When to Refer

The recently revised American Academy of Sleep Medicine Practice Parameters  indicate that physicians may refer patients to an experienced sleep disorders dentist for oral appliance therapy as first-line treatment for primary snoring and for mild and moderate OSA.

"Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP."

The ideal patients for oral appliance therapy include those that are:

• Less obese
• Primary snoring
• Mild and moderate OSA
• Adequate dentition
• Asymptomatic TMJ
• Motivated
• Failures of CPAP or surgery at any OSA severity