Letter 1, Issue 13.1

Tick Tock

http://dx.doi.org/10.15331/jdsm.7426

Michael Simmons, DMD, MScMed, MPH, MSc, FAASM, FAAOP1,2

1UCLA School of Dentistry (1987-2018); 2Encino Center for Sleep and TMJ Disorders

I really appreciate the recent editorial by JF Masse addressing social media versus science1. Getting it right when our viewpoint conflicts with that of powerful influencers and media such as TikTok can be challenging. Anyone susceptible to commentary from the uninformed, who cannot discern truth from lies, or hype and spin, may suffer the consequences of ill-informed decisions. Separating information from true subject matter experts  compared with overly opinionated know-it-alls is not always easy and may depend on your own subject matter knowledge.  Microsoft’s CoPilot let me know that a “know-it-all” is someone who claims to have extensive knowledge on a wide range of subjects and is always eager to share (or rather, impose) this information on others. It is characterized by an individual’s persistent need to demonstrate superior knowledge or expertise, often at the expense of others’ opinions or experiences”. Should I trust this AI commentary?

As dentists we have for decades enjoyed an elevated level of trust with our patients, but that trust is a sacred bond. This hard-earned bond can be broken if we do not continue to provide our patients with educated information. The erosion of trust can occur at the individual patient level, and also at the level of our collective dental profession bond with all patients, if we do not continue to safeguard informed guidance. We probably do not want to earn the reputation of a used car salesman.  

It is hard work to continue to be recognized as informed. It is challenging to maintain the public’s trust of the dental profession as a whole, to be able to inoculate patients from choosing a competing viewpoint proffered by alternate nonexpert voices. A recent example of erosion of trust in public health occurred related to questions revolving around Dr. Anthony S. Fauci and management of the COVID pandemic. Erosion of trust can be swift and persistent.

The question for our profession and for us dentists practicing in sleep medicine becomes how to stay informed and who do we trust as sleep medicine professionals to guide us? Do we trust our colleague physicians to recommend oral appliances for OSA as an equal first- line treatment option to PAP therapies because both treatment methods show equivalent mean disease alleviation2,3?  Do we trust our colleague dentist subject matter experts in sleep medicine to guide us with emerging treatments we offer to our patients4, or are we swayed by public or popular opinion adopted by other less informed individual dentists? An increasing number of our dentist colleagues continue to recommend frenum releases to prevent future OSA development when there is literally no proof of concept4. Other dentists break into religious fervor to dissuade patients from having orthodontic extractions on their family members with concerns such extraction will cause future airway restriction leading to OSA. The evidence to support this fervor is based on reasonable belief, not scientific proof. It sounds reasonable, but then so does drinking diet soda as a weight loss strategy. Of course, science has shown us that drinking diet soda is associated with weight gain5 and a good number of patients with extraction orthodontics end up with enlarged post extraction airways6,7.  

Science is not perfect, and it evolves through periodic setbacks and disappointments as a slow methodologic advance. Nevertheless, it is the best anchor we have to reality. The TikTok social revolution may continue to affect the uninformed while the less flamboyant march of health science continues to be marked by the real tick tock of time. TikTok or tick tock we ask? If it is the tick tock choice, then you can help by spreading the validated expert information to colleagues and help protect professional trust.

CITATION

Simmons, M. Tick Tock. J Dent Sleep Med. 2026;13(1).

REFERENCES

  1. Masse JF. Navigating the social media wave: Mouth taping and the role of sleep dentistry. J Dent Sleep Med. 2025;12(2)
  2. Dieltjens M, Vanderveken O. Oral appliances in obstructive sleep apnea. Healthcare (Basel). 2019 Nov 8;7(4):141. doi: 10.3390/healthcare7040141. PMID: 31717429; PMCID: PMC6956298.
  3. Kaffenberger TM, Soose RJ, Strollo PJ, Vanderveken OM. Three-dimensional mean disease alleviation (3D-MDA): The next step in measuring sleep apnea treatment effectiveness. Sleep Med. 2025 Jan;125:27-30. doi: 10.1016/j.sleep.2024.11.027. Epub 2024 Nov 16. PMID: 39561670.
  4. Sheats R, Masse J-F, Levine M, et al. Novel therapies for preventing, managing and treating obstructive sleep apnea and snoring in pediatric and adult patients. J Dent Sleep Med. 2024;11(2).  http://dx.doi.org/10.15331/jdsm.7332 
  5. Ruanpeng D, Thongprayoon C, Cheungpasitporn W, Harindhanavudhi T. Sugar and artificially sweetened beverages linked to obesity: a systematic review and meta-analysis. QJM. 2017 Aug 1;110(8):513-520. doi: 10.1093/qjmed/hcx068. PMID: 28402535.
  6. Mladenovic M, Freezer S, Dreyer C, Meade MJ. The orthodontic extraction of second premolars: The influence on airway volume. Am J Orthod Dentofacial Orthop. 2024 Jul;166(1):61-68. doi: 10.1016/j.ajodo.2024.02.013. Epub 2024 Apr 26. PMID: 38678455.
  7. Papageorgiou SN, Zyli M, Papadopoulou AK. Extraction of premolars in orthodontic treatment does not negatively affect upper airway volume and minimum cross-sectional area: a systematic review with meta-analysis. Eur J Orthod. 2025 Feb 7;47(2):cjaf012. doi: 10.1093/ejo/cjaf012. PMID: 40062590; PMCID: PMC11891658.  

SUBMISSION AND CORRESPONDENCE INFORMATION

Submitted for publication May 9, 2025
Accepted for publication July 31, 2025

Address correspondence to: Michael Simmons, DMD, MScMed, MPH, MSc, FAASM, FAAOP; Email: msimmons@g.ucla.edu
 

DISCLOSURE STATEMENT

The author has no relevant conflicts of interest to disclose. 

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