Hello Dr. Tony,
I have a few questions maybe you can assist me with. I have had a very difficult time finding a qualified dentist in my area trained in sleep medicine. I am from Arkansas. I have had a couple of appliances made over the years and I was wondering if you had an answer for this. How can an appliance have better results in an end to end position rather than 3,4,5 or even 6mm advancement out? It would seem that further advancement would always mean further area behind the tongue? How can you have a worse AHI with further advancement than you did without an appliance in at all?? I have had an in home sleep study and I had a higher score with advancement than end to end. Also, have you seen over time an appliance works better than when you first start using it. Lets say you get an appliance and you don't change the position on it for 3 months, have you seen in your practice people getting better results after months of treatment rather than at the initial start of it? If so, why is that? Thank you Dr. for your time.
