The Rise of Need For Dentists to Treat Obstructive Sleep Apnea
The need for dentists to take a greater role in the identification and treatment of obstructive sleep apnea (OSA) has never been higher; according to a Harvard health report approximately 25 million adults in the U.S. suffer from the condition and almost 19 million of them are undiagnosed. OSA is a condition that affects the airway and since dentists and dental hygienists see the airway of their dental patients every day, they can potentially be the first line of defense in the identification of OSA, a condition that leaves sufferers excessively tired and increases the chance of suffering from cardiovascular problems.
“Gary walked into the dental office, asked for Dianna, our hygienist, gave her a big hug and said, ‘You changed my life!’.
For many years, Gary would come in for a periodic dental prophylaxis, and as soon as the dental chair was reclined, he immediately fell asleep and started snoring. Dianna tried a few times to wake him, but she quickly realized it was useless. She continued to clean his teeth while he was sleeping.
Gary is 45 years old, in good health and in good shape. You would not expect him to be a severe sleep apnea patient, but he suffered from excessive daytime sleepiness. He felt he was sleeping his life away – not able to spend quality time with his family. His snoring had become so bad that he no longer slept in the bedroom with his wife.
Dianna showed Gary many of the anatomic indicators of sleep apnea while he was in the dental chair for his cleaning appointment. She reviewed his symptoms and saw that they were consistent with what she saw. Dianna informed Gary that he should see a sleep specialist and discuss if he is a candidate for a sleep test. He was tested with a sleep study and diagnosed with severe obstructive sleep apnea.
Gary was first recommended to use a CPAP machine but found he was not able to tolerate it. He was then referred for oral appliance therapy, which finally gave his energy and life back. The daytime sleepiness is gone, the snoring is gone and Gary is now back in the bedroom with his wife.
Recently our hygienists all took dental sleep medicine training and learned how to screen patients for the signs and symptoms of obstructive sleep apnea. As a dental hygienist with the awareness and training for screening for sleep apnea, Dianna has truly changed the lives of her patients. Now she consistently gets big hugs.”
Dr. Barry Chase, an expert sleep dentist with over 10 years’ experience in the field, shares the above true story from his practice.
Dentist’s Role in Treating OSA
There are over 100,000 dentists in the U.S., each seeing between eight and 15 patients per day. The American Dental Association states that 60% of the U.S. population sees a dentist every year, meaning that most dental practices will have several undiagnosed OSA sufferers walk through their doors on a daily basis. Dentists and dental hygienists are in a unique position to identify the intraoral indicators of OSA while assisting patients with other dental needs, and many already do in cases for oral cancer. The same can be applied for OSA. Even though the formal diagnosis of OSA should be made by sleep physicians, sleep dentists and hygienists can take the role of identifying, referring and, in many cases, treating OSA patients and help them get their lives – and health – back.
Identifying the Signs of OSA Among Your Patients
For dentists that are expanding into the field of sleep dentistry, step one to grow a sleep practice is to know how to detect the signs of OSA among the patients who come for dental treatment. In a normal intraoral cavity exam the dentist will need to keep an eye out for the following indicators: A large scalloped tongue
- Narrow maxillary and mandibular arches
- A narrow vaulted hard palate
- Class II retrognathic mandible
- Inability to see the posterior wall of the pharynx, and associated tissues
- A long soft palate hanging below the level of the posterior aspect of the tongue (Fig. 1 Mallampati score)
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