Sleep Dentistry
An easy-to-incorporate service with a big impact
According to an article published in the January 2009 issue of Sleep Medicine, 20% of US adults have obstructive sleep apnea (OSA), and 90% of these people are undiagnosed. This is a staggering number of people that need help.
Aside from the obvious problems associated with constantly being tired (eg, difficulty concentrating, falling asleep while driving, mental fatigue, snoring), there are also significant medical issues (eg, high blood pressure, diabetes, stroke, gastric reflex, ED) that can be directly linked to the presence of OSA. Extrapolating the OSA statistics, a dental practice with 2000 active patients would have an estimated 360 patients with undiagnosed OSA.
Although dentists have been involved in the treatment of OSA for many years, it has been limited to a very small segment of the practicing dental population. However, in the past 5 to 7 years, there has been a dramatic increase in the awareness among dentists that OSA is a significant health concern and that dentistry, as a profession, is in a position to identify and help treat patients with this serious health disorder.
Lately, OSA has gotten much more exposure in the dental literature, largely focusing on how dentists can contribute to treating this silent epidemic that affects so many of our patients. We have seen an explosion in continuing education opportunities designed to help dentists learn more about this disease, it’s treatments, and how we can begin to provide help. In addition, the American Academy of Dental Sleep Medicine (AADSM) and the Academy of Clinical Sleep Disorders Disciplines (ACSDD) have seen a dramatic increase in memberships and meeting attendance—just another indication of the interest within our profession to learn more.
Using proven screening tools (eg, Epworth, Berlin, STOP-Bang), it is easy to incorporate surveys into our dental/medical histories to help identify patients who are at risk. The nature of dentistry puts us in the perfect position to evaluate the anatomical structures that affect a patient’s risk of developing OSA. By increasing our awareness and knowledge of the condition, we can improve and change the lives of 20% of our patients with little to no increase in chair time.
If you found out there was a disease in another area of dentistry that was affecting 20% of your patients, and you could identify and treat it with minimal education and training, wouldn’t you do so? What if you also found out that with treatment these patients would live an average of 12 years longer? What healthcare professional could pass up on that opportunity? This is exactly where we are with OSA in dentistry.
As with any new type of dentistry that you would consider bringing into your practice and service offerings, education is key and critical. Because of the recent awareness raised by the professional journals, as well as by the general public, there are now numerous continuing education opportunities available. Identifying and treating patients requires learning more about the disease as well as how to work with our physician counterparts to deliver comprehensive care. The technical skills involved are minimal, but the diagnostic elements necessitate study.
The AADSM, ACSDD, and other dental professional organizations provide support for dentists as they are beginning to learn how to provide care for OSA patients. And for those with deeper interest and commitment, these organizations offer certification processes to validate their knowledge, experience, and competence.
Although trends indicate that dental spending is leveling off throughout the United States, many dentists are looking for the opportunity to add new services to their practices that can help their patients while at the same time increase their production. For the general dentist to add orthodontics, endodontics, or implant placement to his or her services, extensive academic education, very specific technical and clinical skills, and frequently, the purchase of new equipment or technologies is required. The addition of dental sleep medicine to a practice still requires academic study, but the technical chairside skills are easily learned, and minimal new equipment is required. This makes the incorporation of dental sleep medicine easier and faster to add to a list of services.
The growing awareness of and increased educational opportunities in dental sleep medicine make its adoption an easy and timely decision. By including screening, education, assistance, and treatment for patients who may suffer from OSA, dentists can provide more comprehensive and complete care for their patients, while adding a needed and new service to their practice.
About the Author
Gary M. Radz, DDS, maintains a private practice in downtown Denver, Colorado. He is a faculty member at the University of Colorado School of Dental Medicine, a founding member of the Catapult Group, and the Director of Industry Relations with SmileSource.
