Experts assert to effectively treat patients, dentists should be aware of chronic conditions that impact overall health. Often, this requires dentists to be prepared to diagnose these conditions themselves.1 In particular, obstructive sleep apnea (OSA) represents a nexus of underdiagnosed disease that compromises overall health and directly relates to dental care.2 As such, dentists could incorporate diagnostic tools like home sleep apnea tests (HSATs) into their practice to improve how patients with this condition can access and experience treatment. And because sleep apnea is a key risk factor for cardiovascular disease and other chronic conditions, OSA screening is a great way for dentists to elevate their role in patients’ overall healthcare.2
How Dentists Can Play a Key Role in Patients’ Overall Health
Due to their knowledge of oral cavity and craniofacial structures, studies say dentists occupy a uniquely qualified position to screen patients for anatomical signs and physiological symptoms of OSA.1,2 Using a combination of clinical examinations and home sleep apnea tests, dentists could potentially recognize the visible signs of undiagnosed OSA as described by the American Dental Association that other health professionals may not have the opportunity to uncover.
Dentists’ involvement in OSA treatment has been shown to deliver improved long-term outcomes and patient satisfaction when compared to medical care alone, through patient education, regular oral examinations, and oral fittings for oral appliances that treat sleep apnea.2,4,5
The Link Between Sleep Apnea and Dental Care
Despite OSA’s disruptive nature, patients may only perceive their symptoms as simple restless sleep, snoring, or daytime drowsiness without a specific cause2. Obstructive sleep apnea is particularly relevant to dental care because of its inherent involvement in oral health and anatomy. Many of the signs and symptoms that potentially indicate an OSA case can be observed while conducting a patient history or a bi-annual oral exam during dental care, including2:
- Bruxism
- Scalloped tongue
- Retrognathia
- Large tonsils
- Retrusive jaw
- Large neck circumference
After taking a clinical exam and administering relevant questionnaires, dentists can provide patients with home sleep tests to put them on a path to confirm a diagnosis of obstructive sleep apnea and show patients whether they are experiencing more than a simple poor night’s rest.2 Home sleep tests like the WatchPAT® One device serve to help a dentist incorporate this additional business stream into their practice very easily, for the dentists themselves, additional staff, and their patients, for whom lab sleep studies may seem a burden.
Dentists Can Act as a Supplement to Medical Care
Left untreated, obstructive sleep apnea poses danger to both patients’ quality and quantity of life. Studies clearly show systemic illnesses like cardiovascular disease and hypertension directly impact oral health, and vice versa, so dentists could consider equipping their practices with appropriate tools to identify dangerous conditions like OSA. Home sleep apnea tests are a useful diagnostic tool that are a cost-effective way to assess potential OSA in patients exhibiting typical symptoms.
By adopting effective, convenient tools for OSA screenings into their practice, such as a home sleep tests, dentists can refer and treat previously undiagnosed patients early and accurately. This allows patients to receive sleep apnea care that integrates dental expertise when needed.4 Gathering information through clinical exams, sleep apnea devices, and patient questionnaires, dentists are able to fill the role of “oral physicians,” to the benefit of the health of the patient and the community.3
Dental OSA Screenings Improve Long-term Outcomes and Patient Satisfaction
When operating in the role of “oral physician,” dentists have two distinct advantages regarding primary healthcare screenings:
- Dentists likely see patients more often, as patients are used to making and keeping dental appointments twice a year.1
- Patients with diagnosed OSA largely prefer oral appliance therapy (which dentists can custom fit for patients) over traditional CPAP therapy.5
Dentists who screen patients for OSA with home sleep apnea tests will be involved in treatment of the condition from the start. Working in conjunction with patients’ medical care teams, dentists can be called upon to provide properly fitted sleep apnea devices that patients prefer over positive airway pressure (PAP) machines.
CPAP Therapy vs. Custom-Fit Oral Appliances
As many as 50% of patients prescribed CPAP therapy either fail to fulfill their prescription or stop treatment before indicating, primarily because of mask discomfort.4 In addition to mask discomfort, OSA patients may also experience oral dryness and nasal congestion.
These side effects contribute to poor patient adherence and satisfaction with OSA treatment, which is why dentists can make a significant difference in patients’ long-term health. Without consistent treatment, patients with OSA will struggle with chronic exhaustion, poor attentiveness, lowered productivity, and anxiety.4
In contrast, oral appliance therapy often results in greater treatment adherence and success among patients with mild to moderate OSA. For those who struggle with the discomfort of CPAP therapy, their dentists can custom-fit oral appliances that are much easier to sleep with comfortably.2,5
Conclusion
As a result of their specialized expertise, dentists provide a convenient and logical avenue to identify obstructive sleep apnea in patients.1 Unlike other healthcare professionals, dentists are more likely to see patients for frequent follow-up visits, which makes them an accessible source for primary care screenings patients may not otherwise receive.3
In addition to the above advantages that dentists have in being the one to make a difference in a OSA patient’s life, WatchPAT® One, the only fully disposable home sleep apnea test, can integrate into dental practices seamlessly with little to no investment. By monitoring OSA patients and remaining involved in their care, dentists can elevate their role in collaborative healthcare that puts patient health first.
References:
- Lavanya R, Gandhi Babu DB, Chavva S, Boringi M, Waghray S, Yeladandi M. The role of oral physicians in predicting the risk of obstructive sleep apnea: A case-control study. Imaging Sci Dent. 2016 Sep;46(3):167-171. https://doi.org/10.5624/isd.2016.46.3.167
- Oral health topic – Sleep apnea (obstructive). American Dental Association. https://www.ada.org/en/member-center/oral-health-topics/sleep-apnea-obstructive
- Gambhir RS. Primary care in dentistry – an untapped potential. J Family Med Prim Care. 2015;4(1):13-18. https://doi.org/10.4103/2249-4863.152239
- Knight V. I’m a CPAP Dropout: Why Many Lose Sleep Over Apnea Treatment. Khn.org. https://khn.org/news/im-a-cpap-dropout-why-many-lose-sleep-over-apnea-treatment/. Published July 17, 2019. Accessed February 2, 2021.
- Callender E. Treatments for Obstructive Sleep Apnea. Sleepfoundation.org. https://www.sleepfoundation.org/sleep-apnea/obstructive-sleep-apnea/treatments. Updated September 4, 2020. Accessed February 2, 2021.