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With our mutual desire to improve the health and well being of island residents, I am pleased to advance this with the opening of Dental Sleep Center of Hawaii in Waimea (Kamuela).  The Center provides oral appliance therapy (mandibular repositioning devices) for patients with Obstructive Sleep Apnea (OSA).  Given the high rates of obesity, heart disease, and hypertension on Hawaii Island, which are only a few of the side effects of OSA, we have our work cut out for us. In addition to being the new frontline treatment for mild to moderate OSA, oral appliance therapy is also available to treat:

  • All CPAP (continuous positive airway pressure device) failures, and
  • Primary Snoring and Upper Airway Resistance Syndrome.

Oral appliances provide tremendous benefits to patients, the most obvious of which is on-par effectiveness with CPAP and BiPAP machines—without the constraint of being tethered to an electrical outlet.  In addition, many people find the mask uncomfortable and irritating to their skin.  As a result, on average half of CPAP patients stop utilizing their devices after 3 years.  Oral appliances, which are more comfortable, easier to wear, aesthetically pleasing, and smaller to travel with, have a compliance rate exceeding 75 percent after 3 years.  The ability to achieve similar efficacy and ensure 25 percent greater compliance is a huge step in effective treatment of OSA – and in reducing the human and financial costs associated with treating related conditions. For your reference, the following citations discuss the efficacy of oral appliance therapy: “Although CPAP was superior for patients with severe OSA, the difference in AHI reduction between the aOA (adjustable Oral Appliance) and CPAP was not significant for patients with mild and moderate disease.”

Source: Holley, C. Lettieri & A. Shah “Efficacy of an Adjustable Oral Appliance and Comparison With Continuous Positive Airway Pressure for the Treatment of Obstructive Sleep Apnea Syndrome” Chest, December, 2011

“Treatment was effective for 76.5% of patients using an oral appliance and 82.7% of patients using CPAP.”… “In this randomized parallel trial, oral-appliance therapy was not inferior to CPAP as effective treatment of OSA.”

Source: Hoekema, Aarnoud. “Oral-Appliance Therapy in Obstructive Sleep Apnea-Hypopnea Syndrome: A Clinical Study of Therapeutic Outcomes” American Academy of Dental Sleep Medicine, 2007

As your partner in patient care, I have extensive study and experience in treating OSA and snoring.  Recently, I completed UCLA School of Dentistry’s Sleep Medicine Residency, one of a handful of nationally recognized curriculum-based courses in the country.  With leading faculty in the field of sleep medicine, the five-month program entailed more than 60 hours of training. While the Dental Sleep Center of Hawaii is located adjacent to my general dentistry practice at Hawaii Holistic Dentistry, we encourage patients to maintain relationships with their current providers.  We are dedicated to working closely with all health professionals in the coordination of a person’s treatment.  Most medical insurers cover OA therapy; currently, the Center is a participating provider with HMSA, VA and Kaiser, and I anticipate this list will continue to grow. I welcome the opportunity to discuss dental sleep medicine and how we can work together to best serve our patients.  Please contact me at or by phone at 808.443.2636. Thank you in advance for your referrals – and please accept my appreciation for working in partnership towards the health and longevity of Island residents.  

Trevor Hartwell, DDS