Editorial 2, Issue 1.1
New Journal Continues the Growth and Progress of Dental Sleep Medicine
B. Gail Demko, DMD, D. ABDSM
Sleep Apnea Dentists of New England, Weston, MA; President, American Academy of Dental Sleep Medicine
“Without continual growth and progress, such words as improvement, achievement, and success have no meaning.” —Benjamin Franklin
The publication of this inaugural issue of the Journal of Dental Sleep Medicine by the American Academy of Dental Sleep Medicine (AADSM) is a landmark achievement signifying that oral appliance therapy truly has come of age. This peer-reviewed, scientific and clinical journal is a product of the continual growth and progress of dentistry’s role in treating sleep-disordered breathing through collaboration with our physician colleagues.
This milestone is remarkable when you consider that it has been only about 30 years since the first reports describing the use of oral devices for the treatment of obstructive sleep apnea (OSA) began to appear in the medical literature.1,2 Practice parameters published by the American Academy of Sleep Medicine in 2006 validated oral appliance therapy as an appropriate treatment alternative to positive airway pressure (PAP) therapy for OSA,3 and today there is a wealth of scientific evidence supporting the effectiveness of mandibular advancement devices in reducing the severity of OSA and improving health outcomes.4
The rapid expansion of the scientific evidence base for oral appliance therapy has been mirrored by the growth of the AADSM as the only not-for-profit professional society that is dedicated exclusively to the practice of dental sleep medicine. Established by a small group of dentists in 1991, the AADSM now has more than 3,000 members as the organization approaches its silver anniversary. The AADSM always has attracted some of the best and brightest minds in dentistry, and our membership continues to grow as an increasing number of dentists recognize the important role they can play in reducing the burden of snoring and obstructive sleep apnea.
In addition to growing quantitatively, the AADSM has spurred qualitative progress in the practice of dental sleep medicine. Although dental sleep medicine began in independent commercial venues with a heavy emphasis on product sales, the AADSM was built on a cornerstone of evidence-based dentistry long before that term was used in any dental training program in the country. As a result the field has witnessed the emergence of university-based programs that are providing comprehensive education and training to teach dentists about oral appliance therapy at both the pre-doctoral and postdoctoral level. Evidence of the field’s scientific maturation can be seen in the recent establishment of the Oral Appliance Network for Global Effectiveness (ORANGE), an international collaboration supported by the AADSM that is mobilizing leading researchers to evaluate the long-term effectiveness and health outcomes of oral appliance therapy for OSA.
The growing knowledge base in dental sleep medicine has yielded significant improvements in the practice of dental sleep medicine. Gone are the days when some dentists promulgated the idea that oral appliance therapy is a simple treatment and that anyone can make an oral device. Now relying on skilled laboratories to craft custom-fabricated appliances using digital or physical impressions and models, today’s dental sleep medicine practitioners are much more than just oral device providers. We are clinicians with expertise in screening patients to identify those who are most at risk for OSA, conducting thorough evaluations of patients’ oral anatomy, selecting the most appropriate device for each patient, fitting and calibrating the device, assessing potential side effects and complications, monitoring adherence, and ensuring long-term effectiveness.
Although there has been an explosion of dental sleep medicine literature in recent years, much of this research has been published in medical journals that are inaccessible to the typical dental sleep medicine clinician. The Journal of Dental Sleep Medicine will span this gap by providing AADSM members with immediate and complimentary access to new research, case reports and commentaries. We are in the midst of an exciting stage in the progression of dental sleep medicine, bearing witness to a proliferation of novel advances and developments in oral appliance therapy. In the last year alone, we have seen evidence that mandibular advancement devices reduce the risk of fatal cardiovascular events in patients with severe OSA, treatment success can be predicted using a remotely controlled mandibular protrusion device, and objective measurement of compliance can be achieved using an embedded microsensor thermometer with on-chip integrated readout electronics.5-7 I am certain that we will see more progress in the years ahead, and AADSM members will stay abreast of these new findings and trends with the journal at their fingertips.
The publication of this journal also is significant because it will heighten recognition of dental sleep medicine among our physician colleagues, who regularly consult sleep medicine journals such as SLEEP and the Journal of Clinical Sleep Medicine. The AADSM has worked hard to forge strong ties with the AASM, understanding that teamwork between physicians and dentists promotes optimal care for the patients who suffer from sleep disordered breathing. Millions of people in the U.S. have undiagnosed and untreated OSA, and dentists are well positioned to address this crisis by screening the large number of patients who enter our offices every day, directing at-risk patients into the proper medical channels for a comprehensive sleep evaluation and diagnosis. Sleep medicine physicians also are gaining a better understanding of how oral appliance therapy is the most advantageous treatment for many patients with mild-to-moderate OSA, especially those who have a lower body mass index (BMI) or fail to comply with PAP therapy. Everyone benefits when physicians and dentists collaborate to achieve the common goal of providing the highest quality of care for OSA patients.
This journal’s publication is no small feat. It has taken nearly two years of planning, development, and coordination by Editor-in-Chief Leslie C. Dort, DDS, and the capable staff in the national office, who have worked diligently to bring the journal from a dream to a reality. Under the expert hand of Dr. Dort, and with the assistance of Deputy Editor Olivier Vanderveken, MD, PhD, talented associate editors and a dedicated editorial board, this journal will flourish.
The publication of the Journal of Dental Sleep Medicine by the AADSM is an important achievement that will promote continued growth and progress in the field of dental sleep medicine.
Demko BG. New journal continues the growth and progress of dental sleep medicine. Journal of Dental Sleep Medicine 2014;1(1):7–8.
1. Cartwright RD, Samelson CF. The effects of a nonsurgical treatment for obstructive sleep apnea. The tongue-retaining device. JAMA 1982;248:705-9.
2. Meier-Ewert K, Schäfer H, Kloss W. Treatment of sleep apnea by mandibular protracting device. [Abstract] Proceedings of the Seventh European Sleep Congress. Munich, 1984:217.
3. Kushida CA, Morgenthaler TI, Littner MR, et al. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: An update for 2005. Sleep 2006;29:240-3.
4. Sutherland K, Vanderveken OM, Tsuda H, et al; on behalf of the ORANGE-Registry. Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med 2014;10:215-27.
5. Anandam A, Patil M, Akinnusi M, Jaoude P, El-Solh AA. Cardiovascular mortality in obstructive sleep apnoea treated with continuous positive airway pressure or oral appliance: an observational study. Respirology 2013;18:1184-90.
6. Remmers J, Charkhandeh S, Grosse J, et al. Remotely controlled mandibular protrusion during sleep predicts therapeutic success with oral appliances in patients with obstructive sleep apnea. Sleep 2013;36:1517-25.
7. Vanderveken OM, Dieltjens M, Wouters K, De Backer WA, Van de Heyning PH, Braem MJ. Objective measurement of compliance during oral appliance therapy for sleep-disordered breathing. Thorax 2013;68:91-6.
SUBMISSION & CORRESPONDENCE INFORMATION
Submitted for publication February, 2014
Accepted for publication February, 2014
Address correspondence to: B. Gail Demko, DMD, 140 Merriam St., Weston, MA 02493; Tel: (617) 964-4028; Fax: (617) 595-4591; E-mail: DrDemko@SleepApneaDentist.com
Dr. Demko has indicated no financial conflicts of interest.