we have a great deal of work to do to address practitioner and patient awareness of the growing OSA epidemic. But there is good news. Dentists have an opportunity to be a part of the solution-an opportunity that is not only good for patients and public health but also good for business.

The First Line of Defense

Considering that a majority of Americans (58%) reportedly visit the dentist at least once per year,3 it is easy to see the opportunity and-more importantly-the responsibility that dentists have in assuming a greater role in their patients' preventive  care routines.

Take oral cancer as an example. When detected early, it's a disease that has a 5-year survival rate of 75%; when it's detected late, however, the survival rate drops to 20%.4 Early detection is key, and dentists have answered the charge by implementing oral cancer screening into their routine care procedures.

Imagine the impact on public health if dentists took on similar routine screening measures for OSA-a condition unequivocally linked to a "marked elevated risk of mortality, cancer, and stroke."5 As dentists, we must recognize our role in addressing the OSA epidemic, its related public safety implications, and the increased healthcare costs associated with the condition and its comorbidities.

A CPAP Alternative

Although continuous positive airway pressure (CPAP) is universally accepted as the most effective treatment for OSA, low adherence rates mean that many patients who are prescribed CPAP remain undertreated or ineffectively treated because they cannot or will not use their machine. Providing these patients with an alternative to CPAP treatment is essential to restoring their health.

Fortunately, oral appliance therapy administered by dentists who specialize in dental sleep medicine is increasingly recognized as an effective alternative treatment option for CPAP-intolerant patients. Once a patient has been diagnosed with OSA and has demonstrated an inability or unwillingness to adhere to CPAP therapy, oral appliance therapy becomes a potentially viable option to properly regulate and treat his or her condition.

The Business Case

During the next 5 years, the sleep apnea oral appliance market is projected to more than double-reaching a value of $483 million by 2023-driven by "the growing popularity of oral appliances in sleep apnea management, technological advancements in oral appliances, a large pool of undiagnosed sleep apnea patients, and a growing awareness of sleep apnea."6

Herein lies the business case for specialization in dental sleep medicine, either as the sole focus of a practice or as a supplementary source of revenue for an existing general dental practice. For young dentists, this profit center is beneficial in decreasing the burden of student loan debt, which averages $285,184 per dental school graduate.7

Dental sleep medicine can also be particularly interesting for general dentists who have been working in the same operatory for years and find themselves feeling burned out or seeking a new opportunity for professional growth and satisfaction.

Whatever the motivation, now is the time for dentists to incorporate dental sleep medicine into their practices.

Note: The references are available with the online version of the article at:

About the Author

Kent Smith, DDS, is the founding director of Sleep Dallas, a dental sleep medicine practice in the Dallas-Fort Worth metroplex. He is the president of the American Sleep and Breathing Academy and a diplomate of the American Board of Dental Sleep Medicine.

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