By Kevin Postol, DDS, president of the American Academy of Dental Sleep Medicine
Advances in technology have impacted awareness, diagnosis and treatment for obstructive sleep apnea (OSA). Wearables now provide patients with insights into whether they may be at risk for sleep apnea. Home sleep apnea tests are becoming more accurate and can record multiple nights of sleep data, and telemedicine has increased access to sleep physicians. Dental sleep medicine, historically reliant solely on in-person care, is no exception. Teledentistry has emerged as a promising tool to increase access and convenience for oral appliance therapy (OAT) for OSA. But with innovation comes responsibility, particularly with ensuring patient safety and long-term treatment success.
To ensure that technology complements, rather than compromises, clinical outcomes, the American Academy of Dental Sleep Medicine (AADSM) released updated standards. These standards address what components of OAT should be provided in person and reaffirms the critical role qualified dentists play in the treatment and ongoing management of OSA.
A shift in care delivery
Teledentistry is not just a response to the pandemic; it’s a reflection of evolving technology and patient expectations. Many individuals with OSA are seeking care that is more accessible and convenient. Virtual consultations and follow-ups can remove geographic and logistical barriers, improving the likelihood that patients engage with and complete treatment. However, OAT is a nuanced treatment that demands precision and clinical oversight. Recognizing this, AADSM’s updated standards provide a clear framework for integrating teledentistry while preserving essential, in-person care.
Safeguards for effective treatment
The updated standards define three steps that should be completed in person to ensure safety, comfort and effectiveness: the comprehensive dental sleep medicine exam, dental impressions and bite registration.
During the comprehensive dental sleep medicine exam, the dentist examines and evaluates the patient’s existing restorations (like fillings, crowns and dentures), their teeth and bite, the temporomandibular joint, and craniofacial structures to determine candidacy for treatment. Dental impressions are also best done in person. Accurate scans or molds are critical to ensure the custom appliance fits correctly and comfortably and effectively treats OSA. The bite registration requires a precise measurement that guides the starting position for the oral appliance. This step is essential for both therapeutic outcomes and patient comfort.
Each of these steps are important safeguards because OAT has potential adverse effects. Based on extensive clinical experience and professional expertise, these complications are best managed when the comprehensive dental sleep medicine exam, impressions, and construction bite registration are completed in person with professional oversight.
The role of qualified dentists
Qualified dentists, including American Board of Dental Sleep Medicine (ABDSM) diplomates, AADSM qualified dentists and ABDSM international certificates, are uniquely trained to bridge the worlds of dentistry and sleep medicine. They are trained to evaluate the patient’s dentition as well as intraoral hard and soft tissues; consider craniofacial structures and oral, dental and periodontal tissues to select the appropriate appliance for a patient; and manage treatment effects from OAT on the temporomandibular joint, dental occlusion, and related structures, all of which impact adherence and treatment success. They also understand the anatomical, functional and behavioral complexities of treating OSA and are committed to collaborating with medical colleagues and following protocols that uphold patient outcomes above all else.
Qualified dentists also recognize that in-person evaluations, clinical expertise and ongoing patient relationships are irreplaceable safeguards against ineffective or potentially harmful treatment. These professionals ensure that patients are not just treated; they’re supported, monitored and guided toward sustainable improvement.
A balanced path for patient-centered progress
The AADSM’s revised standards acknowledge the value of virtual care and lay out a responsible path forward. While teledentistry holds a real promise, it must be paired with clinical rigor. As the industry continues to evolve, collaboration between sleep physicians, qualified dentists and technology partners will be key. By anchoring digital tools to sound clinical practices, we can meet patients where they are without compromising where they need to go.
Teledentistry is here to stay. But in dental sleep medicine, it is not an end-to-end solution. With clear standards in place and qualified dentists at the forefront, we can move forward with both innovation and accountability, ensuring that patients receive care that’s convenient, effective and safe.
