At its January 21, 2017 meeting, the Colorado Dental Board began to consider the dentist’s role in the evaluation and treatment of obstructive sleep apnea (OSA). After a lengthy discussion among Board members and the public, the Dental Board decided to create a committee comprising members of Colorado’s Dental Board and a member of the Colorado Medical Board to examine the current Dentist and Dental Hygienist Practice Act to determine if these rules and regulations should be revised to allow for more dental involvement in the management of OSA. Colorado sleep medicine professionals are encouraged to attend the committee’s first public meeting on Friday, March 31.

The AASM has engaged the Colorado Medical Board, Medical Society and the Dental Board to ensure that its guidelines promote the highest standards of patient care for OSA. The AASM recognizes the role of dentists in the provision of custom-fabricated, titratable oral appliances for select patients with OSA when oral appliance therapy (OAT) has been prescribed by a physician. However, we are unaware of any state dental practice act that allows a licensed dentist to diagnose a medical condition such as snoring or OSA. In order to demonstrate the importance of these high standards, we need your help to reach out to key Colorado stakeholders to discuss the dentist’s role in the management of OSA being limited to fitting and providing oral appliances and follow-up of any dental-related side effects.

The committee meeting on Friday, March 31, will be held at 4 p.m. in Conference Room 110D at the Colorado Department of Regulatory Agencies (DORA) building. DORA is located at 1560 Broadway, Suite 1350, in Denver. It is a public meeting and any interested parties are welcome to participate. If you would like to attend the upcoming meeting and provide comments, please contact Ted Thurn, AASM Sr. Government Relations Analyst, at tthurn@aasm.org. DORA will send out an email in the next couple of weeks with additional information on how to attend via webinar if participants are unable to join the meeting in person.

Participants are encouraged to submit any court rulings, laws, rules, policies, guidelines, or position papers regarding the subject of dentistry and sleep apnea to Mr. Maulid Miskell, Program Director, Healthcare Branch at maulid.miskell@state.co.us. This sample letter can be used to convey your concerns. The letter articulates how:

  • Patients presenting with symptoms of OSA require a face-to-face evaluation conducted by a qualified physician trained in sleep medicine;
  • Therapies for OSA, including positive airway pressure (PAP) and oral appliance therapy (OAT), must be prescribed by a qualified physician;
  • Dentists who have a valid state license to practice dentistry are considered legally qualified to treat patients with OAT in the state(s) where they hold the license; and
  • Dentists providing OAT are encouraged to complete a minimum of 25 hours of recognized continuing education in dental sleep medicine (e.g., American Dental Association Continuing Education Recognition Program [ADA CERP] or Academy of General Dentistry Program Approval for Continuing Education [AGD PACE]) provided by a dental sleep medicine focused non-profit organization or accredited dental school in the last two years.

DORA has already received guidelines from Medicare, AASM, and United Health, so they have requested that you refrain from resending those documents. DORA will also be conducting a review of all state dental board rules and policies to see how each of them is addressing the issue.

This is an open invitation from DORA. Therefore, if you are aware of others who may be interested in participating, please send their email addresses to Mr. Thurn or Mr. Miskell so they can be included on the distribution list for future notices regarding this matter.

As these discussions continue, we will keep our Colorado sleep professionals informed of developments and how you can help. Again, if you are interested in participating at the meetings or speaking with members of the committee, please contact Ted Thurn at tthurn@aasm.org.