February 17, 2022
The ACSDD was founded on the principle of collaborative care: physician and dentist working together for the best patient outcome. In light of recent discussions on the place of the dentist in the treatment of Obstructive Sleep Apnea, we feel it is necessary to clarify the Academy’s position on this subject.
Collaboration between dentist and physician is a founding principle of our organization and has always guided the development of our educational programs. Our belief is that a shared vocabulary and understanding of sleep medicine fosters improved dialog and collaboration between healthcare clinicians. To that end, there are elements of Oral Appliance Therapy for the treatment of Obstructive Sleep Apnea that fall solely under the expertise of the dentist and other aspects that are physician specific. It is our position that prescribing and ordering a home sleep apnea test for diagnostic and efficacy testing should be performed by a qualified physician and interpreting a home sleep test should be done by a board-certified sleep physician, not the dentist. Utilizing home sleep apnea testing for the purposes of guiding effective oral appliance titration is acceptable for the qualified sleep dentist to order since the diagnosis and treatment plans have already been established by the board-certified sleep physician. It is recommended that all home sleep apnea tests are interpreted by a board-certified sleep physician.
There are several reasons for this:
- The need for testing to diagnose OSA must be based on the patient’s medical history and examination by a licensed physician qualified to make this determination;
- Different types of testing may be more appropriate for individual patients based on their body type, comorbidities or other medical conditions and the physician is uniquely qualified to make this determination;
- Home sleep apnea testing is more likely to be covered by medical insurance when initiated and administered by a qualified physician;
- It builds trust and acceptance of Oral Appliance Therapy when testing is overseen and administered by a qualified physician.
This position puts us in agreement with similar policy positions put out by the American Academy of Sleep Medicine (AASM) and American Medical Association (AMA). We believe the future of Oral Appliance Therapy is tied to acceptance within and collaboration with our partners in the medical community. We sign this statement with that goal in mind.
Academy of Clinical Sleep Disorder Disciplines (ACSDD) Advisory Board
Dr. Lee A. Surkin, MD, FACC, FCCP, FASNC
Dr. Michael Lacey, M.D., D.ABSM, Diplomate ABPN- Sleep Medicine
Dr. Andrew Cohen, DMD
Dr. David Rawson, DDS
Dr. Jerry Hu, DDS
Dr. Michael McCormick, DDS