The British Society of Dental Sleep Medicine

The Society is working to enhance the quality of life for those who suffer from sleep disordered breathing such as snoring.

The BSDSM also intends to reach out to the community at large, working towards the creation of a positive public awareness of sleep disorders and the role of the Dentist in recognition and treatment of sleep breathing disorders.

About The British Society of Dental Sleep Medicine

On Tuesday the 5th October 2004, the city of Prague, 'stag party capital of Europe', attracted an international gathering of dentists intent on pursuing their own particular brand of M.A.D.ness, the use of Mandibular Advancement Devices (MAD's) in the treatment of Obstructive Sleep Apnoea (OSA). The Prague International Congress Centre witnessed the inaugural meeting of EdeSA (the European Dental Sleep Medicine Academy).

Over 1/3 of the population snore and whilst mostly causing amusement and embarrassment, a small proportion of snorers suffer from OSA. The recurrent apnoeic/hypoxic episodes lasting anywhere between 10 seconds - 2 minutes, can occur several hundred times during the course of one nights sleep and can be the cause of serious health problems not only for the snorer but also his/her sleep partner.

The prevalence of OSA is estimated at 4% in men and 2% in women in the middle aged work force. Snoring is antisocial and can be near intolerable for the sleep partner. It is even possible that a higher morbidity risk exists for partners of snorers than for the snorers themselves! The medical profession now considers the treatment of antisocial snoring and consequent sleep deficit and fatigue extremely appropriate.

There are many medical conditions linked with OSA including hypertension, stroke, M.I, acid reflux (GERD), diabetes and weight gain. In addition, excessive daytime sleepiness is often severe enough to cause accidents at work and on the road.

The options for treatment of OSA vary. The gold standard treatment is continuous positive airway pressure (CPAP) but this treatment has several drawbacks and long term compliance is poor. Much less than for a MAD.

Surgery may be an option, the commonest procedure being uvulopalatalpharyngoplasty. Sadly, the success rate at 6 months post op is <50% with this percentage dropping with time.

MAD's however have been proven to be effective in the treatment of simple snorers and in those suffering from mild - moderate OSA. More recently they have been used with effect in the treatment of some severe OSA patients. MAD's are definitely the treatment of choice for primary snoring and upper airway resistance.

The dentist has a role in screening for OSA by regularly updating medical histories, questioning on basic health issues, B.P, quality of sleep, daytime sleepiness, presence of witnessed apnoea's, oesophageal reflux, heartburn and dental acid erosion. Positive responses should be referred to an ENT or chest physician for investigation and diagnosis. The diagnosis can only be accurately made after a polysomnogram, a laboratory controlled 'all night' sleep study.

Trained GDP's are required to treat patients with sleep disordered breathing. The dentist should understand the nature of the patient's dysfunction and should be familiar with the range of effective treatments available. There is a need to develop protocols for the assessment, treatment and long term follow up of OSA patients treated in general dental practice and to investigate and identify reliable predictors of successful treatment with MAD's.

It is clear that in the UK, we are lagging behind the Americans and most of Europe in this field. To help encourage more effective treatments, we propose that an association of all interested parties should be organised so that we can educate and support ourselves.

Anyone connected with the provision of treatment to OSA patients would be welcome to join, be they dental surgeons, dental technicians, medical practitioners, respiratory nurses, ENT consultants and Respiratory Medicine physicians.

A group of highly motivated dentists and technicians, listed below, have decided to act as a catalyst for the establishment of a British group. This group will encourage intercommunication and dissemination of knowledge between interested parties, with the ultimate aim of improving the treatment of patients with sleep disorders, through the involvement of GDP's and the utilisation of oral appliances.

  • Dr. Roy Dookun
  • Dr. Quentin Jones
  • Dr. Rob Miller
  • Mr. Adrian Zacher - ZSA Ltd. (Zacher Sleep Appliances)
  • Mr. Derek Hudson - JJ Thompson
  • Dr. Mark Ter-Berg

To this end, 'The British Society of Dental Sleep Medicine' was launched at a two-day residential sleep seminar 'An exploration of Dental Sleep Medicine and the role of the GDP' in Oxford on Friday 29th - Saturday 30th April 2005. Practitioners and technicians interested in the treatment of OSA are urged to register for what I believe are most informative and stimulating courses.

The British Society of Dental Sleep Medicine is affiliated to the European Dental Sleep Medicine Academy (EdeSA).