Dive Deeper into Dental Sleep Medicine

That long stretch at the end of the day feels great! And, what you might look forward to the most is sitting back, relaxing and finally getting some rest. However, not everyone can say the same thing. While we all want rest and relaxation, some people often wake up feeling even more tired than when they went to bed. And that is never a good thing.

This means the person is most likely suffering from a sleep disordered breathing condition like obstructive sleep apnea or a form of it. When this occurs, most people don’t even realize it unless their bed partner says something. And, even when they are aware, many people don’t seek treatment for their condition. To help patients get the care they need, dentists should provide dental sleep medicine in their practices. Let’s take a closer look at what dental sleep medicine is in comparison to periodontology:

What is Dental Sleep Medicine (DSM)?

DSM is an area of dentistry focusing on the use of oral appliance therapy to manage sleep-disordered breathing, which includes snoring and obstructive sleep apnea (OSA). Dentists pioneered the use of oral appliance therapy for the treatment of OSA and snoring. The use of an oral appliance allows for a more comfortable treatment option for many patients that might be CPAP inept. It is similar to a mouth guard for sports or an orthodontic retainer, which makes for an easier solution to a condition. A custom-fit oral sleep appliance is an effective treatment for preventing the airway from collapsing by supporting the jaw in a forward position. An easy solution for a complicated condition. And, with the help of a sleep physician, you can receive proper diagnosis in order to properly treat your patient.

What is Periodontology?

Periodontology is a dental specialty that involves the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes. It is also the maintenance of the health, function and esthetics of these structures and tissues. In other words, a periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease, as well as the placement of dental implants.

A Difference in Approach

While periodontology focuses on prevention, diagnosis and treatment, so does dental sleep medicine. However, dental sleep medicine dentists don’t do the diagnosing. Instead, dental sleep medicine dentists work with sleep physicians to gain a diagnosis after they might have noticed symptoms or signs of sleep disordered breathing or a patient’s responses to a questionnaire showed a possibility of this condition. From a diagnosis through a sleep physician, dentists can plan for proper treatment with oral appliance therapy.

A Joint Effort

Research has shown that periodontal disease is associated with several other systemic diseases. It has always been thought that bacteria were the factor linking periodontal disease to other diseases, but, more recently, research has shown that inflammation may be the culprit. By treating inflammation, it may not only help to manage periodontal diseases, but also the management of other chronic inflammatory conditions, such as:

  • Diabetes
  • Heart Disease
  • High Blood Pressure
  • Acid Reflux

Similarly, sleep apnea affects the body in the same way.  From increased risk of cardiovascular disease to diabetes, comorbidities of sleep apnea are nothing to be ignored. By treating sleep apnea and periodontal disease, you can help your patients prevent further complications and systemic conditions.

Take a stand and help your patients receive the best care available. Remember, you’re often the first step toward a healthier life for your patients, so make sure you are aware of signs and symptoms.

How to Use Dr. Patel’s Educational Sleep Apnea Book

In March of 2015 I teamed up with Dr. Dillard to create Freedom from CPAP: Sleep Apnea Hurts, the Cure Doesn’t Have To. Together we wanted to educate dentists and other physicians on sleep apnea and the options available for treatment. If you haven’t picked up this educational book on sleep apnea, I highly suggest purchasing at least one copy now. And, if you have already purchased the book, now what?

With the availability of this educational book on sleep apnea, I want to help you help your patients receive the care they need through better understanding. Purchase the book for yourself or your entire dental office. By reading this book you can take the next steps toward a better understanding of sleep apnea and the treatment options available. Let’s take a look at a few ways you can use this educational book to help your patients and staff in the area of sleep apnea.

Educate Patients on Sleep Apnea

The main purpose of this sleep apnea book is to get your patients “in the know” about sleep apnea. We work to inform you and your patients on sleep apnea and what it is–because not everyone understands this often debilitating sleep disorder. By understanding sleep apnea, your patients can take proactive steps toward better health.

Whether you sell this book to your patient, or give it to them, allow your patient to read this book for further knowledge of sleep apnea and treatment options available. The goal of this book is to educate patients on what sleep apnea is and what treatment options, other than CPAP, are currently available for comfortable care.

Maintain an Informed Dental Team

Freedom from CPAP: Sleep Apnea Hurts, the Cure Doesn’t Have To can also be a beneficial tool for your office to read themselves while also sharing the information with patients. Supply this book for your team, or have them purchase the book to improve their knowledge and understanding of sleep apnea ($15 is a steal for a book these days!). While it is important for patients to understand this condition, it is even more important for your dental office to know sleep apnea, what it is and how to treat it. Knowledgeable staff members go a long way in helping with diagnosis and treatment of your patients.

Take charge of your office and your patients’ health by providing, “Freedom from CPAP: Sleep Apnea Hurts, the Cure Doesn’t Have To.” The more your patients and staff know, the better they are equipped to take the next steps in sleep apnea recognition and treatment. Click here to purchase Freedom from CPAP: Sleep Apnea Hurts, the Cure Doesn’t Have To.

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.