By Deborah Bostock-Kelley
In 2009, Jay A. Nelson, DMD, took a course in dental sleep medicine that changed his career trajectory.
“The course spoke about how dentists can treat obstructive sleep apnea and provide a proven alternative to CPAP machines.”
A practicing general dentist since 1981, he is a diplomate of the American Board of Dental Sleep Medicine, The American Academy of Craniofacial Dental Sleep Medicine, and the American Board of Sleep & Breathing, Dr. Nelson decided in 2021 to give up his restorative dental practice to concentrate exclusively on dental sleep medicine.
“It was intellectually interesting to me. Being a dentist for so long, every few years, I try to update my knowledge and become proficient in a new procedure or discipline. When I learned about this, it really caught my interest,” he explained. “I started doing sleep medicine as a sideline of my dental practice, but it became my passion, and my ultimate goal was to have practiced just doing that. I sold my dental practice, moved to another office, and now solely practice dental sleep medicine. I opened in April of this year.”
Dr. Nelson has over 1000 hours of education on dental sleep disorders and was one of only two dentists invited to speak on the subject at Johns Hopkins’ virtual Current Concepts in Sleep medical conference. He treats adult patients that suffer from snoring and sleep apnea with a safe, non-surgical alternative to a CPAP machine called a mandibular advancement device. For those under 18, tonsil removal or orthodontic expansion treatment can frequently help.
“The device brings your lower jaw forward and prevents your tongue from dropping back during sleep, along with opening and tightening some of the structures in the throat to prevent snoring, as well.”
At Nelson Dental Sleep Medicine, adult patients are fitted with this device that prevents your tongue from falling backward and blocking your airway, resulting in the management of sleep apnea. With the airway open throughout the night, patients continue to get oxygen to breathe consistently. It fits snugly to the teeth, so there is no possibility of swallowing the device.
In laymen’s terms, in concept, it is like orthodontic retainers, except the top and the bottom are designed to pull the jaw forward.
While males over 50 are most at risk, Dr. Nelson has also seen men and women of all ages, shapes, and sizes impacted by sleep breathing disorders.
If you are unhappy with the CPAP prescribed for continual breathing through the night, this safe, affordable FDA-approved alternative is covered under most medical insurance and Medicare. The device is custom-fabricated and custom-fitted for each patient.
Dr. Nelson utilizes the STOP-BANG questionnaire, one of the most widely accepted screening tools for obstructive sleep apnea. The questionnaire asks about loud snoring, feelings of fatigue, tiredness, and daytime sleepiness if anyone observed the patient stopping breathing during sleep and if the patient is being treated for high blood pressure. Points are assessed and tallied to see if further evaluation is needed. While the STOP-BANG screening tools can help determine whether someone is likely to have obstructive sleep apnea, he stressed that the only fully reliable test is a physician ordering an actual sleep study.
He often receives referrals from cardiologists, sleep physicians, pulmonary doctors, primary care physicians, and ENTs for patients who can’t tolerate a CPAP.
Besides the apparent snoring, some other signs of obstructive sleep apnea include difficulty sleeping, insomnia, waking up at night short of breath, gasping for breath while sleeping, and headaches upon waking because you are not getting enough oxygen to your brain throughout the night.
Obstructive sleep apnea is also associated with high blood pressure, impotence, stroke, diabetes, and depression, among other maladies.
“A lot of major disasters were caused by people who have fallen asleep on the job,” he said. “There are so many medical consequences of sleep apnea, so by treating it, we are helping people to become healthier.”
Though the mandibular advancement device is not new, it is only recently becoming more accepted as an alternative to the CPAP machine.
“CPAP is still considered the gold standard by physicians for treating sleep apnea, particularly when severe. The problem is that 50% of patients give up on using the CPAP within the first year. In many cases, we are saving lives because obstructive sleep apnea can cause shortening of a person’s lifespan.”
Dr. Nelson said that positive stories about the oral device are plentiful, especially with frustrated spouses dealing with snoring.
One of Dr. Nelson’s first sleep patients snored so loudly that his wife was forced to wear earplugs at night. The first night he wore the device, he was so silent that his wife had to check and confirm he was still alive because his snoring had been eliminated.
“He was happy that his wife was happy,” he joked. “Before as a general dentist, I was working on saving teeth and beautifying smiles, now I’m working on saving lives and marriages.”
To learn more about the mandibular advancement sleep apnea device through Nelson Dental Sleep Medicine, visit sleepbetterflorida.com or call (813) 733-4169. Nelson Dental Sleep Medicine is located at 26907 Foggy Ridge Dr., Suite 101 in Wesley Chapel.