"please keep me updated about oximeters "
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the kind of message that erodes dentists' credibility
below is the kind of marketing i object to from dentists. notice that the description of CPAP is: a "gas mask-like device which forces air into the lungs of apnea suffers through a mask or a nose appliance." contrast that with the description of the oral appliance: "A simple intraoral device."
the dentist goes on to say that CPAP is "uncomfortable," and "noisy." i don't think this language paints a fair portrait of the choice between CPAP and an oral appliance -- it also pits one treatment modality against the other, as if it's one or the other. what do you guys think of this PR?
A simple intraoral device called a TAP 3 appliance may be a more suitable treatment choice for many patients who suffer from sleep apnea than the traditional CPAP device. CPAP is a gas mask-like device which forces air into the lungs of apnea suffers through a mask or a nose appliance. As many as 20 million Americans suffer from sleep apnea, a potentially deadly disease which ruins the quality of life of those who suffer from it as well as the lives of those around them. People with sleep apnea frequently snore very loudly as well and stop breathing for 10 or more seconds five or more times per hour during their “sleeping” period, rarely achieving the deeper stages of sleep necessary for wellness.
Colleyville dentist Dr. John Vinings has successfully treated hundreds of sleep apnea sufferers with the TAP 3 appliance over the past three years. Dr. Vinings says fewer than 40% of those who have been diagnosed with sleep apnea use the CPAP on a regular basis. Vinings says “the mask is uncomfortable and frequently dislodges when the patient turns to the side in their sleep making it ineffective. Additionally, the machine is noisy and the patient feels air being forced through their mouth and onto their face if the mask doesn’t seal properly.” All this creates a situation which many patients find is impossible to tolerate, even though without treatment, sleep apnea can lead to many other health problems such as heart disease, type 2 diabetes, depression, erectile dysfunction in men, and decreased libido in women. People with sleep apnea also have a higher number of automobile accidents than average due to the fact that they do not get restful sleep and fall asleep at the wheel frequently.
There are countless millions of Americans with sleep apnea who remain undiagnosed and untreated. In many cases, this is due to their fear that they will have to sleep each night for the rest of their lives attempting to wear a CPAP. Now, there is an effective alternative worn inside the mouth which will provide an airway which relieves the symptoms of sleep apnea. Dr. Vinings says the TAP 3 is easy to fabricate, more portable than a CPAP, and much more comfortable. Dr. Vinings works with several area physicians who specialize in sleep disorders. Many recommend the TAP 3 as treatment of choice for their patients and send patients directly to Dr. Vinings. Following initial adjustment, Dr. Vinings returns the patient to their sleep doctor for a follow-up sleep study and final adjustment of the TAP 3 appliance to insure maximum effectiveness.
The TAP 3 appliance may be your best choice in treating sleep apnea and enjoying the benefits of improved health and well being.
For more information, please visit www.drvinings.com.
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Views: 931
Replies to This Discussion
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Permalink Reply by Banyon on
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Mike, I understand your righteous indignation and have empathy with it.
However, I have changed my opinion and now say let 'em promote and sell oral devices as they see fit.
Maybe the CPAP failure rate is as high as 50% and this doesn't include the legions who won't go for sleep studies because "I will never wear a mask to bed", and the legions who use CPAP in a suboptimal way. So let some of them get some relief with oral appliances..
I had a friend that underwent UPPP last summer ("I won't wear a mask") and I ran into his wife at the grocery store last week. She told me he has not been feeling well and just had an overnight oximetery study. His sats are falling below 90%. Damn!!! Permanently altered anatomy with the bad side effects for the rest of his life and still has sleep apnea!
At least if he had paid for an oral appliance and got those oximetry results, he could just spit it out and now go buy a CPAP.
As for the dentists telling patients appliances are sure to cure them, let one of their patients have a heart attack or stroke and sue their asses off. Insurance companies and dentists will take note quickly and change their methods.
Maybe I am getting too old, but it just amazes me that people will buy any expensive product or service without studying the product and the options. Don't we all know that all advertising states the benefits and omits the disadvantages???
A lot of this goes back to our poor education and lack of critical thinking skills. Guess what, if you have poor critical thinking skills, in the real world you will pay for it.
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Permalink Reply by Connie B on
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A good reliable sleep doctor recommended an oral device for me in 1995 I have been searching for a Sleep specialist /dentist who could make the corrective/ apnea preventive device ever since. Finally in 2007 I find him. This doctor has been having very good success with devices including himself for years. Mean while all this time I tried CPAP with no success went through two sleep doctors who just left me hanging because I could not tolerate CPAP. Mean while I’m developed central sleep apnea, obesity, my blood pressure is beginning to rise, I am suffering the consequences of the worsening of my disease process. I was able to get my insurance to pay because I removed all heavily sedating medications from my regimen not easy when you live with a chronic pain disease. I lost twenty pounds I did everything right but my sleep apnea got worse. I am a nurse so I knew I had to do something and I did everything right including finding a medical professional who could meet my oral and medical needs. The device improved my severe sleep apnea studies drastically. Place me in your positive column for medically fitted and dispensed oral devices and encourage more of your sleep apnea patients to try it and sleep doctors and dentist to recommend it.
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Permalink Reply by Jay Polatnick on
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There is a '3rd Way' that my dentist, Dr. Felix Liao of Fairfax,VA has offered. He approaches the problem by correcting the bite/jaw misalignment, largely without surgery. He's sad significant results and I'm currently in the beginning of his treatment protocol. At least this Dr. Vinings has encouraged his patients to seek a follow-up Sleep Study evaluation to certify the credibility of his treatment. All practioners have their bias and as long as they can offer a proven alternative, I do not thing they are doing great harm to their patients.
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Permalink Reply by Dr Eng on
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There are pros and cons to all OSA treatments, nonsurgical and surgical. There is certainly no one size fits all in any of these treatments. As far as oral appliances are concerned, most of my patients do well but not all. I've read in the past from dentists who claim 100% success rate. I have to ask to define what success is. There are many factors relating to comfort and tolerance which applies to both CPAP and oral appliance users. There is no such thing as 100% acceptance and adherence for either treatment. For me, most patients who don't do well are those who are noncompliant due to jaw or teeth discomfort even after many adjustments. Then on the other side of the spectrum, I have patients who adapted easily and refuse to sleep without the dental device. The same applies to CPAP. My patients who see me just for the dental appliance are usually those who are intolerant of CPAP and refuse to have surgery. I tell them the statistics that it is not as efficacious as CPAP especially as the OSA severity is increased. However, some improvement is better than no improvement such as when the CPAP is not used. Then again, I do have my own general dental patients whom I have refered to the sleep physician who return with the diagnosis of severe OSA and I tell them their best option is CPAP. There are also patients of mine who have large tonsils and snore and I send them to Dr Park, the otolaryngologist, for possible tonsillectomy. Then it will be his call to treat or to also refer to the sleep physician. OSA treatment should definitely be approached with a multidisciplinary teamwork amongst the health professionals. Individually we don't have all the options which is why it's critical for the patients well being that the doctors communicate and plan together with the patient.
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Dr. Eng, Good post. Your approach seems appropriate given the current state of treatment options.
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Dr. Eng,
Have you ever considered adjusting your patients bite ? This is often the underlying cause of the issue and my wonderful dentist is going to take this route with me. I think there is another choice beyond simply a. CPAP b. Oral Appliance c. Surgery. Readjusting one's bite alignment also has effects on the central nervous system as well as frequency of tension headaches. I consider my dentist to be on the cutting edge in this regard and I feel blessed to have come across him. (see www.wholehealthdentalcenter.com
Jay
Dr Eng said:There are pros and cons to all OSA treatments, nonsurgical and surgical. There is certainly no one size fits all in any of these treatments. As far as oral appliances are concerned, most of my patients do well but not all. I've read in the past from dentists who claim 100% success rate. I have to ask to define what success is. There are many factors relating to comfort and tolerance which applies to both CPAP and oral appliance users. There is no such thing as 100% acceptance and adherence for either treatment. For me, most patients who don't do well are those who are noncompliant due to jaw or teeth discomfort even after many adjustments. Then on the other side of the spectrum, I have patients who adapted easily and refuse to sleep without the dental device. The same applies to CPAP. My patients who see me just for the dental appliance are usually those who are intolerant of CPAP and refuse to have surgery. I tell them the statistics that it is not as efficacious as CPAP especially as the OSA severity is increased. However, some improvement is better than no improvement such as when the CPAP is not used. Then again, I do have my own general dental patients whom I have refered to the sleep physician who return with the diagnosis of severe OSA and I tell them their best option is CPAP. There are also patients of mine who have large tonsils and snore and I send them to Dr Park, the otolaryngologist, for possible tonsillectomy. Then it will be his call to treat or to also refer to the sleep physician. OSA treatment should definitely be approached with a multidisciplinary teamwork amongst the health professionals. Individually we don't have all the options which is why it's critical for the patients well being that the doctors communicate and plan together with the patient.
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Jay, I see from another post of yours that you have a "pronounced underbite". How will this be corrected?
Thanks.
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Permalink Reply by Henning on
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Here in the country CPAP is always the first choice.
But as Banyon described previously the CPAP compliance for various reasons is very low - perhaps lower than 50%.
So there may be various options if CPAP cannot be used (alone):
- OA
- Surgery
- OA + CPAP
- Surgery + CPAP
- OA + Surgery
- Surgery + OA + CPAP
The alternative is - Nothing.
So I certainly agree with Dr. Eng
"OSA treatment should definitely be approached with a multidisciplinary teamwork amongst the health professionals. Individually we do not have all the options Which is why it's critical for the patient's wellbeing that the doctors communicate and plan together with the patient."
Henning
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Permalink Reply by Mark Douglas on
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Well if TAP3 works -- great! Whatever works, right?
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Connie B - great, if it helped you 100% thats wonderful. Id love such a device, and so would several people I know.
I thought I would never get used to my CPAP, but one open heart surgery later, I was motivited to actually use it!!
I took Ambien for five or six nights, and got used to CPAP that way. Now, I don't mind it at all, without Ambien.
Just curious -- if your sleep doctor was amazed at the positive results of your dental appliance remedy, and actually did a sleep study to verify it, why would he AND the dentist say for you to use the CPAP anyway?
I assume they weren't satisified with the results of the appliance by itself, and they based that opinion on numeric results from your follow up sleep study. . So, what were the numbers from your sleep doctor on the test with just the appliance? And how much of an improvement did it make?
Connie B said:I have been using an oral device for the treatment of my obstructive and central sleep apnea for over a year now. It is wonderful I could not tolerate any form of CPAP mask, nasal pillows, etc, what ever they tried I suffocated. Even after suffering through six week and longer of trials at home with the "best" masks made. I could not adapt to a mask. Than we tried xyrum I was zonked and the mask stayed on but when they increased the pressure I stopped breathing. I finally found a Dentist who could fit and make the device of course my insurance would not pay for it. But I fought and won. I know I do not snore, wake up gasping for breath, and when I do sleep I feel better when I use my device. So it is something worth looking into and fighting your insurance to pay for. My sleep study with the oral device improved almost 100% my sleep doctor was truly amazed. He and My dentist still think I should try to use CPAP again with the device... Yeah right. we will see…
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Mike's discussion is titled "the kind of message that erodes dentists' credibility", so while we are on the topic take a look at this current news.
Twilight fans are sinking their teeth into vampire culture by paying cosmetic surgeons to give them fangs.
In most cases the young fans are willing to spend around $200 (about £132) of their - or their parents' - money on temporary vampire veneers.
Taylor Wilkins, 16, had the sharp fangs installed at the Houston office of Floss Dental.
"I'm Team Edward," Taylor said, "and he has them, so ..."
For those unfamiliar with the teen-targeted Twilight series of books and films, Team Edward backs the vampire played by Robert Pattinson and Team Jacob favours Taylor Lautner's werewolf character.
In the clinic Dr Clint Herzog applied a tooth-coloured resin to Taylor's canines then shaped the composite into gently-sloped fangs.
"It's similar to the material that we use to bond braces on the teeth," Dr Herzog explains.
"So it can be put on and taken off very easily with no damage to the teeth."
The dentist, who operates five offices in Texas, says vampire veneers are in demand, especially in suburbia.
"In the areas where we have a lot of people that follow Twilight, yeah, we get a lot of calls."
After a 15-minute procedure, Taylor sported a subtle but distinctive set of fangs.
"I was really excited to get them," she said. "It didn't hurt at all."
But the true test was to come later, when her mother delivered her judgement
"I almost didn't notice that she had it done," said Jamie Wilkins, "until she really smiled and then they were noticeable."
Sadly for Taylor, her mum was quick to stress that her vampire life will be short-lived and the fangs would be coming off before school starts.
http://www.cinenema.com/twilight-fans-flock-for-vampire-fangs
Only in America?
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Which just shows to go you many of our teens have too much access to too much money - and a sheep-like mentality.
Our neighboring farmer hired some husky 17 year old teen boys to load and unload hay wagons at $10 an hour back when minimum wage was $4.75 or so. Only one lasted a full day. 2 took jobs at McDonald's & Wendy's at minimum wage rather than do a little physical labor. One had no job all summer. Too hot, sweaty and dirty was their complaint. All 4 were on the high school football team.
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