Dr. Shankland provides a variety of services to treat snoring and obstructive sleep apnea. Primarily, however, he provides various types of intra-oral appliances for those who either cannot tolerate CPAP treatment, who have failed CPAP treatment, or simply do not want to deal with the cumbersome and confining apparatus of a CPAP machine.

As each patient is different, each patient is assessed as to what type of appliance therapy he or she may need. Working in conjunction with a physician (usually, a sleep specialist), Dr. Shankland would first conduct an extensive examination, which includes a couple of brief questionnaires. If he feels that you're at risk due to your history and examination findings, he will refer you to a physician sleep specialist for a polysomnogram, or sleep study in a laboratory. After consulting with the physician after the sleep study, he will most likely see you again, discuss the results of the sleep study and then, make a recommendation concerning the type of intra-oral appliance that bests suits you. Impressions will be made and an intra-oral appliance or appliances will be custom fabricated for you.

Dr. Shankland will deliver the appliance or appliances to you, go over the care and use of the appliances and then see you in a week to begin the process of titration . . . adjusting the appliance to move your lower jaw into a position in which your snoring and/or sleep apnea will be eliminated or greatly reduced. Once you and he are satisfied that your lower jaw is in the best position to treat your problem(s), then he'll refer you back to the sleep specialist for a follow-up sleep study to confirm the effectiveness of your appliance therapy.