Author: Michael Kelley
How the Herbst Device Can Transform Your Sleep Apnea Experience
By Edd Thiele Dear David Gergen, I am writing to thank you for adding energy back into my life, and I hope for many extra years added to my life! By a stroke of good fortune, you invited my business partner to attend a Phoenix session of the American Sleep and Breathing Academy, which you founded 17 years ago. In addition to the academy, I found you to be a visionary and man of many accomplishments in the field of orthodontic and sleep dentistry. You had about 25 dentists from around the country learning and adding to their knowledge of sleep disorders, and your methods for treating them. Everyone I met expressed enthusiasm about what they were learning and doing. I have been using a CPAP machine for almost fifteen years with mixed results, so when you offered me the opportunity to try one of your Herbst devices, I jumped at the opportunity. So, I met you Friday afternoon, Saturday morning you used me to demonstrate your special technique for taking a impression of my mouth for the device, and on Wednesday, I was in the Gilbert, AZ office Bruce Herr, Jr., DDS fitting the device made from the impression. Dr. Herr certainly deserves my praise. He spent several hours fitting and adjusting and explaining how to use the Herbst Device, the accompanying exercises and how to adjust it. That night I popped the device in my mouth, hit the pillow and woke up seven hours laterwith no discomfort whatsoever and most importantly I felt about 30% more rested! And I still do, every day! As for snoring, Dr. Herr recommended a mobile app called Snore Lab. It records how much and how loud you snore each night. My results so far have improved. So, Good-bye CPAP! How important is it to deal with a sleep disorder? Extremely important! And there are many millions of people in the USA who are undiagnosed or unaware of the trouble they could be in. Understanding Sleep Apnea: A Silent Disruptor Sleep apnea, a condition characterized by repeated interruptions in breathing during sleep, affects millions worldwide. (“Sleep Apnea Through Time: A Comprehensive Look at Its History and Evolution”) While it may seem like a benign issue, its impact on health and quality of life is profound. Sleep apnea disrupts the natural sleep cycle, preventing individuals from achieving restorative rest. Types of Sleep Apnea Sleep apnea manifests in three primary forms: 1. Obstructive Sleep Apnea (OSA): The most usual form, OSA, occurs when throat muscles relax excessively, blocking airflow. Factors like obesity, age, and anatomical variations can increase susceptibility. 2. Central Sleep Apnea (CSA): Unlike OSA, CSA originates in the brain. It fails to signal the respiratory muscles to breathe, leading to pauses in airflow. 3. Complex Sleep Apnea Syndrome: A combination of OSA and CSA, this form highlights the multifaceted nature of the condition. Symptoms and Health Risks Symptoms of sleep apnea often go unnoticed but can significantly affect daily functioning. They include: • Loud, chronic snoring. • Gasping or choking during sleep. • Daytime fatigue and difficulty concentrating. • Morning headaches. Left untreated, sleep apnea can lead to: • Cardiovascular problems: Hypertension, heart attacks, and arrhythmias are common among sufferers. • Metabolic disorders: Sleep apnea has been linked to diabetes and obesity. • Cognitive impairments: Poor sleep affects memory, decision-making, and mood. Research from the National Institutes of Health (NIH) emphasizes that treating sleep apnea improves not only sleep quality but also reduces risks of associated conditions (NIH, 2023). Exploring Treatment Options Traditional Methods Treatment for sleep apnea varies depending on severity and underlying causes. Common approaches include: • Continuous Positive Airway Pressure (CPAP): A device delivering a steady stream of air through a mask to keep airways open. Though effective, many patients struggle with discomfort and compliance. • Lifestyle Modifications: Weight loss, regular exercise, and avoiding alcohol can reduce symptoms, particularly for those with mild OSA. • Surgical Interventions: Procedures like uvulopalatopharyngoplasty (UPPP) or maxillomandibular advancement (MMA) restructure the airway to prevent obstructions. Modern Alternatives Emerging treatments offer promising solutions for those seeking less invasive or more personalized approaches: • Oral Appliances: Devices like the Herbst appliance adjust the jaw’s position to maintain airway patency. • Positional Therapy: Encouraging side-sleeping can reduce airway collapse in positional OSA. • Hypoglossal Nerve Stimulation: This implantable device stimulates tongue muscles to keep the airway open during sleep. Introducing the Herbst Device What Is the Herbst Device? The Herbst device is an FDA-approved oral appliance specifically designed to treat mild to moderate OSA. Unlike CPAP machines, they are discreet and user-friendly, resembling a custom-fitted retainer. How It Works The device repositions the lower jaw (mandible) slightly forward, increasing the space in the airway and reducing the likelihood of obstruction. Its adjustable hinges allow for personalized settings, ensuring both comfort and efficacy. According to the American Academy of Dental Sleep Medicine (AADSM), the Herbst appliance is particularly effective for patients with OSA who cannot tolerate CPAP therapy (AADSM, 2023). Benefits of the Herbst Appliance Clinical Effectiveness Studies show that oral appliances like the Herbst device can reduce apneic episodes by up to 50%, particularly in patients with mild to moderate OSA (Journal of Clinical Sleep Medicine, 2022). Comfort and Convenience Unlike CPAP machines, which can be cumbersome, the Herbst device is lightweight and easy to travel with. Patients report improved compliance due to its simplicity and adjustability. Improved Quality of Life Many users notice immediate benefits, such as reduced snoring and fewer nighttime awakenings. Over time, they experience increased energy, better focus, and improved overall health. Beyond the Herbst Device: Comprehensive Snoring Solutions Addressing Lifestyle Factors Snoring, a hallmark symptom of OSA, can often be mitigated through lifestyle changes: • Weight Management: Excess weight, particularly around the neck, can exacerbate airway obstruction. • Dietary Adjustments: Reducing alcohol and sedative use before bedtime minimizes throat muscle relaxation. • Sleep Hygiene: Maintaining consistent sleep schedules and creating a restful environment enhances overall sleep quality. Complementary Tools For those seeking additional support, the following tools may help: • Nasal Strips: These improve airflow by opening nasal passages. • Anti-Snore Pillows: Designed to support the head and neck, these encourage optimal sleeping positions. • Humidifiers: Adding moisture to the air can ease breathing and reduce snoring caused by dry airways. Personalizing Your Herbst Treatment Experience Fitting and Adjustment The Herbst device is custom-made by dental professionals to ensure a precise fit. Regular follow-ups allow for fine-tuning, ensuring optimal results as the jaw adapts. Monitoring Progress Tracking sleep patterns with wearable devices or sleep journals can help patients and clinicians assess the effectiveness of the device. Adjustments can then be made to maximize benefits. Collaborative Care Effective treatment often involves a team approach. Sleep specialists, dentists, and primary care providers work together to address the unique needs of each patient. Reviews and Testimonials Common Themes Patient reviews of the Herbst device frequently highlight: • Its comfort compared to CPAP machines. • Significant reductions in snoring and daytime fatigue. • Ease of integration into daily life. Success Stories Many users share transformative experiences, describing how the device has improved their relationships, productivity, and overall quality of life. These testimonials underscore the Herbst appliance’s potential to bring meaningful change. Advanced Research and Future Directions Ongoing research continues to refine oral appliance therapy. Innovations include: • Smart Appliances: Devices equipped with sensors to monitor usage and effectiveness in real-time. • 3D Printing: Enhancing customization and comfort. • Combination Therapies: Exploring synergies between oral appliances and other treatments, such as positional therapy or nasal decongestants. Tips to Improve Sleep Quality Environmental Adjustments Creating a sleep-friendly environment can make a significant difference. Key tips include: • Temperature Control: Keep the room cool for optimal comfort. • Noise Reduction: Use earplugs or white noise machines to block disturbances. • Lighting: Invest in blackout curtains to eliminate light pollution. Behavioral Strategies Establishing healthy routines can promote better sleep: • Wind-Down Rituals: Incorporate relaxation techniques like meditation or reading before bed. • Screen-Free Time: Avoid electronic devices at least an hour before sleeping to reduce blue light exposure. Professional Support If lifestyle changes do not yield results, consult a sleep specialist to explore additional interventions. Conclusion: A Path to Restful Nights The Herbst device represents a powerful tool in the fight against sleep apnea. By addressing the root cause of the condition—airway obstruction—it offers a practical, patient-friendly alternative to traditional treatments. Whether you are new to sleep apnea management or exploring alternatives to CPAP therapy, the Herbst device can serve as a steppingstone toward better health and vitality. With the guidance of healthcare professionals and a commitment to personalization, restful nights and energized days are within reach. Take the first step today by consulting with your provider about the Herbst appliance and other treatment options. Reclaim your nights and transform your life—because everyone deserves the gift of quality sleep. References 1. American Academy of Dental Sleep Medicine (2023). Oral Appliance Therapy Overview. 2. National Institutes of Health (2023). Sleep Apnea and Health Risks. 3. Mayo Clinic (2023). Sleep Apnea Treatment Options. 4. Journal of Clinical Sleep Medicine (2022). Efficacy of Oral Appliances in Sleep Apnea Management. By Edd Thiele
The ASBA 2025 Strategic Plan: A Vision for the Future
As we begin 2025, we are excited to announce the American Sleep and Breathing Academy’s (ASBA) annual meeting. This year co-hosted with the Southern Sleep Society. This collaboration will bring our members the most dynamic network in sleep medicine since 2019, reflecting the enduring vision of Alan Hickey who sadly passed away a few days ago on January 10. Alan Hickey’s vision continues to guide us. One of his proudest achievements last year was announcing our best sleep medicine conference since the pandemic. This milestone event will take place in Houston, TX, on April 4-5, 2025. Bringing together over 700 attendees. It promises to be more than just a gathering—it will be a celebration of our enduring commitment to our shared mission. Collaborating with Southern Sleep not only more than doubles the attendance at the Annual Sleep & Wellness Conference, but also brings hundreds of medical professionals together with their counterparts from dental sleep, greatly enhancing opportunities for fostering working relationships. As we gather in Houston this April, for the ASBA Annual Sleep & Wellness Conference let us honor Alan’s legacy by coming together in the spirit of collaboration and innovation. Let this conference be a testament to his vision, a vision of a world where sleep medicine professionals unite to make meaningful, lasting impacts on patient’s lives. The 2025 Conference will have two lecture tracks combining both dental and medical, with over 30 speakers of the very highest caliber. The lineup of speakers boasts an equal mix of DDS and MDs, each trailblazing in their respective fields and setting themselves apart. Attendees can also look forward to diverse classes, ample networking opportunities with peers and experts; offering both CE and CME with a larger showcase of vendor exhibit booths. This joint conference will host a broad spectrum of professionals, including sleep physicians, ASBA-certified sleep dentists, registered PSG technicians, ENTs, pulmonologists, cardiologists, PAs, nurses, lab technicians, and allied healthcare professionals. Alan often referred to it as a “Meeting for the Ages,” where barriers would be broken, ideas exchanged, and the future of sleep medicine reshaped. One of Alan’s key focuses for this conference was to highlight the pivotal role of ASBA in training dentists toward advancing patient care. He was specifically passionate about sharing evidence-based insights into the transformative impact of the Herbst sleep appliance with its unparalleled efficacy in reducing apnea burden, alleviating disease, and improving long-term patient outcomes. These strengths led to the Herbst’s adoption by the Federal Government and Medicare, including its inclusion in the 2019 PDAC studies conducted by the NIH and regulatory data from CMS in 2015. The ASBA focus is not just about science; it is about people too. Better education and networking opportunities translate into patients whose lives are transformed by ASBA-certified dentists. From overcoming severe sleep apnea to achieving life-changing weight loss, these patients found not just better sleep but a renewed quality of life. ASBA Diplomacy: Our academy is deeply inspired by the extraordinary dentists who have become ASBA diplomates, including leaders like Dr. Paul Serrano, Dr. Jerry Hu, Dr. Paul Van Wallingham, Dr. Ed Hobbs, and Dr. Brad Eli. Each of these individuals brought their expertise and compassion to the forefront. Their dedication to using Herbst-style appliances and their commitment to patient care and education was always a source of pride for Alan. I want to highlight some of our members and the results of achieving dental sleep ASBA diplomacy in our past conferences. First of which, is Dr. Paul Serrano, a diplomate of the ASBA, who is considered by many to be one of the finest orthodontists in all of America. He is one of the first members of the ASBA and worked Directly with the Dr. Robert Ricketts and Dr. Ed Spiegel. Dr. Serrano preferably uses Herbst type Appliances for sleep disorders because he knows the value of the built-in lateral slop. That is very important, for instance, if a provider misses the airway bite a little to the left or a little to the right of the mandible while coming off the eminence, the Herbst design will automatically fix it. The Herbst allows Synovial fluid, Hyaluronic Acid, and the excursive movements that are needed, not like TMJ entrapments from dorsal fins. That is very crucial during sleep, especially during bruxism, other appliances are restricted in that sense! These are extra potentially unnecessary issues that he or other dentists have to mitigate when they don’t use Herbst ( Especially the dorsal fin appliances that lock patients in). In contrast to fixed and constrictive appliances, the comfort and the benefits that the Herbst appliance provides for the TMJ will all benefit the patient from the Herbst Arm component, allowing range of motion during excursions in these oral appliances. Dr. Serrano has finished many cases where he had taken their AHI down to below 5. These patients’ oxygen minimum was at 90 and above, simply incredible! They come from all walks of life with their own personal struggles and stories from extreme. Dr. Serrano informed me that he was fortunate enough to receive first-class training from the ASBA. He felt it was very valuable and saved him from buying unnecessary equipment, software, and test units. He said “The ASBA has provided Great training and education from greats like Dr. Ed Spiegel and Dr. Alan Bernstein. This has benefited members like myself. I am so loyal to the American Sleep and Breathing Academy, that even my son, Dr Andrew Serrano joined the academy and will be speaking at the annual meeting April 4th and 5th. For those who are just now beginning this journey this year we will have leaders like Dr. Atul Malhotra MD with the newest in sleep disorders and treatment.” The best sleep experts have demonstrated that they value calibration titration and put in the necessary time to achieve and uphold the highest standards. Dr. Jerry Hu, with practices in Las Vegas and Alaska comes highly recommended by Dr. Paul Serrano and whom I have had the opportunity to share patients with. Dr. Jerry Hu, a certified diplomate sleep expert had been using precision-milled dorsal fins prior to meeting David Gergen. Mr. Gergen explained to Dr. Hu all the value of the Herbst device that only a dentist of his skill level would understand. He put it into such a simple and articulate way that it completely resonated with Dr. Jerry Hu. Now he consistently gets his patients’ AHI below 2.5. His record, most successful change, was a severe OSA patient now with a normal AHI. This patient had a dramatic improvement and change in the quality of his life. Prior to Dr. Hu this patient was morbidly obese and could not climb a flight of stairs. According to Dr. Hu this patient gives him all of the credit and he lost over 160 pounds of weight and is now very active. This patient also wished to thank David Gergen himself so Dr. Hu told me he made that phone call happen. Another member Dr. Paul Van Wallingham, one of the founding members of ASBA and a well-renowned sleep dentist in Grosse Pointe Michigan and part of the Ford Medical Clinic, also uses the PDAC Herbst Appliance for his sleep patients as well. He, too, is knowledgeable about the government studies that back up this style of appliance. Being a sleep dentist and the credentialing director for the ASBA, he understands why the Herbst style appliance is the only one that makes any sense to him. It is the workhorse of dental sleep medicine. Continuing with Dr. Hobbs in Dallas Texas, this fantastic dentist has years and years of knowledge and background in dental sleep medicine behind his name. He took over the wonderful practice of the great Dr. Harry Sugg and has continued his legacy of saving lives doing PDAC approved Herbst style appliances. Dr. Ed Hobbs is very meticulous and methodical. He is a CE junkie and utilizes the Rickett’s Phonetic Silibant bite for all his Herbst appliances. He uses the original Ricketts bite. I would also like to add that Dr. Hobbs is one of the few tenth degree black belts in the world of Karate, having trained with the legendary two time Taekwondo world champion Mack Newton who has recently passed away. We both met Mack through David Gergen. Finally, Dr. Brad Eli based in San Diego, CA. who is sleep expert who has an impressive volume of patients he has helped. Dr. Eli is an expert in TMJ and Pain management as well as airway. He, too, only uses the PDAC style appliance for his sleep patients. Having dealt with so many pain and TMD patients, he is more than qualified to back up his preference for Herbst-style appliances. Dr. Eli has seen the freedom that these arms provide for movement. He has seen TMD subside using the downward and forward position that is a characteristic of this appliance. Like many others he has seen the side effects and problems that dorsal style restrictive appliances can have. This can lead to loss of confidence in the appliance as it may create more issues than it solves. By using Herbst style appliances, he has been able to improve the lives of his patients not only with sleep issues but also remove the debilitating pain from TMD as well as wean them off of pain medications. He is a hero to his patients. These and many other talented ASBA members will be networking and teaching at our 2025 annual meeting. Alan Hickey will forever be remembered as a cornerstone of the ASBA and a tireless advocate for progress in sleep medicine. His work, his passion, and his unwavering belief in the power of collaboration will continue to inspire us all. In his honor, let us move forward together, upholding the highest standards and striving to create a brighter future for sleep medicine. Alan, your legacy lives on in the work we do and the lives we change. You will be deeply missed, God bless. Dr. Rudi Ferrate
In loving memory of Alan Hickey: ASBA Executive Director and friend
It is with profound sadness that we share the news of the passing of our dear colleague, mentor, and friend, Alan Hickey, on January 10, 2025. Alan joined the American Sleep & Breathing Academy (ASBA) over a decade ago and quickly became an indispensable leader in our organization, serving as Executive Director and Editor-in-Chief of Sleep & Wellness magazine. His tireless dedication, innovative vision, and commitment to advancing dental sleep medicine left an indelible mark on the field and on all of us fortunate enough to know and work alongside him. Alan’s contributions to the medical publishing world were equally remarkable. Prior to his tenure at ASBA, he served as Publisher for esteemed journals including Sleep Diagnosis and Therapy, the International Journal of Anesthesiology, CHEST India Edition, CHEST Brazil Edition, Pediatrics Russia Edition, and Pediatrics India Edition. In addition to his contributions to healthcare, Alan was a visionary entrepreneur. As the founder of Arrow, a software company developing gaming and business applications, he applied his ingenuity to a variety of fields. This included the creation of the ASBA app, a tool that has become central to our mission of education and innovation. Alan also took on the responsibility of principal event planner for the ASBA. These responsibilities included negotiating conference venues, contracting, securing World class speakers, ordering food and beverage CE’s and hotel rooms for the attendees. He became well versed as being an Event planner out of necessity and everyone who attended an ASBA function, which ranged from the annual conference, Diplomat review, exam session, or most recently the revival of the ASBA Study Club has benefited from his contribution. Beyond his professional accomplishments, Alan was deeply loved as a husband, father, son, and friend. He embodied kindness, generosity, and integrity in every aspect of his life. To those who knew him personally, he was a steadfast source of support, always offering a listening ear, wise advice, and unwavering encouragement. His warmth and humor made him not just a colleague, but a part of our extended family. Our hearts go out to Elaine and the entire Hickey family during this incredibly difficult time. Alan’s legacy is one of excellence, compassion, and lasting impact, and he will be deeply missed by all who had the privilege to know him. With heartfelt sympathy, David Gergen Chief Executive Officer, ASBA Chief Executive Officer, Pro Player Health Alliance Dr. R.M. Ferrate, MD President, ASBA Dr. Eugene Azuma Executive Board member, ASBA Mallory Love Event coordinator, ASBA
Veterans and Wonderful Patients- What Priceless Gifts
There is no doubt in any American’s point of view that our veterans deserve better. Being in the field of dental sleep medicine, it is a blessing to be able to improve and even in some instances, save lives of our veterans. There are myriad of studies and evidence based articles that link PTSD, Alzheimer’s, Parkinson’s, Depression, Suicidal Tendencies, etc. to obstructive sleep apnea. Below is a picture of a hero veteran who came to Nevada Dental Sleep for care and help. With his full permission, he wanted to share his story. Almost a double amputee (prosthetic arm and the other one has no hand), he has had terrible sleep breathing problems and airway disorder. His wife has witnessed him snoring and gasping for air and they haven’t had restful sleep in years together being in the same bedroom. His stories during the Vietnam War were all so inspiring and what a hero this gentleman is. He also went to a different local Vegas dentist before seeing Nevada Dental Sleep and he told us the other dentist treated him like cattle and they never did any follow up with him. None at all. The appliance they gave him also was way too tight and hurt his dentition, and he couldn’t even get it out on his own due to his disability. He needed assistance just to loosen it. Therefore, it had been an honor and privilege to make things right and give the caliber of treatment he deserves. Using Herbst style customized sleep appliances and measuring anatomical features of his nasal and oro-pharyngeal airway, the treatment was a full success. Nevada dental sleep was able to knock his AHI out of the park! He reported back that his entire quality of life has improved. His wife is also so very pleased and sleep quality has substantially improved for the both of them. Other wonderful patients have benefited as well from Herbst style appliances. The photo below shows a patient who also has successful outcomes at Nevada Dental Sleep. He was so pleased with his treatment that he wanted to share with the public his story. With the intention of bringing more awareness to the public, he did a full podcast with a Vegas local well known person Patranya’s Business Showcase Podcast series. He came to Nevada Dental Sleep weighing over 440 pounds. He’s completely CPAP intolerant and had been let go at his job because he kept falling asleep during the middle of work- almost daily. He was not able to climb a flight of stairs and had to always wait for elevators. A year after compliance with his oral appliance, exercise and nutrition changes, he has now lost 160 pounds, became able to climb stairs and will be up for promotion on his new career/ employment! These are the gifts for being in dental sleep medicine and doing a thorough and caring service. Choosing the right experienced labs and technicians all matter (these cases were made by Gergens Orthodontic Lab). Some dentists are in a race to go up on stage to exaggerate doing hundreds of cases per month or that they can herd cattle in and out of their clinics and that is tragic. An important admonition is work ethics. Please remember your healthcare oath. These veterans and wonderful patients deserve thorough treatment!
New Playbook for Airway Dentists and Sleep Physicians
Felix Liao, DDS Hi, Fellow ASBA Members:. I’m delighted to share a new playbook for airway dentists and sleep physicians to join forces. 99% of all patients (their doctors included) suffer from Impaired Mouth Syndrome: oral contributions to narrow airway, chronic pain, fatigue, bruxing, TMJ, anxiety, depression, brain fog, and more. A novel Airway Facial Epigenetics method can treat Impaired Mouth as follows:. ✅ Resulting in wider airway, deeper sleep, and facial radiance ✅ Using no shots, drills, pills, surgery, screws, brackets & wires ✅ Causing no side effects and no pain! I’m excited to introduce an Inaugural Special, thoughtfully designed to support and rejuvenate the healers among ASBA members. This Special expires midnight, Dec. 31, 2024. Register now to make your 2025 the best year. Felix Liao, DDS, MAGD, ABGD, Dip.ASBA Text or Call: 800-969-8035 DrFelixLiao@gmail.com
Hidden Treasures
A Year of Transformation in Sleep Apnea Treatment: My Journey with Gergen’s Herbst Appliances By Jerry Hu, DDS, DASBA, DACSDD, DABDSM Recently, a well-known maxim, “All things happen for a reason,” has brought such splendid music to my ears. This year, ever since I began providing Gergen’s Orthodontic Lab’s Herbst appliances for my sleep apnea patients and using the Rickett’s Sibilant Phonetics Bite, I have experienced incredible results—results like I’ve never seen in the past. Milled dorsal appliances simply cannot compare. As a matter of fact, several of the “precision” milled appliances have resulted in side effects like TMJ/TMD discomfort, orofacial muscle hypertonicity aches, and trigger point issues. Thankfully, the Herbst appliance—ideal for synovial fluids and freedom of border movements—is available to remedy those cases. Additionally, with over four decades of experience embedded in the skillful hands of David Gergen, one cannot go wrong with using a Herbst appliance made from Gergen’s lab. Amazing Results and Remarkable Patient Stories Stories have been building up in all my clinics, and many of them involve veterans. It is quite an honor and unforgettable when these patients return with such improved quality of life. War heroes, veterans with disabilities, and even a double amputee from the Vietnam War have all benefited from using Gergen’s Herbst appliance. One of the most noteworthy cases involves a veteran with severe sleep apnea. His baseline AHI score was 49, and after treatment, it dropped to an astonishing 0.27. He came back to report unbelievable improvements in energy, memory, and even his ability to dream and remember those dreams. He shared that he is now able to sleep on the same bed as his wife, something he hadn’t been able to do for several years. Another remarkable success story comes from a well-known attorney who retired in Los Angeles and moved to Las Vegas. When he came to our office for his consultation, we immediately noticed how lethargic he seemed—continually yawning while talking and visibly tired. He told us it was a struggle for him in the first few hours of the day after waking up, and that he hadn’t remembered dreaming for years. One week after we delivered his Herbst appliance, he called us to express his excitement about the changes he’d experienced. He wanted to meet us in person to share the details of his improvements. Not only that, but his wife, a retired judge from California who was CPAP intolerant, also wanted to get an appliance. A Journey to Phoenix: Discovering Hidden Treasures These amazing results inspired me to visit Gergen’s Orthodontic Laboratory in Phoenix myself. When I arrived, I was asked to help instruct a study club for the American Sleep and Breathing Academy. During this meeting, I received additional pearls of wisdom about the Rickett’s phonetic bite method. David Gergen, who was personally trained by Dr. Ricketts, passed along these detailed specifics to everyone in attendance. Using the word “Shun” and looking for 5’s, 6’s, and 9’s, along with verifying the bite registration with Airway Metrics jigs, helped make the bite registrations incredibly precise. This was the first “hidden treasure” I discovered during my visit. Next, I visited the lab itself. Upon entering, I was immediately struck by the energy and drive of everyone there. Not a single person was sitting idle—every team member was working efficiently. David informed us that the lab handles 600-700 cases per day on average, and seeing this in action was jaw-dropping. We were given the opportunity to witness the craftsmanship of the technicians, who explained the steps and rationale behind their processes, as well as the stringent quality control checks they performed. The complexity of the cases they worked on was impressive, and the attention to detail was unmatched. With over 40 years of experience, David had a natural ability to identify undercuts, draw, and block out for the most ideal comfort, retention, and fit of each appliance. This level of expertise was the second hidden treasure I uncovered. The Icing on the Cake: Supporting NFL Retirees Lastly, I learned about David’s deep commitment to helping NFL retirees. His lab has a dedicated section focused on assisting retired NFL players who suffer from various health issues, including the aftermath of concussions, sleep apnea-induced dementia, and conditions like Alzheimer’s or Parkinson’s. The remarkable work being done here is truly life-changing for many former athletes. The NFLPA’s involvement speaks volumes about the quality of care provided, as many retired players have found much-needed relief and improved quality of sleep with the Herbst appliance. A Cosmic Connection I truly believe the universe has a way of leading us to certain people in our lifetime, and I am certain there is a reason the universe directed me to meet David Gergen. I have developed a strong connection with him and share his passion for advancing dental sleep medicine. We are both committed to increasing awareness of treatment options, advancing care, and most importantly, making our world a less tired and more energized place.
A Letter from Bruce L. Herr, Jr., DDS: Reflections on the ASBA Study Club
I was invited by the CEO of the American Sleep and Breathing Academy (ASBA), David Gergen, to attend the academy’s annual study club which was held in Phoenix, Arizona on October 4th and 5th 2024. I accepted this gracious invitation to attend, and I have to say that this was 2 days packed full of great instruction and was 2 days well spent. I must admit that this academy goes above and beyond because it understands the future of dental medicine. The caliber of the presentations was top notch, and I walked away from the study club that weekend with more knowledge and a better understanding of how to identify patients who are likely to suffer from sleep breathing disorders. I learned about more efficient ways to treat patients who walk into both my dental practice and into my dental sleep medicine practice. David Gergen started off with his presentation about pediatric sleep appliances from Bionators , Occlusal Corrector’s to Crickets.. He had been doing them for almost 40 years and the results he showed were simply amazing. David has definitely come back and made the ASBA unbelievably impressive. He surprised us all when he brought the head of the VA, Dr. Patricio Reyes MD, to be at the meeting. David Gergen even gave me a referrals from the VA, I saw him at the meeting and got him taken care of right away. This has been such an unforgettable and unexpected added bonus, the connections David set me up with were all so remarkable. Not only I was able to even able to make a life saving Herbst appliance for a VA member who was there. He has sent me two new Sleep referrals. David reviewed the Ricketts Silibant Phonetics bite with all of us in person. He showed us all how he directly learned from Dr. Ricketts himself, and the appliance was simply life changing for this VA patient. Next, Dr. Diana Batoon spoke about communication and setting up cases with Pediatric treatment options and myofunctional therapy. Next, Dr. Jerry Hu spoke about expansion cases, treatment protocols and the Herbst appliance and comparing different bite methods. His deprh of knowledge and passion on dental sleep medicine treatment options were outstanding. Finally, the main lecturer Tim Adams DDS spoke about correcting cranial strains, distortions and fixing torsions and side bends. Tim spoke for 13 hours of the meeting and I will only say ( He’s Unbelievable ) Tim Adams is a must see. I learned so much, and I can’t stress enough how incredible ASBA is now and what great value. All in all, there is no Academy and no study club who teach on the level and caliber like this. This study club is for sure an important aspect for any dentist to gain further knowledge and understanding for the choices and future of dental sleep medicine. The study club is a small group of like-minded practitioners, and the small group provided an opportunity to ask a lot of questions and to have discussions about the material presented and how to apply the knowledge in our day-to-day interactions with our patients. I would highly recommend that members of the ASBA take advantage of future study club events and make this investment in your education and journey to become a more educated practitioner so that you can make a difference in the lives of our patients that suffer from poor sleep! Warmest regards, Ram On, Bruce L Herr, Jr., DDS
Divine Intervention (Current Events of Dr. Jerry Hu)
Several years back, when I began my journey in dental sleep medicine, I quickly identified that it is a calling for me to propel this field. I am to do so by using all that I have in me for the rest of my life. I understood that the best approach to fulfilling this calling is by doing decent and good old fashioned hard work with research, lecturing, mentoring continuing education, and creating my on intellectual property innovations. I was destined to make a change for the better. However, Little did I expect that it would lead me to the successful outcomes of where I am today. Meeting David Gergen and immersing myself with the Amercian Sleep and Breathing Academy have made me conclude that there’s divine intervention. First, saying how incredible and nice so many Academy members have been to me is truly an understatement. This Academy is so positive and inspiring. The current board is looking to shape and improve all of dental sleep medicine. Their support, clinical experience and skills are priceless. Recently, I taught at Academy’s study club in Phoenix along side Dr’s. Timothy Adams, Diana Batoon and David Gergen. The amazing caliber of the topics taught ranged from correcting facial and cranial distortions, to expansion and quantum physics and to pediatric sleep medicine treatment options; and, that proved to all who attended that dentists have the ability to change and improve the world with dental sleep medicine. What was also so remarkable is that David Gergen was able to educate on the amazing orthodontic appliances that he’s been making for over 4 decades ! To him, he goes so far back, as he had the privilege to work with some of the world’s most respected and renowned orthodontists like Dr. Robert Ricketts and Dr. Paul Serrano as well as several others doing Crickets with loops, OC’s and Rickonators, etc. When combining those appliances with myofunctional therapy, thorough assessments of fascia (ankyloglossia), breathing (Buteyko), neurology, pH and biotensegrity, the sky is the limit on what we dentists can do to help our patients. It’s truly been an honor and privilege teaching along with these stellar intellectuals at the meeting. Moreover, it’s an honor for me to be the one to announce the next meeting coming up in 2025. It will continue the saga and have more advanced discussions alongside with excellent reviews. Dave has referred me so many incredible people, too. From both NFL and NBA Hall of Famers, to celebrities from Hollywood, I was reminded of how down to earth, genuinely nice & friendly, and humble great people can be. I mean, these are people who have reached the pinnacle and were on top of their careers. The struggles and obstacles that they must all have met and overcame to be at that highest level is very noteworthy to me. Plus, they all know the value of loyalty, friendship and respect. Bottom line, they have character. They know how to leave every interaction they have with dignity and radiant light. I observed and confirmed that there are for sure several people in dental sleep medicine who can learn a thing or two from these giants. I also wanted to add how much Dave is a legend in his own right. He ran next to Carl Lewis for 100 m growing up and did professional boxing. How cool is that ! What also is amazing is regarding the sleep apnea cases I’ve done recently for veterans with Dave’s Herbst PDAC appliance. I have the honor to take care of real war-time heros, some who are double amputees and notably disabled for their service in the military. Although I’ve used Silibant phonetics bite methods in the past, it’s nothing like getting the exact specifics that comes from the creator of that bite method himself, that of Dr. Ricketts. There’s nothing in comparison. Dr. Ricketts had passed down his exact techniques to Dave. Dave then showed me all of Rickett’s pearls, like using the word “SHUN” in addition to counting the numbers, looking for 5’s, 6’s and 9’s. The clinical outcomes are nothing short of incredible. Most of them come back with AHI below 5 and such outstanding improvement on their oxygen saturation levels. Just the other day, a veteran with AHI of 49 and oxygen desaturating down to 78, had his post sleep test done and now with AHI of 2.7 and minimum oxygen at 91. These are the real, life changing, and life impacting treatment outcomes working with Dave. Again, I am so honored to have the opportunity to give it my all to help those veteran heros and give my personal thanks to them. Dave has also told me several times that he must have came back from the dead for me. I now completely understand that. I feel that God sees my heart and knows that I simply want to help the world and to propel this field the best I can. I never thought that I would be meeting and connecting to all the great people from legends to celebrities, and Dave has connected me to so many of them. Coming back, I feel that Dave has been given the blessing of knowing who his true friends are, too. Next, I want to express how unbelievable it is to work along side some of the world’s most remarkable and renowned physicians for projects to better our world. Dr.’s Patricio Reyes, Virend Somers, and Neal ElAttrache have all worked with me and are committed to new studies and research to improve and and advance the field of dental sleep medicine. WOW, how awesome is that ! I can’t express how wonderful it feels just to be in the same room talking with these giants. The sheer number of accomplishments, for example, that Dr. Reyes has done for Alzheimer’s, PTSD, concussions, and mental health, I’m simply blown away. Dr. Somers, as a famous cardiologist at Mayo, also leads the way for studies that will impact the NFL. And, Dr. ElAttrache, having done so many amazing things for Olympians and athletes, I am simply in awe of all of them. Furthermore, they even all told me how important it is to stay away from dorsal fin sleep appliances and to teach how magnificent the Herbst appliances are in dental sleep medicine: particularly involving the synovial fluid and TMJ anatomy and physiology. They all get the science behind that, and how important it is to spread evidence based findings. Again, it is my honor to work with these healthcare legends in conducting new research and important projects to advance sleep medicine. Additionally, I have had the privilege to meet in person all the great lab technicians at Gergen’s Dental Lab. Their skills and experience just impressed me to no end. But more importantly, the humbleness and kindness of each of David’s team members displayed to me was not only extremely professional, but also simply impactful. I’ve been to so many labs in my life, and it is truly a gem in a haystack to see the quality of their craftsmanship and hard work ethic, which all of them have. Finally, it truly is about divine intervention. I believe that it’s the perfect timing, the ideal place and what the universe has yet to unfold which will all have deep reason, meaning and purpose for me and my life. If I can be a simple instrument for the power of positivity, I will channel all that energy with hard work, synergistic motivation, and be carrying a team of people with me to improve and change the world.