Long-term treatment for adolescents with TMJ pain

I want to take a moment to discuss a study I was looking at the other day. This study looked at the long-term treatment outcome for adolescents with temporomandibular joint (TMJ) pain. I find this interesting because it is a subject that doesn’t always get a lot of attention.

What the study says

In this study, their waim was to evaluate long-term, self-perceived outcomes in adulthood for individuals treated as adolescents for TMD. To find this they looked at two previous randomized controlled trials.

There were 116 participants with 81 percent female and were treated for frequent TMD pain in previous years. The treatment for these individuals consisted of an oral appliance or relaxation training. For those that participated, they answered a questionnaire based on their experience of “frequency and intensity of TMD pain impaired chewing capacity and daily social activities, help-seeking behavior and treatment, general health, other pain and depressive symptoms,” according to the study.

Older participants reported lower levels of frequency and intensity of TMD pain, impairment and depressive symptoms. They also reported better general health. Females, which were the majority of the participants, reported more frequent and more intense pain associated with the TMJ. They also reported greater impairment and more often reported other pain compared to males.

What did we learn from this?

From this study we understand that adolescents treated with oral appliance therapy showed a somewhat better sustained improvement over the extended follow-up period than those treated with relaxation therapy. This highlights the need to pay closer attention to these groups. By looking closer at this information we can extend or create different treatment plans to improve patient outcomes.

Keep an eye out for adolescent patients that might be experiencing TMJ pain and think about the long-term goals. By helping this patient population, we can better equip them for adulthood.

Patient adherence rate to sleep study referrals

Let’s talk about patient adherence. I think this is an area that we often overlook and really don’t pay too close attention to, but it is so important to better understand this. Patients become non-adherent for a variety of reasons and it is our job to make sure we know why this is happening so we can improve outcomes.

A study from 2017 looked at the facilitators and barriers to referral compliance among dental patients at risk for obstructive sleep apnea. The goal of this study was to determine the adherence rate to dentist referrals for sleep apnea evaluation. It also looked at the barriers and facilitators to referral compliance.

What the study found

Researchers looked at a sample of 1,099 patients that were given the STOP-Bang questionnaire. Based on the results from this questionnaire, those with elevated risk were referred for a sleep evaluation. After the referral, an interview was completed over the phone to determine if those patients followed through with the recommendation to determine compliance.

The study found that of the almost 1,100 patients screened, 224 (20 percent) were determined to be at-risk for obstructive sleep apnea. However, only 41 of those with an increased risk actually adhered to the referral recommendation. So only 18 percent actually followed through with what was recommended. That isn’t good.

It was found that the most common facilitators to compliance were increased awareness about OSA and dentist recommendation. The most common barriers to compliance were misconceptions about OSA and work responsibilities.

What can we do?

With only a small percentage of patients adherent to the recommendation of their dentist to see a sleep specialist, we need to do something. As dentists we should provide increased awareness about OSA, so that our patients better understand the importance of treatment for the improvement of their health and well-being. By providing better education, our patients can understand just how serious of a condition OSA really is. As far as work responsibilities go, we can look into home sleep testing and inform them that they can work with the sleep specialist to find the best solution.

Continue to educate your patients and staff so that you can not only improve your patients’ health but their adherence as well.

Now is the time to offer dental sleep medicine in your practice

With the release of a new hypertension guideline that includes advice on sleep apnea and new policy from the American Dental Association on obstructive sleep apnea screening for dentists, it is important to find ways to stand out from other practices. The first step in doing this is deciding to offer dental sleep medicine services. And if you are thinking about it now, you’re one step in the right direction!

Once you have decided to offer these services, you will need to complete continuing education courses and lectures to ensure you are able to provide your patients with proper care, as well as how to implement these services at your dental practice. To help you get going, here are some steps you can take to implement dental sleep medicine into your dental practice.

Complete continuing education

Once you have made the decision to offer dental sleep medicine services, it is important to start your education. This will help you to establish a practice that offers the best care possible.

Just as you completed dental school, you will need to do the same with dental sleep medicine. This will include lectures, seminars and shadowing and experienced dental sleep medicine specialist. No matter what, you are getting the experience and knowledge you need to provide superior care for your patients.

Maintain open communication

By integrating dental sleep medicine into your practice, it requires new behaviors and ways of adapting—especially through the words you use. Pay close attention to how you describe your service. Using the wrong words can deter patients away from your office and new services, so make sure you word your content appropriately. Everyone in your office should have a solid understanding of what dental sleep medicine is, who can benefit, how it works, and why it is so important.

And, with that comes being fluent in dental sleep medicine so that everyone can describe it to patients without hesitation. The future of dental sleep medicine is a bright one. With numerous opportunities to provide value through improved patient care, your options are endless, so take charge as soon as possible.

Remember, anything is possible and if you put your mind and energy into this, your practice has the opportunity to be extremely successful.

Let’s revisit dental sleep medicine and what it means for dentists

We’ve talked about this before, but I think it is time we revisit what dental sleep medicine is and how dentists can take advantage of this unique opportunity. So, what is dental sleep medicine (DSM) exactly?

DSM is an area of dentistry focusing on the use of oral appliance therapy to manage sleep-disordered breathing. And that includes snoring and obstructive sleep apnea (OSA). When providing dental sleep medicine services, dentists will work together with sleep specialists to help identify the best treatment option for each patient.

What is the dentist’s role?

Dentists pioneered the use of oral appliance therapy for the treatment of OSA and snoring–cool, right? 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.

Dental sleep medicine specialists 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.

Have you ever thought about providing your patients with dental sleep medicine services? Now is the time to get out there and gain a better understanding of this unique area of dentistry to help your patients live happy, healthy, well-rested lives.