16 exhibitors Chicago Midwinter — February 21, 2019 Breakthrough non-surgical laser sleep applications can aid dentistry patients By Harvey S. Shiffman, DDS n Snoring and sleep disordered breathing affects millions of Ameri- cans, both adults and children.1,2 The signs and symptoms are the result of partial or complete collapse of the upper airway during sleep.3 The structures involved in our protocol include the soft palate, uvula and the base of the tongue.4 The goal of the treatment is to decrease the amount of blockage of the upper airway.5 Dentists are in a great position to help screen and, in many cases, treat these problems with airway health management. The gold standard for the treat- ment of sleep disordered breathing is the CPAP type device. Following that, in 1981, was the introduction of man- dibular advancement devices (MAD). Both of these treatment modalities show a reduction in compliance over time and significant side effects. However, the NIGHTLASE™ Snor- ing and Sleep Apnea Reduction Ther- apy protocol is a unique approach to treatment using the Fotona Light- walker dental laser with a proprie- tary protocol and handpiece. Another positive benefit is the 24-hour-a-day improvement in nasal breathing vs. CPAP and MAD. NIGHTLASE uses the photother- mal capabilities of the Fotona Light- walker laser to convert and initiate the formation of new and more elastic collagen.6 The target mucosal tis- sues are the oropharynx, soft palate and uvula. The proprietary “Smooth Mode” pulse characteristics create a non-ablative heat generation that ini- tiates the conversion of existing col- lagen to more elastic and organized forms and also initiates “neocollagen- esis,” the creation of new collagen. The effect of the laser energy as it penetrates (by transmission) deeper into the tissues is a low-level photobio- modulation that directly affects the fibroblast cells and has been found to stimulate protein production from quiescent cells.7 This process results in a visible elevation of the soft palate and uvula Here in Chicago To learn more about the NIGHTLASE Snoring and Sleep Apnea Reduction Therapy protocol and the Fotona Light- walker dental laser, stop by booth No. 2137. About the author Dr. Harvey S. Shiffman is in general practice at the Laser Dental Center in Boynton Beach, Fla. He is a graduate of Georgetown University School of Den- tistry and completed a general practice residency at Georgetown University Medical Center, with an emphasis on treating medically compromised pa- tients. Shiffman completed certification with the Academy of Laser Dentistry (ALD) in three types of laser systems and was recently awarded a fellowship in the ALD. He is personally involved in the use and development of cutting- edge technology and has performed tens of thousands of laser dental proce- dures during the past 15 years. Shiffman is an instructor for the Academy of Clinical Technology. He most recently lectured at the Yankee Dental Congress, the Greater New York Dental Meeting, Rocky Mountain Den- tal Convention, American Sleep and Breathing Association, Seattle Study Club Symposium and the 2018 Lasers and Health Conference in Portoroz, Slovenia, on “Advances in Laser Den- tistry.” Shiffman is an adjunct professor in the Department of Prosthodontics at Nova Southeastern College of Dental Medicine. CO2 laser, and radiofrequency injury in the porcine soft palate. Laryngoscope 109: 1316-1319. 5. Fomin D, Nicola E, Oliver C, Farci M, Dibbern R, et al. (2007) Collagen type analysis in the soft palate after surgical intervention with CO(2) laser and radio- frequency ablation. Photomed Laser Surg 25: 449-454. 6. Liu H, Dang Y, Wang Z, Chai X, Ren Q (2008) Laser induced collagen remod- eling: a comparative study in vivo on mouse model. Lasers Surg Med 40: 13-19. 7. Christopher Spock, Adrei Metelitsa et al. Lasers and Lightsources to Activate Fibroblasts. Cosmet Dermotology 2012; 25:27-33. 8. Miracki K, Vizintin Z (2013) Nonsurgi- cal minimally invasive Er: YAG laser snoring treatment. J Laser and Health Academy 1:36-41. 5 Photos show before and after the use of the NIGHTLASE Snoring and Sleep Apnea Reduction Therapy protocol. (Photos/Provided by Harvey S. Shiffman, DDS) and tightening of the oropharyngeal tissues, which leads to an improve- ment in the upper airway volume. The results can be seen in the photo above. NIGHTLASE therapy is indicated for cases when the patient has been diagnosed with chronic snoring, UARS or mild to moderate sleep apnea and either cannot or chooses not to wear a MAD appliance or CPAP device. It can also be used in co- therapy with those devices. NIGHTLASE has a significant suc- cess rate in producing a positive change in sleep patterns. Research published by Miracki and Visintin8 has shown that it can reduce and attenuate snoring and provides an effective non-invasive modality to lessen the effects of obstructive sleep apnea. NIGHTLASE therapy is not a permanent alteration and lasts from six to 12 months and is easily touched up at follow-up appointments. We consider NIGHTLASE to be another tool in our treatment “tool- box,” giving us more options and the possibility of better results when used in combination with MADs and CPAP for those patients who may not get adequate improvements from those therapies alone. References 1. A Report of the National Commission on Sleep Disorders Research (1995) Wake Up America: A National Sleep Alert. Washington, D.C.: U. S. Government Printing Office. 2. Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep ap- nea: a population health perspective. Am J Respir Crit Care Med 165: 1217- 1239. 3. Lattimore JD, Celermajer DS, Wilcox I (2003) Obstructive sleep apnea and car- diovascular disease. J Am Coll Cardiol 41: 1429-1437. 4. Courey MS, Fomin D, Smith T, Huang S, Sanders D, et al. (1999) Histologic and physiologic effects of electrocautery,