RICHARD A BONATO, PHD, MA, RPSGT
DENTITRAC: A MICRO-RECORDER FOR THE
DETECTION OF ORAL APPLIANCE COMPLIANCE
A
dherence data for oral
appliances (OA) typically
rely on subjective reports
with few studies reporting
objective compliance data
measurement. In contrast,
CPAP compliance is routinely
reported and is now required
by insurance payers for
continued CPAP funding.
The need for objective OA
compliance measurement
is widely recognized. In the
AASM OA practice parameters
paper published in 2006 1 ,
Kushida et al. call for the
development of objective OA
measurement technology and
this was reiterated in 2015 by
Ramar et al. 2 Indeed, several
attempts have been made
to objectively measure OA
adherence.
In 1974, Northcutt described
an extra-oral orthodontic
headgear with a timing gear
mechanism to objectively
measure wearing time. 3 This
device had internal power,
memory, and the ability to
communicate the data to
a reading station. When
patients were informed
they were being monitored,
wearing time increased from
about 45 hours weekly to
100 hours weekly. Another
extra-oral orthodontic
headgear was introduced
and commercialized about 25
years later by Orthokinetics
Corporation and called the
Compliance Science System.
This device also used internal
power, internal memory and
a reading station; however,
additional PC software was
included. In a study of 46
patients originally blind to the
existence of the compliance
monitor, Doruk et al. reported
a statistically significant
increase in usage time in the
second four-month follow-
up compared to the two-
month baseline period. 4 Thus,
patients’ knowledge of OA
compliance measurement
is sufficient to significantly
increase OA wearing time
in patients. Despite these
early remarkable attempts
to obtain objective OA
adherence data, issues
were encountered. First,
orthodontics was generally
headed in a direction away
from extra-oral headgear
towards removable intra-
oral appliances making
widespread application
limited. Second, creative
children discovered that
placing the headgear on teddy
bears or dolls could deceive
the compliance monitor.
RICHARD A. BONATO
PHD, MA, RPSGT
Richard A. Bonato, Ph.D., M.A.,
RPSGT, CEO and Co-Founder of
BRAEBON Medical Corporation,
has been involved in advancing
the science of sleep for over 30
years with the development of
the DentiTrac® micro-recorder,
the MediByte® family of
advanced home sleep testing
equipment, numerous sleep
sensor technologies, and in-
laboratory PSG systems.