Dental sleep medicine - obstructive sleep apnoea + sleep bruxism

Position Summary: Initial diagnosis of Sleep Apnoea must be made by an appropriate medical practitioner. If a dental appliance is required, it should be managed by a dentist or dental specialist.
Amended 27 June 2025

A list of Standards Papers, Consensus Papers, Policy and Position Statements.

Published in Journal of Dental Sleep Medicine, 2025, 12(2), this standard is an update of the 2022 standard endorsed by the American Academy of Dental Sleep Medicine (AADSM) outlines an approach to patient management that underscores the collaborative care that is necessary between dentists and physicians and provides guidance for patient examination, patient screening, treatment management, education, and follow- up care. Although this article provides best practices for dental sleep medicine as it currently exists, the fluid and dynamic nature of DSM should be recognized, with the understanding that periodic updates to these standards will be required.

This page lists active AASM clinical practice guidelines and clinical guidance statements, formerly called position papers, on the use of diagnostic and treatment options for patients with sleep disorders. Of particular relevance are the sections on Diagnostics and Sleep-Related Breathing Disorders.

The AASM International Classification of Sleep Disorders – Third Edition, Text Revision (ICSD-3-TR), released 2023 by American Academy of Sleep Medicine.
Not freely available, purchase required.

National Institute for Health Care Excellence (NICE) guideline reference number:NG202, Published: 20 August 2021.
This guideline covers the diagnosis and management of obstructive sleep apnoea/hypopnoea syndrome (OSAHS), obesity hypoventilation syndrome (OHS) and chronic obstructive pulmonary disease with OSAHS (COPD–OSAHS overlap syndrome) in people over 16. It aims to improve recognition, investigation and treatment of these related conditions.

Position statement of the American College of Prosthodontists.
Revised August 2020

This position paper from the Australasian Sleep Association (ASA) provides a summary of the literature on best practice in dental sleep medicine.

Huang, Z., Zhou, N., Lobbezoo, et al. (2023, February). Dental sleep-related conditions and the role of oral healthcare providers: A scoping review. Sleep Medicine Reviews, 67, 1-11. https://doi.org/10.1016/j.smrv.2022.101721

Alrejaye, N.S., & Al-Jahdali, H. (2024, December). Dentists’ role in obstructive sleep apnea: A more comprehensive review. Sleep Epidemiology, 4, 100073. https://doi.org/10.1016/j.sleepe.2024.100073

Moreno-Hay, I., Bender, S., Alonso, A., Lockerman, L., Arman, S., & Mulet Pradera, M. (2025, June). How does dental sleep medicine fit into the specialty of orofacial pain?: A narrative review. Journal of the American Dental Association, 156(6), 439-446. https://doi.org/10.1016/j.adaj.2025.03.003

Cioboata, R., Balteanu, M. A., Mitroi, D.M., et al. (2025, August 7). Interdisciplinary perspectives on dentistry and sleep medicine: A narrative review of sleep apnea and oral health. Journal of Clinical Medicine, 14(15), 5603. https://doi.org/10.3390/jcm14155603

Colonna, A., Thomas, D.C., Do, T.T., & Manfredini, D. (2024, October). Sleep disorders affecting prognosis of dental treatment. Dental Clinics of North America, 68(4), 647-657. https://doi.org/10.1016/j.cden.2024.05.002

Manfredini, D., Thomas, D.C., & Lobbezoo, F. (2023, April). Temporomandibular disorders within the context of sleep disorders. Dental Clinics of North America, 67(2), 323-334. https://doi.org/10.1016/j.cden.2022.10.004

Thomas, D.C., Somaiya, T., Meira E Cruz, M., Kodaganallur Pitchumani, P., Ardeshna, A., Ravi, A., & Prabhakar, S. (2024, July 13). The enigma of sleep: Implications of sleep neuroscience for the dental clinician and patient. Journal of the American Dental Association, 155(9), 735-746. https://doi.org/10.1016/j.adaj.2024.05.007

Suzuki, Y. (2024). The link between prosthodontics and sleep dentistry. Journal of Prosthodontic Research, 68(2), vii-viii. https://doi.org/10.2186/jpr.JPR_D_24_00059

Smith, H.A., Smith, M.L., & Smith, M.L. (2017, June 15). The role of dentists and primary care physicians in the care of patients with sleep-related breathing disorders. Frontiers in Public Health, 5, 137. https://doi.org/10.3389/fpubh.2017.00137

Duan, J., Xia, W., Li, X. et al. (2025, January 30). Airway morphology, hyoid position, and serum inflammatory markers of obstructive sleep apnea in children treated with modified twin-block appliances. BMC Oral Health 25, 162. https://doi.org/10.1186/s12903-025-05528-y

Özköylü, G., Saraç, D., Sasany, R. & Umurac, D.G. (2024, August 30). Comparison of monoblock and twinblock mandibular advancement devices in patiens with obstructive sleep apnea and temporomandibular disorder: effects on airway volume, polysomnography parameters, and sleepiness scale scores. BMC Oral Health, 24, 1026. https://doi.org/10.1186/s12903-024-04653-4

Gunel, E., Kurtulmus, H., Bursa, M.C. & Peker, Y. (2025, January 14). Current perspectives in treatment of obstructive sleep apnea with mandibular advancement devices: A narrative review. Current Pulmonology Reports 14, 6. https://doi.org/10.1007/s13665-025-00369-0

Hynes, D., & Mansfield, D. (2024, April 23). Diagnosis and management of obstructive sleep apnoea in adults. Australian Prescriber, 47, 52-56. https://doi.org/10.18773/austprescr.2024.010

Okuno, K., Wang, L., & Almeida, F.R. (2023, August 30). Focus of dental sleep medicine on obstructive sleep apnea in older adults: A narrative review, Journal of Prosthodontic Research, 68(2), 227-236. https://doi.org/10.2186/jpr.JPR_D_23_00047

Abruzzi, C.M., Yoon, A., & Faber, J. (2025, April 5). Long-term mandibular advancement appliance therapy for obstructive sleep apnea. The Journal of the American Dental Association, 156(5), 390-397. https://doi.org/10.1016/j.adaj.2025.03.001

Quinn, B.M., & McCracken, G. (2024, December 2). Mandibular Advancement Splints, Obstructive Sleep Apnoea and Occlusal Derangement: A Case Report. Dental Update, 51(11), 793-795. https://doi.org/10.12968/denu.2024.51.11.793

Ning, R., Chen, J., Lu, Y. & Guo, J. (2023, August 19). Obstructive sleep apnea: a follow-up program in its relation to temporomandibular joint disorder, sleep bruxism and orofacial pain. BMC Oral Health 23, 578 (2023). https://doi.org/10.1186/s12903-023-03264-9

Mohamed, A.M., Mohammed, O.M., Liu, S. et al. (2024, June 7). Oral appliance therapy vs. positional therapy for managing positional obstructive sleep apnea; A systematic review and meta-analysis of randomized control trials. BMC Oral Health 24, 666. https://doi.org/10.1186/s12903-024-04277-8

Maniaci, A., Lavalle, S., Anzalone, R., et al. (2024, June 21). Oral health implications of obstructive sleep apnea: A literature review. Biomedicines, 12(7), 1382. https://doi.org/10.3390/biomedicines12071382

Yang, J., Rosenmöller, B.R., van Riet, T.C,. et al. (2024, June 18). Smart mandibular advancement devices for obstructive sleep apnea: A systematic literature review. Sleep and Breathing,28,1879-1887. https://doi.org/10.1007/s11325-024-03068-3

Worrall, J. & Strange, M. (2020. March). Bruxism: A medical or dental issue? RDH, 40(3), 58–60.

Ainoosah, S., Farghal, A.E., Alzemei, M.S. et al. (2024, January 5). Comparative analysis of different types of occlusal splints for the management of sleep bruxism: a systematic review. BMC Oral Health 24, 29. https://doi.org/10.1186/s12903-023-03782-6

Laksamikeeratikul, I., Jariyasakulroj, S., Chattrattrai, T., & Pongrrojpaw, S. (2025, August 21). Digital measurement of tooth wear in sleep bruxism patients wearing occlusal splints. BMC Oral Health 25, 1349 (2025). https://doi.org/10.1186/s12903-025-06716-6

Sambale, J., Koehler, U., Conradt, R. et al. (2024, May 14). Is sleep bruxism in obstructive sleep apnea only an oral health related problem?. BMC Oral Health 24, 565. https://doi.org/10.1186/s12903-024-04351-1

(2025, April 30). Orthodontic intervention for dental changes induced by ‘off the shelf’ and custom-made occlusal splint therapy for bruxism: a report of two cases. Orthodontic Update, 18(2), 72-80, https://doi.org/10.12968/ortu.2025.18.2.72

Bucheridge, A. & Balasubramaniam, R. (2022, September). Paediatric sleep bruxism. ADA News Bulletin, 523, 38-40.

Beddis, H., Pemberton, M., & Davies, S. (2018, September 21). Sleep bruxism: an overview for clinicians. British Dental Journal, 225, 497-501. https://doi.org/10.1038/sj.bdj.2018.757

Thomas, D.C., Manfredini, D., Patel, J., George, A., Chanamolu, B., Pitchumani, P.K., & Sangalli, L. (2024, April). Sleep bruxism: The past, the present, and the future-evolution of a concept. Journal of the American Dental Association, 155(4), 329-343. https://doi.org/10.1016/j.adaj.2023.12.004

Huynh, N., & Fabbro, C.D. (2024, January). Sleep bruxism in children and adolescents. A scoping review. Journal of Oral Rehabilitation, 51(1), 103-109. https://doi.org/10.1111/joor.13603

Manfredini, D., Ahlberg, J., Aarab, G.,et al. (2024, January 5). Standardised Tool for the Assessment of Bruxism. Journal of Oral rehabilitation, 51(1), 29-58. https://doi.org/10.1111/joor.13411

Cerón, L., Pacheco, M., Delgado Gaete, A., Bravo Torres, W., & Astudillo Rubio, D. (2023). Therapies for sleep bruxism in dentistry: A critical evaluation of systematic reviews. Dental and medical problems, 60(2), 335–344. https://doi.org/10.17219/dmp/156400

Webinar based on the 2024 Australian Dental Journal Supplement featuring co-editors A/Prof Ramesh Balasubramaniam and Professor Peter Cistulli and Dr Peter Norton.
4 December 2024, 78m 42s
Learning outcomes:
• Understand the critical role of dentistry in sleep medicine.
• Become familiar with the latest developments in dental sleep medicine and apply current guidelines to clinical practice.

Webinar recording featuring Drs Fernanda Almeida and Andrew Gikas.
7 March 2024, 90m 51s
Learning outcomes:
• Examine adult over diagnosis and unwanted treatments.
• Examine Paediatric sleep disordered breathing (definition, prevalence and over diagnosis).
• Examine pathophysiology and craniofacial characteristics.
Identify craniofacial risk factors of children with OSA.
• Discuss recommendations on how to manage OSA in children.

Dental Health Week2021 webinar with Mikaela Chinotti and Dr Nour Tarraf
1 August 2021, 50m 52s
Learning outcomes:
• Discuss the link between transverse maxillary deficiency and upper airway obstruction.
• Outline common signs in children and adolescents indicating need for referral to investigate possible sleep disorders.
• Outline the new available options for managing maxillary deficiency in children, adolescents and adults.
• Understand the limitations of orthodontic treatment in relation to managing upper airway obstruction.

#Dental Files Podcast, 24 October 2025, 27m 37s
Dr Andrew Gikas who is on the Board of the Australasian Sleep Association along with Professor Tony Skapeti Clinical Director of Education at Westmead Centre for Oral Health explore clinical steps pertaining to oral appliance selection and the long term implications to the dentition.
Learning outcomes:
• Understand the key evidence and scientific background of this growing field
• Understand the benefits, limitations, side effects and long term outcomes of oral appliance therapy for patients with sleep disordered breathing
• Identify patients who would benefit from this growing field of dental practice

#Dental Files Podcast, 1 September 2025, 15m 25s
A/Prof Ramesh Balasubramaniam OAM, Oral Medicine Specialist with Mohamed El-Hahim, a lecturer in Clinical Dentistry at the University of WA, explore the role of occlusal splints in managing temporomandibular disorders and sleep bruxism.
Learning outcomes:
• Identify different types of occlusal splints and their indications for temporomandibular disorders and sleep bruxism management.
• Understand the mechanisms of action of occlusal splints for the management of temporomandibular disorders and sleep bruxism.
• Develop evidence-based treatment plans involving occlusal splints

#Dental Files Podcast, 19 June 2024, 15m 12s.
In this interview, Professor Eckert speaks with Dr Andrew Gikas about the work being done by the multidisciplinary team at Flinders University, to predict which patients will benefit from various treatments, and explore how combination therapy might improve the lives of even highly-complex sleep disordered breathing patients.
Learning outcomes:
• Describe the key anatomical and non-anatomical traits that contribute to sleep disordered breathing.
• Appreciate novel therapies and combination therapies that can benefit patients with sleep disordered breathing,
• Understand the importance of a multidisciplinary team.

#Dental Files Podcast, 23 November 2023, 30m 34s
Professor Daniele Manfredini introduces the listeners to the Standardised Tool for the Assessment of Bruxism (STAB) and explains that what the patients do with their muscles may have a clinical impact.
Learning outcomes:
• The latest definition and classification for bruxism has evolved.
• The broader umbrella term for bruxism revolves around muscle activity and that Bruxism without tooth contact is a thing.
• The old epidemiological data which is based on surveys is outdated.
• Technology will increase patient awareness of bruxism and allow us to see frequency, intensity and number of events over period of time.
• Bruxism is not a disorder, that we do not have bruxism patients, the disorder is the underlying condition that leads to bruxism.
• Occlusion and interferences do not lead to bruxism.
• The S.T.A.B. is the first multidimensional evaluation system for bruxism looking at status, aetiology, clinical consequences.

Evidence-based resource to assess and manage adult patients with Obstructive Sleep Apnoea developed by Australasian Sleep Association.

Part of the Australasian Sleep Association's primary care resources for OSA

Subscription publication which provides free access to range of articles, podcasts and webinars

The Scientific and Education Committee of WDSS has developed a program of monthly one-hour presentations in topics related to dental sleep medicine. This content is made freely available for the community.