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Supporting Your Practice

What Do You Do For a Patient Whose GP Refuses to Prescribe a Sleep Appliance?

Dr. John Viviano
General Dentist

As per the 2015 American Academy of Sleep Medicine guidelines, oral appliance therapy is considered to be a standard of care when a patient cannot tolerate CPAP,or if they would prefer an oral appliance. Yet despite CPAP compliance rates as low as 17% after five years of therapy, oral appliance therapy is often overlooked as an alternative.

In this latest in a series of discussions relating to dental sleep medicine, Dr. John O’Keefe, Director of Knowledge Networks CDA, invites Dr. John Viviano to offer his insight into navigating a scenario where a patient’s sleep physician refuses to write a prescription for oral appliance therapy.

Here are some of the key takeaways from the conversation…

  • There is a certain amount of resistance to oral appliance therapy among the medical community. Much of this stems from a lack of knowledge in what oral appliances have to offer and certain myths that encourage people to use CPAP.
  • When a physician refuses to write a prescription for an oral appliance, the dentist is in a strong position to become the patient’s advocate and guide them through the process. If that doesn’t happen, the patient is likely to go untreated.
  • A simple phone call or written correspondence to the sleep physician citing AASM guidelines is often enough to resolve the situation.
  • If the physician does not accommodate the request, then a prescription can be acquired from the family physician or another physician.
  • If you are making an appliance based on a prescription by someone other than the patient’s sleep specialist, it is important to include the sleep specialist in any correspondence so as to be completely transparent.

We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
CDA Oasis Team


Full Conversation (8.56")


  1. Vasant Ramlaggan July 6, 2021

    Thank you for the clear information. I have seen even some Family Physicians REFUSE to send their patients for even a sleep study despite overwhelming evidence and letter showing it being sent! It’s very frustrating when even the patient wants to get a study.

    Thank you for addressing patients that have been diagnosed with apnea for whom the Sleep Specialist tells them not to worry about it!

  2. Steve Lipinski July 8, 2021

    Please let me know how I can find oasis posts of letter templates, and other documents/articles as commented about by speakers on oasis video presentations.
    Thanks You!
    Steve Lipinski


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