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I have made close to 200 dental appliances for sleep apnea. I am a dentist who has taken a big interest in this field. I have attented hours of lectures on the topic. I have had 100% success not one patient doesn't like the appliance. Everyone and studies show improvements. It is a option that anyone who can't wear CPAP should look into.

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I know that there are something like 80 different dental appliances for sleep apnea out there. How does a dentist decide which to use? I've always had the feeling that they find one they like and that is the only one they offer.
I've used CPAP for 2 years now. But after a nose operation, and after an examination of my tongue base, I am sure that I am a good candidate for an oral appliance.

Currently I am testing a "boil-and-bite" appliance to see if it works. It works apparently fine, but now I am looking after a more permanent solution.

The problem is that I on occasion have some TMJ problems. I use an NTI device for this. What type of oral appliance would you recommend who also can manage the TMJ problem?

Henning
The best oral applaince for your situation is one that is made (custom) by a dentist and it is called a Somnomed/ with a anterior ramp.. The ramp portion is basically the same thing as a NTI appliance. However the oral appliance covers all of your upper and lower teeth it is horse shoe shape. You can find a dentist who is QUALIFIED by looking on the American academy of Dental Sleep Medicine web site.. Google the name and you'll be able to find a dentist in your area who is capable of making one of these devices.
Is this what is called a TAP device. I have communicated with Somnomed and they have regrettably no dentists here in Denmark.

Is it the case that it is possible to communicate experiences between a good dentist here in the country and one with experience in Somnomed?

Henning
Daniel Levy said:
I know that there are something like 80 different dental appliances for sleep apnea out there. How does a dentist decide which to use? I've always had the feeling that they find one they like and that is the only one they offer.
Dr. Richard Charmoy DMD said:
Daniel Levy said:
I know that there are something like 80 different dental appliances for sleep apnea out there. How does a dentist decide which to use? I've always had the feeling that they find one they like and that is the only one they offer.
Welcome. I've been meaning to ask these questions for a long time....

1. What's your feeling about using mandibular advancement devices for people with TMJ?
2. How far away are you from NYC?
3. Do you use in-lab testing or a home study after the device is fully adjusted and in place?
4. What kind of dental work or dental conditions are contraindications for these devices?
5. How do you define "success"?
6. I've had some of my patients have it covered by insurance. Most have to pay out of pocket. How can someone know if it's covered or not? How do you handle this issue?
7. What's your long-term compliance rate? (over one year)

Thanks in advance of your answers.

Steven Y. Park, M.D.
http://www.doctorstevenpark.com
Steven Y. Park, MD said:
Welcome. I've been meaning to ask these questions for a long time....

1. What's your feeling about using mandibular advancement devices for people with TMJ?
2. How far away are you from NYC?
3. Do you use in-lab testing or a home study after the device is fully adjusted and in place?
4. What kind of dental work or dental conditions are contraindications for these devices?
5. How do you define "success"?
6. I've had some of my patients have it covered by insurance. Most have to pay out of pocket. How can someone know if it's covered or not? How do you handle this issue?
7. What's your long-term compliance rate? (over one year)

Thanks in advance of your answers.

Steven Y. Park, M.D.
http://www.doctorstevenpark.com
I am all in favor of mandibular advancement appliance provided the dentist is aware of what he is doing. We are constantly getting flyers about making these appliances to help our patients.. I have studied this extensively with some of the top sleep dentist in the country. If the proper appliance is made and considerations for TMJ situation you should have
no problems. All of the appliances I make I take this into consideration therefore avoiding TMJ problems. If they do occur most resolve themselves within a week or two. I am in Central Jersey it takes me 45 minutes from NYC, my practice is in Somerville. I use both lab testing at our local Sleep for life Center apart of Somerset Medical Center and also ambulatory sleep studies. Obviously if a patient has cardiac or other medical conditions I would prefer a sleep lab test.Since sleep apene is a life threatening condition there are not many dental situation to prevent the fabrication of these appliances. I have made them on patients who have no teeth and patients who have periodontal conditions. I define success two ways one by patients epsworth and berlin tests, family and the patients reporting back to me. Secondly I like a lab or ambulatory test to quantify my numbers and compare to original sleep study, RDI/ AHI etc.Insurance is a trety situation they look at a dentist making a medical device, however I have a computer program that will generate a 30 page report including pictures and sleep studies, and all oral cavity related situations that can be a cause of sleep apnea. Over 15 years of making these appliances with really the majority within the last 5 years not one patient on follow up tell me they are not using the appliance. I get quotes of you have changed my life and my families. My spouse now sleeps with me, I am rested, I am now excersizing everyday and am rested. If you wish to contact me further my e-mail is rcharmoy@drcharmoydmd.com.
I am here to help you and your patients in anyway.
Dr. Charmoy
Henning said:
Is this what is called a TAP device. I have communicated with Somnomed and they have regrettably no dentists here in Denmark.

Is it the case that it is possible to communicate experiences between a good dentist here in the country and one with experience in Somnomed?

Henning
I don’t know what you were looking to tell.

What I thought was that my dentist could take the imprint of my teeth and send them to a dentist with Somnomed experience, and then made an oral appliance. Subsequently, this could be adapted with a communication between my dentist and the experienced Somnomed dentist.

Meanwhile, I have been informed by Somnomed that there is a dentist with a great deal of experience in the north of Germany. It takes me one day for each visit. But it may be the solution.

Here in the country, I have only seen uncomfortable appliances. But I know that Somnomed has planned to establishing here and in the other Scandinavian countries next year.

Henning

Dr. Richard Charmoy DMD said:
Henning said:
Is this what is called a TAP device. I have communicated with Somnomed and they have regrettably no dentists here in Denmark.

Is it the case that it is possible to communicate experiences between a good dentist here in the country and one with experience in Somnomed?

Henning
Henning said:
Is this what is called a TAP device. I have communicated with Somnomed and they have regrettably no dentists here in Denmark.

Is it the case that it is possible to communicate experiences between a good dentist here in the country and one with experience in Somnomed?

Henning

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