What’s the ugliest word you can think of? I asked several people this same question.





Those were a few of the responses people gave. It’s hard to argue with those phonetic ugly ducklings, but only one respondent offered up the word I was thinking of – schadenfreude – which Webster’s Dictionary defines as “enjoyment obtained from the troubles of others.” It’s the glee you feel when the star player on the other team gets food poisoning the night before the big game or that jubilation you experience when a stroke of bad luck hits the Patriots, the 90s-era Bulls, or when your romantic rival drops their pants or shits the bed. Or both.

Schadenfreude has been on big screen 4k display with the saga of Elon Musk. Sure, his company, Tesla has been the strongest driver to mass market electric vehicles and another of his companies, Space X launched more satellites into orbit than nearly every other country on earth combined. We shouldn’t forget that a company he co-founded, PayPal, is ubiquitous and revolutionized online financial transactions.


Once an icon of the political left, Musk was chided by the right for being a wacky, tree-hugging futurist. But time heals old wounds and opens new ones. The tables have turned with Musk’s acquisition of Twitter and his related hijinx. In the past 18 months, the right has canonized him as the dual patron saint of bootstrapping and free speech, while the left cheers every time one of his company’s gets sued or he publicly eats his foot, a habit he seems to relish. Look, I am not an Elon Musk apologist, but it’s disingenuous to argue that his contributions to humanity haven’t been a net positive. If Tesla fails, it’s evidence that electric vehicles are not a plausible part of the world’s future. No one has a better chance of making light year leaps in space innovation. If Space X fails, guess what? There is probably no future in space. Praying Musk fails is akin to praying that electric cars disappear from the roadways, his huge tax bill goes unpaid, thousands of jobs are lost, and Ukraine is eliminated from the map because they can’t leverage the battlefield advantages provided by Space X’s StarLink satellites. This doesn’t take anything away from Ford’s electric vehicles. Nor does it detract from NASA’s accomplishments. They just haven’t achieved the scope or scale of the aforementioned Musk-helmed organizations. Don’t hate the player. Hate the game.

So, what does this have to do with Dental Sleep Medicine?

I’ve watched this play out in our little corner of the sleep medicine field since May 8thThat’s the date ProSomnus announced their plans to file Chapter 11 bankruptcy. Chapter 11 bankruptcy is a legal process in the United States allowing companies to reorganize debts while remaining in operation. It gives the company the opportunity to restructure its finances, renegotiate contracts, and develop a plan to repay creditors over time. Simply stated, it provides companies with breathing room to fix things while still operating.

Since ProSomnus’s announcement, schadenfreude has been popping up all over the place like pimples the day before prom. I’ve seen it on social media and in texts. Lots of people in dental sleep medicine are jubilant about ProSomnus’s predicament. The pettiness is so ugly. Dancing on your dad’s grave at the funeral while he’s actually getting a routine checkup. Gross.

“Oh, I can’t wait to hear this bullshit, Jason. Don’t tell me they don’t pay you. Their appliance is on the cover of your book.”

Before I continue, and you accuse me of being a paid shill, here’s my full disclosure. I drive a Tesla and I wear a ProSomnus, but I don’t have a vested interest in the success of either company. Neither of them pay my bills. Actually, one of them is a bill. ProSomnus bought some books, but that was it. ProSomnus paid to exhibit at the Transform Dental Sleep Symposium, and I paid my tuition to attend their excellent ProSleep meeting, just like I paid the tuition to attend Somnomed’s informative Sleep Summit and the Annual AADSM meeting. I’d like to see all these organizations succeed.

I’m going to say this slowly and very clearly so there is no mistaking my position:


I’ll pause so you can unbunch your panties and take a deep breath. I’m not saying their CEO should be venerated. I’m not even saying their devices are “the best.” I am saying that no other company has invested as much into funding research to increase acceptance of oral appliance therapy as a non-inferior alternative to CPAP. They’ve done a great deal to change the prescribing habits of the medical community. They secured millions of dollars in funding and funneled that into boosting awareness of OAT as a viable solution for a large swath of apneics. If you’re a DSM provider, regardless of whether or not you’ve ever used a ProSomnus device, you’ve likely benefitted from the foundational work ProSomnus has done. The rising tide raises all ships, but as John A. Shedd famously wrote, “A ship in harbor is safe, but that is not what ships are built for.” Sometimes the water gets choppy and things don’t work according to plan, but the glory goes to those who try. Allow me one more quote (OK, maybe more than one), this time from Theodore Roosevelt: “The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds.”


None of this is to say that I don’t appreciate the contributions of OAT pioneers like Dr. Keith Thornton and Airway Management or Dr. Don Frantz and his seminal EMA device. This doesn’t take away from the innovations brought to market by SomnoMed and Panthera. It doesn’t erase the industriousness of DynaFlex or the expertise of Sonnie from Apex or Frank at True Function Lab. I applaud their work. And you should too.

However, if a company wholly focused on the success of the OAT market, helmed by an erudite leadership team, with a multi-million dollar war chest can’t make it happen, then who will and what does that say about the potential for the field? Are dentists content to continue contending with physicians for scraps while OAT companies fight over the same one thousand dentists? Is that the future you want? I’m hoping ProSomnus succeeds. If they do, sure their company benefits. So does the field of dental sleep medicine. And most importantly, so do their clients and the patients they serve.

While no one really knows who Ryunosuke Satoro was, I say who cares. His maxim holds true: “Individually, we are one drop. Together, we are an ocean.” Open the OAT floodgates, baby.

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