Today the AASM is attending the Texas State Board of Dental Examiners (TSBDE) meeting, during which the Board will consider a revised proposal regarding the Dental Treatment of Sleep Disorders. This issue has been an ongoing point of contention between the TSBDE, Texas Medical Association (TMA) and the AASM. During the TSBDE’s last meeting on Feb. 26, the Board approved a revised proposal for 22 TAC 108.12 Dental Treatment of Sleep Disorders, which contains the following provisions:
- A dentist shall not independently diagnose obstructive sleep apnea (OSA);
- A dentist may fabricate an oral appliance for treatment of OSA only in collaboration with a licensed physician; and
- A dentist would be responsible for monitoring and maintaining the oral appliance, while the physician should be responsible for monitoring the patient’s medical condition.
The proposal also requires that the dentist complete 12 hours of minimum basic education in sleep-disordered breathing during the first year of treating OSA, along with 3 hours of education for each subsequent year.
Although this revision is an improvement over previous versions, the AASM has requested that the TSBDE include the following amendments in order to ensure that patients are protected and receive the highest quality of care:
- A dental history, questionnaire, or oral examination that suggests increased risk for OSA should lead to a referral to a licensed physician, rather than independent testing or diagnosis of OSA or habitual snoring, which are medical disorders, by a dentist; and
- A dentist may fabricate an oral appliance for treatment of OSA only after referral from a licensed physician and confirmation from a dental perspective that the patient is a good candidate for the device.
- The AASM also is requesting that the educational language be replaced with language from our Clinical Practice Guideline for the Treatment of OSA with OAT, which includes a more rigorous continuing education recommendation for dentists. Finally, we are asking that the proposal also incorporate the follow-up language from our guideline.