I heard about the new Inspire sleep apnea device over a year ago. If you have not heard of “Inspire” yet, be on the lookout. TV commercials are everywhere.

What is Inspire? It’s an implantable device that helps treat sleep apnea. Much like a pacemaker, a surgeon implants a little control device with some electronic leads to manage neural inputs to the muscles around the airway in order to help hold the airway open.

After the device is implanted, the patient presses a button on a smart device app to turn it on and off. It’s as simple as pressing the button when they are ready to go to sleep and pressing it again when they wake up. There is no need to wear a CPAP or oral appliance.

Over a year ago, when I first learned about Inspire, I mentioned it to a patient who had already had orthognathic surgery, had tried CPAP, and was still struggling with his quality of life while dealing with OSA. He was tired of having a dry mouth and increased risk of caries. We had already had several conversations.

At a subsequent appointment, he shared with me that he was extremely grateful we had had that conversation about Inspire. It motivated him to talk to his primary care physician and look at having the device.

He also shared with me that this treatment was covered by Medicare and then his gap insurance. Why did they cover it? Interestingly, it was not because he was CPAP intolerant or he had failed—because he was regularly wearing his CPAP. They covered it because he was suffering dental decay, dry mouth, and other secondary issues due to the CPAP.

I think we’re going to hear about this device more from our patients, and there will be times when we think it is in our patient’s best interest to start a conversation about it. If you are not familiar with Inspire, I recommend that you hop on the Internet and learn more about it.

Interested in Learning More About Dental Sleep?

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Screening our patients for airway and breathing issues is becoming a standard in dentistry. One of the things we have started to do every day in our Hygiene rooms, with our patients from three years old to very elderly, is visually looking at the back of their mouth and assign a Mallampati score.

The Mallampati score was developed by anaesthesiologist Seshagiri Mallampati, in 1985, as a non-invasive way to assess the ease of endotracheal intubation. The test is simply a visual assessment of the distance between the base of the tongue and the roof of the mouth.

In our practice, we begin a conversation about airway with patients. The Mallampati diagram (see below) allows both us and our patient to visualize, on a score of 1 to 4, the patient’s anatomical airway. We laminated the Mallampati diagram off of Google Images, and we can give it to the patient to hold while we screen them, or we share it with them after screening to let them see why they received the score they did. We then continue the conversation with them about their airway and why it might be a good idea for them to observe sleep patterns or be referred to a sleep physician for further diagnosis.