RICK VAN GURP, DDS
WHO IS HOLDING US BACK?
T
here will always be
dabblers – dentists who
want to provide a service but
don’t want to take the time
to really learn it. I saw this in
the 1990’s with the cosmetic
dentistry revolution. It was
as though many dentists
woke up one day and
decided to call themselves
“cosmetic dentists” but
knew little to nothing about
smile design, occlusion, and
material choices.
I see this with TMD where
the answer to ANY joint,
muscle or wear issue is a flat
plane occlusal guard. As the
saying goes, when all you
have is a hammer, everything
is a nail. This doesn’t help
our cause.
Ask yourselves, who is
holding us back?
Is it the sleep physicians?
No, it really isn’t. We should
endeavor to work with sleep
physicians on behalf of our
patients. As we are learning,
so are the sleep physicians.
Some are more amenable
to the use of dental sleep
devices than others. Seek
them out.
Is PAP therapy the
competition? While oral
appliance therapy is gaining
traction, roughly 95% of
OSA treatment in the US
initially involves PAP and it
is still considered the gold
standard. does nothing more than dab-
ble in making dental sleep
devices. I wouldn’t even
classify them as practicing
Dental Sleep Medicine. They
simply make devices.
But if you consider the less
than stellar statistics with
regards to PAP adherence
and the growing patient
population suffering from
OSA, there is literally plenty
to go around. In fact, we
are not keeping up. In other
words, more people are
developing OSA than we are
able to treat. Several months ago, a dentist
told me “all you need to
know about this stuff you
can learn in a weekend
course.” I bit my tongue
so hard I think it’s still
swollen. Some would call
the dentist “unconsciously
incompetent”. He doesn’t
know what he doesn’t
know and he’s doing a great
disservice to his patients.
What about other
treatment options? PAP and
Uvulopalatopharyngoplasty
(UPPP) both came out in
1981 as treatment options
for OSA. Fast forward to 2018
and there are numerous
additional treatment options
including myofunctional
therapy, hypoglossal nerve
stimulation, expansion
sphincter pharyngoplasty,
positional therapy and
of course oral appliance
therapy. Each has its place
in helping OSA patients and
none are the be all end all.
So, who then is the compe-
tition? The competition is
the uninformed dentist who
RICK VAN GURP, DDS
Dr. Rick Van Gurp is a
general dentist in Charlotte,
North Carolina. He has
a solo general dental
practice and a separate
solo dental sleep medicine
practice. He has over
150 hours of continuing
education in dental sleep
medicine including having
recently completed the
Tufts University mini-
residency.