Our Office: Dr Poss has practiced dentistry for nearly 30 years with an emphasis on TMJ and full mouth reconstruction. Through this process Dr. Poss has become involved more with madibular advancement devices and sleep breathing disorders to successfully treat these cases. He is an active member of the AASM, AADSM and a diplomat with the AACSDD.
Our Philosophy: As a dentist we never diagnose sleep breathing disorders but treat those that are CPAP intolerant. We recognized that CPAP is the “Gold Standard” and follow the guidelines set up by the 2006 AASM “Practice Parameters with Oral Appliances and the Treatment of Sleep Apnea.” Mild to moderate AHI is the range that we have the greatest success with an oral appliance but there have been numerous cases where severe AHI and CPAP intolerant patients have been very successful.
Our Protocol: We Never begin treatment on a patient without a current PSG (2 years or less) unless authorized by your office. The patient signs an affidavit to CPAP intolerance and a prescription of medical necessity by the physician’s office. There will be continual communication with the physician’s office as treatment begins and continual updates as treatment progresses. This will usually take place in the form of a letter.
How we treat: Every patient is given a full oral examination. This will include all facial muscles and TMJ evaluations well as a joint sonogram to determine if they are a candidate for an oral appliance and their mandibular jaw relationship can support an oral appliance for obstructive sleep apnea.
All appliances are FDA 510K approved. With all of our appliances we will consider TMJ support and comfort, which will assist in the success of treatment and compliance. All appliances will be carefully titrated. Once the ESS, sleep observer and symptoms are dramatically improved an HST device is given for Titration purposes only. Not for diagnosis. Once the sleep-breathing disorders are in the AASM range of acceptance the patient will be scheduled with your office for a verification of the oral appliance with a follow-up PSG. If the appliance is verified valid in controlling the sleep breathing disorder we will schedule the patient for bi-annual check-up to reconfirm the compliance and comfort of the appliance.
Insurance and cost: Most medical insurance plans cover sleep apnea and at least part of TMJ treatments. Our office is now in network with these medical insurance carriers: BCBS, Aetna, Cigna, UHC and UMR. We continue to support our military as a preferred provider with Tricare.
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