Is CBCT the Way for Identifying Sleep Apnics?

Recently there has been a push for manufacturers to inform dentists that they can find patients that may be at risk for sleep apnea by using the cone beam computed tomography (CBCT). While the CBCT can be used to properly diagnose a patient’s temporomandiublar joint (TMJ) disorder, it can cause missing factors in a sleep breathing disorder diagnosis. Manufacturers are pushing CBCT for a diagnostic tool, but my fear is that dentists will then miss many patients who might have issues because the imaging might show adequate airway size and patients may not be questioned further to determine that a potential issue may exist. Patients should be protected and while the CBCT is a great tool, we need to provide further options to properly identify our patients.


The use of the cone-beam computed tomography (CBCT) of the maxillofacial region has quickly created a revolution in all fields of dentistry. It has expanded the role of imaging from diagnosis to image guidance for many procedures. It has also eliminated some of the inherent limitations we have long since experienced with 2D images such as magnification, distortion, superimposition and misrepresentations.

By utilizing CBCT imaging, clinicians receive sub-millimeter spatial resolution images of high diagnostic quality with relatively short scanning times (10-70 seconds) and a reported radiation dose equivalent to that needed for 4 to 15 panoramic radiographs. CBCT imaging is ideal for the evaluation of fractures, degenerative changes, erosions, infection, airway volume, sinus, nasal passages and various other pathologies or abnormalities.

Missing Part for Airway

While CBCT can be a proper tool to help support our findings in TMD patients and evaluation of the airway, it is still lacking in one area. A risk factor of sleep apnea is a small neck or airway, tongue larger than the space it occupies, vaulted palate, etc. When this is the case, it is important to get screened and tested for sleep apnea or any other form of a sleep related breathing disorder.

However, the use of CBCT imaging may miss people with large airway volume but yet have sleep apnea based on various other factors. As dentists and physicians, we need to be aware of this. While we can use CBCT in our practice, we need to still utilize clinical judgment and an understanding that various other conditions may also contribute to sleep breathing disorders independent of a small airway.

Let’s take a stand for our patients to ensure we are properly treating their symptoms by testing for all symptoms. Contact my office today to learn more about CBCT and ways we can ensure our patients are being treated properly.

4 Day Sleep Course with AACP in San Diego

Hurry! Hurry! Are you ready for a 4-day sleep course with the American Academy of Craniofacial Pain (AACP) in San Diego? I know I am! What better way to learn about dental sleep medicine than on a trip to sunny California! While it won’t be all fun in the sun (we need to learn a lot in these short 4-days, too) I can ensure you that you will leave this mini-residency with more pep in your step because you will be ready to keep pushing through dental sleep medicine and the services available for your patients. Let’s take a look at what to expect in this 4-day sleep course with the AACP in San Diego September 28 – October 1, 2016.

Come Ready to Learn

Yes, this is a 4-day weekend course in sunny San Diego! In this sleep course with the AACP there will be lectures, hands-on workshops and case studies. By completing this mini-seminar you will receive approximately 38 CE credits, but hurry because enrollment is strictly limited to only 25 students!

In this mini-seminar you will pick up the knowledge and clinical skills required to assess and differentially diagnose commonly encountered temporomandibular disorders seen in a dental practice that might impact the success of treatment for a patient with a sleep breathing disorder, such as sleep apnea. You will also gain advanced medical and dental training to successfully treat patients. While learning these specific areas, you will also make progress toward fulfilling AACP fellowship and AGD Mastership requirements. Now that sounds like a win-win to me, doesn’t it?!

Training is provided by both dentists and physicians to increase the scope of understanding, as well as fostering the importance of a team approach to ensure the highest level of patient care possible. Remember, space is limited to only 25 students, so sign up now before it is too late! I hope to see many of you there! If not, please visit my lectures page for more continuing education opportunities. 

Dentists Remain in a Unique Position to Screen for Sleep Breathing Disorders

When it comes to dentistry, dentists and hygienists are trained to evaluate the entire patient–not just the oral cavity. Because of this those in the dental field become increasingly important in the diagnosis of sleep breathing disorders, such as sleep apnea. Even with dentists seeing their patients at least twice a year, they can recognize traits, characteristics and behaviors that predispose patients to a variety of systemic conditions, including sleep disorders.

A dental appointment allows dentists to properly screen for various signs that might signal a sleep breathing disorder. Various tools used regularly by dentists can significantly improve the diagnosis of sleep breathing disorders because they are able to screen and refer suspect patients to their physician for further diagnosis and treatment. Screening tools can be utilized during the dental hygiene appointment to properly identify patients that are at risk of sleep breathing disorders, such as:

  • Completing a simple questionnaire
  • Visual intraoral assessment

These two screening options help dentists to successfully identify patients who are at risk for sleep breathing disorders, or those who may already suffer from them.

The biggest role dentists have in this area is the opportunity to co-treat the condition with the patient’s physician using oral appliance therapy, oral surgical procedures, or even orthodontic approaches. Through these dental approaches, you can address increasing the volume of the upper airway primarily by bringing the tongue forward away from the throat.

Necessity of Continuing Education

With advanced research, there has been mounting evidence that with both the oral appliance therapy and surgical, hard tissue approaches, dentists can successfully treat patients suffering from sleep breathing disorders. For this reason, it is more important than ever for dentists to complete continuing education courses to better understand diagnosis and treatment options for this unique field.

As Dental Sleep Medicine continues to gain popularity in the dental field, dentists are in a unique advantage because of the current availability of these ongoing continuing educational opportunities. Dentists can easily find credited classes to help them advance their knowledge of Dental Sleep Medicine from various accredited programs providing seminars and lectures.

As an expert in Dental Sleep Medicine I currently offer consulting services, and I also lead lectures to further improve the knowledge of dentists and their dental teams. I will work with you and your team to help everyone better understand sleep breathing disorders and how to prepare your office for these patients. With the ever-growing availability of continuing education courses, dentists are at a unique advantage to constantly improve their knowledge while further expanding your dental practice with advanced services, including Dental Sleep Medicine.

Most patients show signs & symptoms of sleep breathing disorders before they are formally diagnosed. As a dentist you hold a unique advantage by being able to identify symptoms early on. From proper screening tools to co-treatments and continuing education, dentists can improve patients’ oral and overall health through dental visits and better understanding sleep breathing disorders.