In Québec, only a dentist can provide treatment for obstructive sleep apnea (AOC) using a mandibular advancement device.
This is why our team espouses a multidisciplinary approach promoting collaboration between the various health professionals involved in managing sleep apnea problems, including family doctors, general dentists, otorhinolaryngologists (ENT), pulmonologists, respiratory therapists, psychiatrists, etc.
We will work with you at all times towards a common goal, which is to provide complementary therapies and interventions for your patient’s health and well-being.
Why prescribe an apnea orthotic?
Although the CPAP mask is a recognized and effective solution, it is not suitable for everyone. Some patients may be claustrophobic or allergic to latex. Others breathe through their mouths or sleep on their sides. Some patients are looking for a solution that is less harmful to their relationship’s harmony and intimacy. Lastly, for many, freedom of movement in bed, ease-of-use while travelling or privacy issues make the CPAP mask undesirable.
When adhering to continuous and meticulous use of a CPAP mask is doubtful or could be detrimental to your patient's overall health, mandibular advancement devices — worn alone or alternately with the mask — are a solution to consider.
Before treatment
Your patient will need to provide a treatment request and diagnosis from you. The results of a sleep study must also be sent to us. This can be either a laboratory polysomnography or a cardiorespiratory polygraphy for sleep disorders (PCRS) done outside the laboratory within the last 5 years. This test may be requested again by the attending physician after the start of the advancement treatment, as a follow-up.
Note that our dentists may also recommend possible repairs to the teeth before the initial impression is taken, since any change in the dentition could require stopping the current treatment and manufacturing new orthoses at an additional cost.
For a technical overview of how orthoses are manufactured, watch Dr. Lechner's presentation produced for the Association pulmonaire du Québec’s YouTube channel (in French only).
During treatment
The mandibular advancement treatment at our clinic includes:
- Consultation with treatment options
- Physical examination (Berlin, Epworth, STOP-BANG, Airway questionnaires, etc.)
- Fingerprinting
- The design of a mandibular advancement device with adjustments
- A diagnosis of any side effects
- Follow-up visits
A follow-up visit to the attending physician or professional will be required 1 to 3 months after the installation of the AOS orthotic. Any change in the patient's dental and overall health status is communicated to the professionals on file.
After treatment
Our treatment plan includes regular follow-ups over a period of 3 to 5 years, in particular to check the appliance’s fit, to re-evaluate the symptoms and to check the condition of the teeth.
The final verification of the treatment’s effectiveness is carried out by the attending physician who may rely on the signs and symptoms or prescribe a control test (PO, HRPO, HSAT, PSG).
Contact us now to find out what options are available to your patient.
