I’m a recovering Dental Sleep Medicine cynic. For nearly 20 years, I’d heard the chatter about how oral appliances were going to supplant CPAP as the gold standard. As Sam Cooke sang, “A change gon’ come, oh yesss it will…” I called BULLSHIT.

Supposedly E0486 was going to change everything. Dentists finally had an appropriate code to bill for oral appliance therapy. But Medicare didn’t publish the allowed amount. 

Eventually payors began paying for treatment, but the machinations of the medical payors proved too much for many dentists. Others bailed claiming that the juice wasn’t worth the squeeze.

Back in the day, PSGs were the name of the game, and home sleep testing was viewed as voodoo. Now many insurance companies mandate HSTs.

There’s the new K code, and a bunch of noise about how the oral appliance floodgates are about to burst open with all the pent up patient demand due to the Philips CPAP recall, the popularity of Matthew Walker’s book, and Inspire’s multi-million marketing machine


There have been numerous innovations in device design, manufacturing processes, and the quality of materials used for oral appliances. Precision medical devices are the name of the game.

The amount of high quality research supporting the effectiveness of oral appliances can fill a big-ass hard drive. While elements of the medical community have really warmed up to oral appliances as a desirable treatment modality for sizable segments of the patient population.

There are more DSM education opportunities on any given weekend than there were in an entire year a decade ago – and some of that education is actually REALLY, REALLY GOOD.

Still, oral appliance adoption is a barely visible ripple in the treatment bucket. It doesn’t even register as a blip on the actual OSA patient population radar.

Reading up to this point, you’ll probably be surprised to hear what I’m about to say– today I am bullish on Dental Sleep Medicine as a profession with real potential to seismically shift the sleep landscape.

You read that right. More than any time in the past, the future’s so bright, I gotta wear shades. There’s a race to bring oral appliances embedded with remote patient monitoring technology to market. This could be a decisive leveler in the OSA treatment field.

The aforementioned developments are compounding into REAL CHANGE. This is leading to more dentists getting involved and doing so with greater penetration. If you look at the customer reports from your favorite appliance manufacturers, you’ll see they have more clients than ever before and more of them are producing higher volumes of cases. In the parlance of the labs, there are less dentists doing onsies and twosies and more doing five to ten cases per month.


We all want to see this trend continue, but dental sleep medicine cannot rest on its laurels. These developments will make it easier for most dental practices treating sleep patients now and the barriers to entry will be less cumbersome for future entrants.

The most successful dental sleep practices weren’t manifested on the wings of new codes or the titrations mechanisms of new devices. No, the most successful practices were created by professionals that made conscious decisions to GO DEEP. They might call it something else, but they all made choices to make it happen. They didn’t wait for the regulatory and payor stars to align. They made their futures.

It’s evident it can be done. If they did it, you can do it too. Hire a competent third party billing company. Designate someone as your SLEEP CHAMPION and then educate them, equip them with the resources they need to do the job, empower them to do it, and encourage them. Reward wins & coach when the goal is missed.

  1. Generate a vision.
  2. Outline the path forward.
  3. Delegate appropriately.
  4. Execute – don’t let your sleep dreams die by analysis paralysis.
  5. Evaluate what’s working and what isn’t.
  6. Then pivot as warranted.

Don’t wait for the change. Be the change they want to see. You can do this. Today. Now.


Registration is now open for the Transform Dental Sleep Symposium to be held in Scottsdale, AZ January 31 – February 1, 2025. Don’t miss out on dozens of dynamic speakers presenting innovative information on practical topics designed to help your sleep practice grow.

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