table

ofco

nte

nts

DISCLAIMERDental Sleep Medicine Magazine, and all of the expert opinion herein, represents many years of dental sleep medicine practice. It is presented as a forum for the advancement of dental sleep medicine. The articles within this publication are the opinions/statements of the medical professionals featured. Sleep Group Solutions is a private medical equipment and education company producing and distributing medical equipment and services. SGS provides practitioners with appealing diagnostic and treatment alternatives and in no way offers medical advice in the sleep disorder industry.

SLEEP DISORDERSThe Fastest Growing Dental Specialty

Change the way you practice dentistry

for the health

of your patients!

Using Anatomical Assessment to Guide Oral Appliance Therapy .................................................... 3

Good Night! ................................................................................................................................. 6

Polycystic Ovarian Syndrome Patient ............................................................................................ 8

Athletes and Sleep Apnea .......................................................................................................... 12

OSA Is Here to Stay ................................................................................................................... 14

Getting Personal With Your Sleep Patterns .................................................................................. 16

The “D” Words .......................................................................................................................... 17

The Virginia Academy of Dental Sleep Medicine ......................................................................... 19

Implementation of Monitoring to Prevent Respiratory Complications ........................................... 20

Decisions, Decisions ................................................................................................................. 21

The Future of Sleep Apnea - Diagnosis and Treatment ................................................................ 24

t’s All About The Air ................................................................................................................... 27

Sleep Seminars 2011 Schedule .......................................................................................... 28-29

No More Guessing Position ........................................................................................................ 30

Welcome Aboard! Dr. Moscovitch............................................................................................... 31

Academic Currents ................................................................................................................... 33

Oral Sleep Appliance - Get Your Air In ......................................................................................... 34

Putting Your Sleep Practice on The Map ..................................................................................... 36

Dental Medical Model ............................................................................................................... 39

Dental Sleep Medicine Seminars Q&A ....................................................................................... 43

Do It For You and Them .............................................................................................................. 44

Million Dollar Question .............................................................................................................. 46

The NEW Art of Dentistry ........................................................................................................... 47

Interpreting Home Sleep Studies ............................................................................................... 48

Sleep Group Solutions Company Profile .................................................................................... 56

Dental Sleep Clinics Directory .................................................................................................... 60

1-800-SLEEPTESTFinding new sleep apnea patients made easy

Using Anatomical Assessment to Guide Oral Appliance

TherapyDr. Atul Malhotra

Using Anatomical Assessment to Guide Oral Appliance

Therapy

Athletes ofSleep Apnea

Holly Jordano

Athletes ofSleep Apnea

Adam Moscovitch, M.D.

No More Guessing Position

The Future of Acoustic Airway Imaging

No More Guessing Position

The Future of Acoustic Airway Imaging

Using Anatomical Assessment to Guide Oral Appliance Therapy

References:1. Malhotra A, White DP. Obstructive sleep apnoea. Lancet 2002;360:237-45.2. Lin HS, Zuliani G, Amjad EH, et al. Treatment compliance in patients lost to follow-up after polysomnography. Otolaryngol Head Neck Surg 2007;136:236-40.

3. Hudgel DW, et al. Pharmacologic treatment of sleep-disordered breathing. Am J Respir Crit Care Med 1998;158:691-9.4. Ayas N, Malhotra, A, and Epstein, L. Alternative Therapies for Sleep Apnea. Drugs of Today 1999;35:811-21.5. Ferguson KA, Ono T, Lowe AA, Keenan SP, Fleetham JA. A randomized crossover study of an oral appliance vs nasal-continuous positive airway pressure in the treatment of mild-moderate obstructive sleep apnea [see comments]. Chest 1996;109:1269-75.6. Zeng B, Ng AT, Darendeliler MA, Petocz P, Cistulli PA. Use of flow-volume curves to predict oral appliance treatment outcome in obstructive sleep apnea. Am J Respir Crit Care Med 2007;175:726-30.

7. Kezirian EJ, Malhotra A, Goldberg AN, White DP. Changes in obstructive sleep apnea severity, biomarkers, and quality of life after multilevel surgery. Laryngoscope 2010;120:1481-8.8. Eckert DJ, Malhotra A, Jordan AS. Mechanisms of apnea. Prog Cardiovasc Dis 2009;51:313-23.9. Saboisky JP, Chamberlin NL, Malhotra A. Potential therapeutic targets in obstructive sleep apnoea. Expert Opin Ther Targets 2009;13:795-809.10. Mostafiz W, Dalci O, Sutherland K, et al. Influence of Oral and Craniofacial Dimensions on Mandibular Advancement Splint Treatment Outcome in Obstructive Sleep Apnea. Chest 2011.11. Fredberg JW, MEB. Glass, GM. Dorkin, HL. Airway area by acoustic reflections measured at the mouth. J Appl Physiol 1980;48:749-58.12. Hoffstein V, Fredberg JJ. The acoustic reflection technique for non-invasive assessment of upper airway area. Eur Respir J 1991;4:602-11.13. Itzhaki S, Dorchin H, Clark G, Lavie L, Lavie P, Pillar G. The effects of 1-year treatment with a herbst mandibular advancement splint on obstructive sleep apnea, oxidative stress, and endothelial function. Chest 2007;131:740-9.14. Wellman A, Malhotra A, Jordan AS, Stevenson KE, Gautam S, White DP. Effect of oxygen in obstructive sleep apnea: role of loop gain. Respir Physiol Neurobiol 2008;162:144-51.

Figure 1: Pre AHI vs. Post AHI

Good Night! An Alternative to CPAP for Treating Sleep ApneaFinding the most comfortable, compliant and effective therapy.

Michael F. Hnat, D.M.D. has advanced training and certifications in the field of dental sleep medicine. An integral focus of his McMurray practice is oral sleep appliance therapy. For more information visit: www.ProgressiveDentalSolutions.com or call 724-942-5630.

The American Academy of

Sleep Medicine recommends

oral sleep appliances as first

line treatment options for those

with mild and moderate levels

of sleep apnea as well as for

individuals who are CPAP

intolerant.

applian

cere

view

The Polycystic Ovarian Syndrome PatientIdentification of an at-risk population of women for Sleep-Disordered Breathing / Temporomandibular & Orofacial Pain Disorders.

pat

ientc

ase

“It is more important to know what sort of person has a disease than to know what disease a person has.” Sir William Osler

TMD, OROFACIAL PAIN AND THE DENTAL PAIN PRACTITIONER

ESTROGEN AND TMD

PCOS: PREVALENCE & CO-MORBIDITIES

Signs and Symptoms of PCOS

1. Absent or irregular menstrual cycles;2. Elevated levels of circulating androgens

or clinical manifestations of hyperandrogenism (eg. hirsutism, acne, alopecia),

3. Polycystic ovaries on ultrasonography

PCOS: RISK FACTOR FOR SDB

PCOS & SDB: RISK FACTORS

TMD and OSAS

Continued on Page 50

REGISTER TODAY FOR THE SLEEP GROUP SOLUTIONS SEMINARS

OSA Is Here To StayAn ENT’s point of view

Kassandra Keller, COO of SleepTech LLC, sleep diagnostic com-pany that manages sleep programs throughout the country.

The “D” Words!

Demo & Tech Support 866 602-6550

Sales 866 353 3936

Software Support Is So Old School!Exclusive for our Practice Management Software Users

Upgrade to the “New School”

All Inclusive Supercharged

Support for Your Entire

Dental Sleep Medicine Practice

www.GetDentalSleep.com ww SleepGroupSolutions.com

Sold Exclusively Through

ww.SSSSlllleeepGroouuppSSoolluuttiioonnss.ccoom

Sold Exclusively Through

Medical Billing and Coding Assistance No monthly minimums for electronic filing Assistance from our affiliated Certified Medical Billers

www.SnoringIsBoring.com Your customized website with all yourDental Sleep Medicine practice information. You’ll be pleasantly surprisedat the effectiveness of this new patient tool.

Unlimited Dental Sleep Med Systems Practice Management Software Training

All Software Updates

Consulting with our Dental Sleep Medicine Team Let our Team of Experts Assist Your Team to Simplify, Streamline and Increase the Efficiency of your Dental Sleep Medicine Practice

Subscription to our E-Snoozeletter

Created as a direct result of Sleep Group Solutions Seminars

The Virginia Academy of Dental Sleep Medicine

Implementation of Monitoring to Prevent Respiratory Complications with Sedation

Scope of the Program

Kathryn Hansen, BS, REEGT, CPCIntegration Consultants, Lexington, KY, Kentucky Sleep Society, Lexington, KY, Consultant, Oridion Technologies

About Kathryn Hansen:Kathryn Hansen is the Executive Director and past President of the Kentucky Sleep Society and has worked with sleep medicine academically and clini-cally. Recently she has been collaborating with Legislative initiatives to draft legislation on drowsy driving. The Kentucky Sleep Society, under her direc-tion, has received granting from the Rural Health Outreach Federal program to evaluate and treat modifiable health risks of obesity, diabetes, and heart disease for patients with untreated sleep apnea with special emphasis on childhood overweight.

Difficulty with intubations, and increased sleep deprivation contribute to elevated risk in the perioperative patient.

Decisions, Decisions!PSG or Home Sleep Test:Which is Better?Testing for Obstructive Sleep Apnea (OSA).

Polysomnograph (PSG)

Home Sleep Study

• Nasal airflow• Heart rate• Oximetry• Abdominal effort• Thorax effort• Body Position• Snoring

The Decision (my opinion)

Dental Sleep Solutions® Protocol

DIAGNOSIS

TREATMENT

Critical to re-energizing and rebuilding our bodies.

Working closely with experienced and qualified dental and Medical professionals can help to optimize outcome for patients.

Disclosure:Dr. Malhotra receives funding from the NIH and AHA. He has received research and/or consulting salary from SGS, SHC, Philips, Ethicon, Medtronic, Pfizer, Merck, Cephalon, Sepracor, Itamar, Apnex1. Malhotra A, White D. Seminar: Obstructive Sleep Apnea. The Lancet 2002;360:237-45.2. Punjabi NM, Caffo BS, Goodwin JL, et al. Sleep-disordered breathing and mortality: a prospective cohort study. PLoS medicine 2009;6(8):e1000132.3. Gottlieb JD, Schwartz AR, Marshall J, et al. Hypoxia, not the frequency of sleep apnea, induces acute hemodynamic stress in patients with chronic heart failure. Journal of the American College of Cardiology 2009;54(18):1706-12.4. Djonlagic I, Malhotra A. Risk of stroke from sleep apnea in men and women. Expert review of neurotherapeutics 2010;10(8):1267-71.5. Saboisky JP, Chamberlin NL, Malhotra A. Potential therapeutic targets in obstructive sleep apnoea. Expert opinion on therapeutic targets 2009;13(7):795-809.6. Badr MS. Pathophysiology of obstructive sleep apnea. Oral and maxillofacial surgery clinics of North America 2002;14(3):285-92.7. Younes M. Role of arousals in the pathogenesis of obstructive sleep apnea. Am J Respir Crit Care Med 2004;169:623-33.8. Patil SP, Schneider H, Schwartz AR, Smith PL. Adult obstructive sleep apnea: pathophysiology and diagnosis. Chest 2007;132(1):325-37.9. Gottlieb DJ, et al. Relation of sleepiness to respiratory disturbance index: the Sleep Heart Health Study. Am J Respir Crit Care Med 1999;159(2):502-7.10. Shahar E, Whitney CW, Redline S, et al. Sleep-disordered Breathing and Cardiovascular Disease. Cross-sectional Results of the Sleep Heart Health Study. Am J Respir Crit Care Med 2001;163:19-25.11. Ayas NT, Patel SR, Malhotra A, et al. Auto-titrating versus standard continuous positive airway pressure for the treatment of obstructive sleep apnea: results of a meta-analysis. Sleep 2004;27(2):249-53.12. Mulgrew AT, Fox N, Ayas NT, Ryan CF. Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study. Annals of internal medicine 2007;146(3):157-66.13. Eastwood PR, Malhotra A, Palmer LJ, et al. Obstructive Sleep Apnea: From pathogenesis to treatment: Current controversies and future directions. Respirology (Carlton, Vic 2010;15(4):587-95.14. Eckert DJ, Malhotra A, Jordan AS. Mechanisms of apnea. Progress in cardiovascular diseases2009;51(4):313-23.15. Campana LM, Owens RL, Clifford GD, Pittman SD, Malhotra A. Phase Rectified Signal Averaging as a Sensitive Index of Autonomic Changes with Aging. J Appl Physiol in press.16. Somers VK. Debating sympathetic overactivity as a hallmark of human obesity: an opposing position. Journal of hypertension 1999;17(8):1061-4.17. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proceedings of the American Thoracic Society 2008;5(2):136-43.

18. Owens R, Wellman A, Malhotra A. The chicken-or-egg debate in OSA pathogenesis. Sleep2009;32(10):1255-6.19. Horner RL. Motor control of the pharyngeal musculature and implications for the pathogenesis of obstructive sleep apnea. Sleep 1996;19(10):827-53.20. Patel S, White DP, Malhotra A, Stanchina M, Ayas NT. The Effect of CPAP Therapy on Subjective and Objective Sleepiness in Obstructive Sleep Apnea: A Meta-analysis of Randomized Controlled Trials. Arch Int Med 2002:in press.21. Li HY, Engleman H, Hsu CY, et al. Acoustic reflection for nasal airway measurement in patients with obstructive sleep apnea-hypopnea syndrome. Sleep 2005;28(12):1554-9.22. Kingshott RN, Vennelle M, Hoy CJ, Engleman HM, Deary IJ, Douglas NJ. Predictors of improvements in daytime function outcomes with CPAP therapy. Am J Respir Crit Care Med 2000;161(3 Pt 1):866-71.23. Hoy CJ, Venelle M, Douglas NJ. Can CPAP use be improved? Am J Respir Crit Care Med 1997;155:304A.24. Hoy CJ, Vennelle M, Kingshott RN, Engleman HM, Douglas NJ. Can intensive support improve continuous positive airway pressure use in patients with the sleep apnea/hypopnea

syndrome? Am J Respir Crit Care Med 1999;159(4 Pt 1):1096-100.25. Ferguson K. Oral appliance therapy for obstructive sleep apnea: finally evidence you can sink your teeth into. Am J Respir Crit Care Med 2001;163(6):1294-5.26. Kezirian EJ, Malhotra A, Goldberg AN, White DP. Changes in obstructive sleep apnea severity, biomarkers, and quality of life after multilevel surgery. Laryngoscope;120(7):1481-8.27. Zeng B, Ng AT, Darendeliler MA, Petocz P, Cistulli PA. Use of flow-volume curves to predict oral appliance treatment outcome in obstructive sleep apnea. Am J Respir Crit Care Med 2007;175(7): 726-30.28. Zeng B, Ng AT, Qian J, Petocz P, Darendeliler MA, Cistulli PA. Influence of nasal resistance on oral appliance treatment outcome in obstructive sleep apnea. Sleep 2008;31(4):543-7.29. Kezirian EJ, White DP, Malhotra A, Ma W, McCulloch CE, Goldberg AN. Interrater reliability of drug-induced sleep endoscopy. Archives of otolaryngology--head & neck surgery;136(4):393-7.30. Weaver EM, Maynard C, Yueh B. Survival of veterans with sleep apnea: continuous positive airway pressure versus surgery. Otolaryngol Head Neck Surg 2004;130(6):659-65.

The Virginia Academy of Dental Sleep Medicine

Visual signs I have observed for all my years in practice but never, not once, related them to a breathing disorder

• Scalloped Tongue• Linea Alba• High Palatal Vaults• Class II Occlusion• Coated Tongue• Friedman Tongue Position Index• Tooth Erosion from GERD• Bruxing

JC Goodwin, DMD, DACSDD, is a general dentist practicing in Prescott since 1987. He uses dental lasers, both surgical and non-surgical, in his office as well as same day crown technology and DNA testing. He started the Sleep Effect Center for Apnea Management in 2009 and holds a Diplomate credential in Dental Sleep Medicine. He is a member of the ADA, the Academy of Clinical Sleep Disorders Disciplines, the American Academy of Dental Sleep Medicine, the World Congress of Minimally Invasive Dentistry and is affiliated with the Centers for Dental Medicine. His office number is 928-778-4555. www.fitnessdental.com.

It’s All About The AirHeavy snoring is not a source of entertainment.

“You need to know where you are going in order to get there.”

No More Guessing Position!The Future of Acoustic Airway Imaging

This image shows a pre and post airway as mea-sured with the Eccovision Pharyngometer and dis-played with the SGS 3D software. “Sample A” is the patient in their natural mandibular position, “Sample B” is with a bite jig in place. The bottom section shows the percentage improvement achieved with the bite jig in place. Offices will frequently try 5-10 bite jigs in various vertical and protrusive positions until optimal results are found.

Sleep Group Solutions Newest Medical/Dental Consultant and Seminar Presenter

Adam Moscovitch, M.D.

Academic CurrentsUndiagnosed /untreated OSA comprises a public health problem of major proportions, and even impacts pediatric populations.

Oral Sleep Appliances: Get Your Air In!Critical to re-energizing and rebuilding our bodies.

Q. What is the concept of SleepTest.com?

A.

Q. Who’s potentially logging onto Sleept-est.com?

A.

Q. How will it help bring potential pa-tients into physicians’ offices?

A.

Q. What’s your main goal?A.

Q. What’s wrong with tradi-tional marketing in a clinical practice?

A.

Q. What can you tell us about online advertising and SEO, how does it work?

A.

Putting Your Sleep Practice on the MapNew Marketing Concepts for Dental Sleep Medicine

Q. In your opinion, what’s a successful marketing cam-paign?

A.

Q. Can you give any examples?

A.

Q. Why the Merger?

A.

Q. Can you tell us a little about the marketing packages?

A.

Q. Whats next?

A.

Co-Morbidity Correlations with Obstructive Sleep Apnea• Coronary heart disease 34%• Congestive heart failure 34%• Hypertension 40 – 50%• Erectile dysfunction 50%• Renal disease 50%• Diabetes 65%• Fibromyalgia 80%• Nocturnal strokes 84%

SNORING INSOMNIA

SNORING TONGUE PARTIALLY BLOCKS THE AIRWAY

SLEEP APNEA - TONGUE COMPLETELY BLOCKS AIRWAY

MILD SLEEP APNEA (OSA) 5 – 15 events per hourMODERATE SLEEP APNEA (OSA) 16 – 30 events per hourSEVERE SLEEP APNEA (OSA) More than 30 events per hour

Dental Medical Model Treatment Obstructive Sleep Apnea

Three treatment options for Obstructive Sleep Apnea1. Oral Appliances2. CPAP Device (Continuous Positive Air

Pressure)3. Surgical removal of structures causing

the obstruction

1. NASAL OBSTRUCTION

RHINOMETER

2. Oropharyngeal Obstructions

3. Hypopharyngeal Obstructions

Pharyngometer

Conclusion

*Read Dr. Brock Rondeau’s article on OSA, and get a free CE. Fax the 10 questions on page 55 or Log on to www.dentalsleepseminars.com to fill out the quiz.

Dr. Brok Rondeau’s credentials

FELLOWSHIPS/MASTERSHIPS/DIPLOMATES 1988 Fellowship International Association for Orthodontics 1988 Diplomate of the International Board of Orthodontics 2005 Fellowship American Academy of Craniofacial Pain 2005 Diplomate American Board of Craniofacial Pain

CONTRIBUTIONS TO THE FIELD OF DENTISTRY Contributing Editor, Journal Clinical Pediatric Dentistry Contributing Editor, Journal of General Orthodontics Contributing Editor, Functional Orthodontist

PROFESSIONAL ACHIEVEMENTS 1982 Certified Instructor, International Association for Orthodontics 1983 IAO Pinsker Award Winner 1986 IAO Past President 1993 AAFO Clinician of the Year Contributing Editor, Journal of General Orthodontics 2006 Voted one of Dentistry Today’s 9th Annual Top Clinicians in CE 2007 Voted one of Dentistry Today’s 10th Annual Top Clinicians in CE

CURRICULUM VITAETMJ Care Centre Northland Dental Centre1275 Highbury Avenue • Suite 16A • London, Ontario N5Y 1A8

Q. Which appliances do you cover and will you tell me which one is best to use?

A.

Dental Sleep Medicine Seminars/Q&ABased on everyday protocols used by highly successful dentists treating sleep apnea.

SMcommentary

Q. Will I be ready to treat patients after your seminar?

A.

Q. Is there a “level 2” course?

A

Q. Is there any hands-on opportunity at your seminars?A.

Q. What’s the difference between your various instructors?

A.

Q. I’m interested in dental sleep medicine but not ready for a full 2-day seminar yet, where can I learn more?

A.

Dr. JC Goodwin has practiced general dentistry in Prescott since 1987. His practice includes same-day crown technology, surgical and non-surgical laser therapy, DNA testing for periodontal disease and apnea management for patients who are not able to use CPAP therapy. He created the Sleep Effect Center for Apnea Management in 2009. Dr. Goodwin is a member of the American Academy of Dental Sleep Medicine, and the Academy of Clinical Sleep Disorders Disciplines and holds Diplomate status in the ACSDD. He can be reached at 928-708-9444 or 928-778-4555.

Do It For You and ThemTest for possible sleep disorders.

Give the gift of better sleep. It will likely improve your health and your quality of life; both night and day for both of you.

-

-

1. Limitations

2. Range of motion:

3. Comfort:

4. Adjustability:

5. Durability:

• Comfortable• Easy to modify• Easy to titrate in both horizontal and

vertical dimensions.• Most importantly, allows for maximum

tongue freedom

“Obtaining a correct diagnosis, using all of the diagnostic aids available, is much more important than a specific appliance.”

Diagnosis Before Appliance

Michael P. Pecenka & John T. Herald, D.D.S., Inc.Diplomates American Academy of Pain Management• Founders of: The Academy of Clinical Sleep Disorders Dentistry• Members Academy of General Dentistry Special Interests• Chronic Cranio-Facial Pain Dental Management of Snoring & Sleep ApneaStrongsville Plaza • 14783 Pearl Road • Strongsville , Oh 44136 Ph: 440-238-1300 • Fax: 440-238-5466 Email: CoQ10Solutions@aol.com

Which appliance should I use?

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. Gy YatrosJanuary 14-15, 2011Tampa, FL

Sleep Group Solutions Dental Sleep MedicineInstructor: TBAJanuary 21-22, 2011San Diego, CA

Sleep Group Solutions Dental Sleep Medicine Instructor: TBAFebruary 4-5, 2011Phoenix, AZ

Sleep Group Solutions Dental Sleep MedicineInstructor: TBAFebruary 18-19, 2011Atlanta, GA

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. LipseyMarch 11-12, 2011San Francisco, CA

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. LipseyMarch 18-19, 2011Chicago, IL

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. Gy YatrosApril 8-9, 2011Boston, MA

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. Gy YatrosApril 22-23, 2011Las Vegas, NV

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. Gy YatrosApril 29-30, 2011Atlanta, GA

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. SlabachMay 6-7, 2011Dallas, TX

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. Gy YatrosMay 20-21, 2011Miami, FL

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. RondeauMay 27-28, 2011Calgary, AB

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. Gy YatrosJune 3-4, 2011New York City

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. Gy YatrosJune 17-18, 2011Phoenix, AZ

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. Tache June 24-25, 2011Chicago, IL

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. Gy YatrosJuly 15-16, 2011San Diego, CA

Sleep Group Solutions Dental Sleep Medicine Instructor: Dr. SlabachAugust 19-20Boston, MA

Sleep Group Solutions Dental Sleep MedicineInstructor: TBASeptember 16-17, 2011Washington, DC

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. TacheSeptember 23-24, 2011Dallas, TX

Sleep Group Solutions Dental Sleep MedicineInstructor: TBASept. 30 -Oct. 1, 2011Las Vegas, NV

Sleep Group Solutions Dental Sleep MedicineInstructor: Dr. Gy YatrosOctober 21-22, 2011Tampa, FL

Sleep Group Solutions Dental Sleep MedicineInstructor: TBANovember 4-5, 2011Phoenix, AZ

Sleep Group Solutions Dental Sleep MedicineInstructor: TBANovember 11-12,2011Boston, MA

Sleep Group Solutions Dental Sleep MedicineInstructor: TBADecember 8-9, 2011Orlando, FL

Sleep Group SolutionsSeminars

To register, visit us online at: www.dentalsleepseminars.com

The NEW Art

Intense focus on total patient wellness inspires dentists to train their office for screening and treating all patients, for sleep apnea.

DENTISTRY

Interpreting Home Sleep StudiesCoverage for the entire United States and Canada is almost there, needing only a few more analyzers to cover a few more states

PCOS: RISK FACTOR FOR TMD?

CASE STUDIES

The Polycystic Ovarian Syndrome Patient

Continue from Page 11

PART II: A CASE STUDY DEMONSTRATING OVERLAPPING SYMPTOMS OF TEMPOROMANDIBULAR DISORDERS (TMD) AND POLYCYSTIC OVARIAN SYNDROME (PCOS) AND THE DIFFICULTIES OFTEN ENCOUNTERED IN THE MANAGEMENT OF SUCH PATIENTS

Figure 1: Meet SMF. SMF was referred to me initially in 2004. She had been referred by her general DDS who had provided a mouthguard which was not helping to reduce her complaints of pain. Her chief complaints at that time were as follows:

1. “Jaw discomfort, feels like a toothache”2. “Jaw joint clicking and grinding noises

when eating”3. “Earache”4. “Not sleeping well; awaken with sore

jaws”5. “Tired all of the time”

A CLOSER LOOK AT THE PAIN PATTERNS

SUGGEST SDB

REFERRAL FOR A POLYSOMNOGRAM / CPAP INTOLERANCE / ORAL AIRWAY DEVICE (OAD)

Part II: Managing The CPAP-Intolerant PCOS Patient: A Case Study Demonstrating The Unique Challenge Of The PCOS Patient

ORAL AIRWAY DEVICES: WHEN ADVANCEMENT ALONE DOES NOT STABILIZE THE AIRWAY

ACOUSTIC PHARYNGOMETRY

To finish this article visit: www.sleepgs.com

OAD MANAGEMENT & MODIFCATION OF SMF

MILDPACKAGE

MODERATEPACKAGE

SEVEREPACKAGE

TOTAL EST SCORE:

EPWORTH SLEEP TEST

If you are still unsure about the test

results, please contact:

Sleep Group Solutions1.866.353.3936

or visit us online at: www.sleepgs.com

www.dentalsleepclinics.com