Is Treating Sleep Disordered Breathing in the Orthodontic Office a Fad?

  1. an intense and widely shared enthusiasm for something, especially one that is short-lived and without basis in the object’s qualities; a craze.

As I write this post, the AAO MidWinter Meeting “Sleep Apnea and Orthodontics: Consensus and Guidance” is wrapping up. Numerous sleep medicine courses for the orthodontist are popping up and even our Orthopreneurs Summit in September will be have a fair amount of lecturers teaching about diagnosing and treating sleep disordered breathing (learn more about the meeting here).  Sleep disordered breathing is definitely a hot topic in our field.
But I recently saw an AAO sponsored lecture entitled: “Is Sleep Related Breathing Disorders Another Déjà vu of Temporomandibular Disorders in Orthodontics?” The title caught my eye because I lived through the “TMD Revolution” and remember how everyone in all of dentistry (not just orthodontics) diagnosed TMD issues for everything from headaches to ringing of the ears. Courses sprung up everywhere and like many other fads in dentistry, a weekend course could be taken to make you an “expert” in all things TMD, as well as help your bottom line.
There are numerous “fads” (others’ word, not mine) in today’s orthodontic world . From clear aligner therapy to lingual orthodontics and sleep disordered breathing, we can find courses and meetings to help us learn more and like TMD, there are debates on both sides for each topic.
But my specific question is: “If we make a considerably better living treating our pediatric patients’ sleep disordered breathing, does that mean our motives are corrupt and that this “fad” is wrong?”
Many out there act as if the answer to the aforementioned question is “yes”. I’m biased because I’ve been following the world of SDB for about a decade. Like many of you, it took me many years to “see the light” and while the essence of the proper treatment modalities for each presentation and the diagnostic criteria are still being unraveled, we know for sure that we can help many pediatric patients who are slipping through the cracks. In doing so, we WILL make a better living in our practices.
While I am sure there are some out there who will embrace the world of SDB to make more money, helping these children who suffer from a poor night’s sleep is one of the most rewarding things I do. To see a mom crying tears of joy because her child’s life has been changed by our intervention, or to hear a parent tell me that her child is now a “totally different kid” because of subtle, easy to implement treatment is incredibly fulfilling.  Don’t believe me? Watch a testimonial video of one of the moms in my practice HERE.
There are so many voices out there screaming about SDB being a fad because of cynicism or a false sense of comparing SDB to some sort of previous dental or orthodontic fad. I don’t believe it is, and when TMD was in vogue, I took a 500 hour course on the impact of occlusion on the muscles of mastication and TMD to separate fact from fiction. I see SDB as being no different. We need to “separate the wheat from the chaff” in the rapidly evolving world that is pediatric SDB. How do we do this? Take many courses from many instructors. Do a lot of reading and of course, document your results from your own treatment outcomes so you can review the impact of your treatment choices. Don’t think that you can attend any single course or meeting and suddenly become an expert.
As I’ve said numerous times, I believe that Orthodontics is the central hub of the wheel that makes up the pediatric SDB treatment team. We, as a specialty have the ability to “own” this field as ours and we have all of the tools in front of us to become gatekeepers for this problem. By educating and working with well informed and trained ENTs, GPs, oral surgeons, myofunctional therapists and pediatric dentists, we can helps countless children (and their parents) lead better lives.
And yes, you WILL grow your practice if you immerse yourself in the educational world of SDB. As you help children sleep and breath better, word will spread and new patients will come to you from far away. You WILL see a better bottom line as you help children who were never screened in the pediatrician’s office. When you treat them, suddenly you will find siblings, parents and friends who become your non-SDB patients and yes, your practice will grow.
The literature is there to support what we’re doing and prudent screening, interviews and proper referrals can change lives and bring tremendous fulfillment.
If it’s a fad, I hope it doesn’t go away.
All the best,
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