What is the burden of sleep apnea?

It is estimated that more than 18 million Americans suffer from sleep apnea. Sleep loss and sleep apnea affect an individual’s performance, safety and quality of life. Almost 20 percent of all serious car crash injuries in the general population are associated with sleepy drivers, independent of alcohol impact. Sleep loss and sleep disorders can also play a large role on the economy. This adds to the burden of sleep apnea. When we take a look at the high estimated costs to society if sleep apnea is left untreated, it costs far more than what would be incurred by delivering adequate treatments.

Hundreds of billions of dollars are spent on direct medical costs associated with doctor visits, hospital services, prescriptions and over-the-counter drugs. When compared to healthy individuals, those who suffer from sleep loss and sleep disorders are less productive. These individuals also experience an increased healthcare utilization and an increased likelihood of accidents.

The Effects of Untreated Sleep Apnea

Despite clear signs and symptoms, many patients with obstructive sleep apnea (OSA) go undiagnosed. In return, patients who finally get diagnosed with OSA might have had obvious symptoms of the disorder for an average of seven years. During those seven years, patients report visiting their family physician about 17 times and a sub-specialist about nine times. With repeated visits, these patients are not receiving the treatment they need to lead healthy, happy lives.

Patients can also experience a number of health conditions associated with untreated sleep apnea, including:

  • High Blood Pressure
  • Heart Disease
  • Type 2 Diabetes
  • Acid Reflux
  • Obesity

With these negative effects of untreated sleep apnea, it is vital that we as dentists take charge of our services so that we can offer patients the best care possible—and that includes adding specialty practices in the area of dental sleep medicine.

Get Involved in Screening for Dental Sleep Medicine and Craniofacial Pain Services

With the year almost over, we need to re-evaluate our roles and practices. As the remaining months unfold and you begin to think ahead to the new year, let’s look at ways you can continue to improve your practice and the services offered. Think about screening for dental sleep medicine (sleep apnea) and Craniofacial Pain–have you ever thought about these areas?

It is estimated that more than 18 million Americans suffer from sleep apnea and 45 million from craniofacial pain. Both sleep apnea and craniofacial pain have been proven to need the expertise of a dentist to help in the screening process. Let’s change our patients’ perceptions on dental care and help them get a better night’s sleep, as well as eliminating pain, by screening for these advanced conditions.

What You Can Do

The first step is to train your staff in what sleep apnea and craniofacial pain are. By informing your staff about signs and symptoms, you can begin to get your office involved in screening. You have several opportunities to identify prospective patients and screening opportunities for advanced diagnosis and care with help from your local dental sleep medicine specialist and sleep physician:

  1. Place educational material, such as posters or brochures, in your waiting room and hygiene rooms. These are great areas for developing verbal dialogue about sleep apnea and craniofacial pain.  
  2. Ask simple questions about their daily health and complications, as well as utilizing the epworth sleepiness scale. These options help in screening.
  3. Every office requires paperwork to be filled out, so why not ask a few extra questions to get the conversation going? Ask about pain, headaches and sleep complications–it only takes a moment.
  4. Review the health questionnaire–it may suggest potential undiagnosed conditions. An example would be a patient with uncontrolled diabetes, A-Fib, GERD, obesity, history of stroke and so on. These conditions may lead you to pushing for your patients to go get diagnosed for a unsuspected SDB.
  5. The exam itself will help you understand signs and symptoms the patient might be having. This is also a great time to create dialogue about the patient’s experience with fatigue, headaches and other complications.

You might have more information then you can digest, but, frankly, we were all once in the same position with information overload. Start by role playing during lunch and understand the flow it will take in screening, discussing, referring and following up with patients that you suspect have sleep apnea, craniofacial pain or other conditions.

Screen each of your patients and, if suspected, refer out for further analysis and diagnosis from an experienced physician. Let’s help our patients overcome further complications with sleep apnea and craniofacial pain by screening each patient and sending out for referral.

Dental sleep medicine: Work with the Medical Community

Sleep Apnea is a medical condition, which means it is important to include a medical professional in the treatment process for dental sleep medicine services. While dentists can treat obstructive sleep apnea, we cannot diagnose it ourselves. What we can do is ask questions and pay attention to symptoms.

Beyond that we need a sleep physician to help us in the diagnosis process through a sleep study. Through a working relationship with a sleep physician, you can send patients for diagnosis while also receiving patients for treatment with oral appliance therapy if they become CPAP intolerant.

The solution is you

At the end of the day, there is an easier solution: You, the dentist. By completing continuing education to advance your services to include sleep apnea care, you can save patients time and money spent on figuring out what might be the problem. Most patients are treated with oral appliance therapy as the leading form of treatment for sleep apnea due to their convenience and ease of use. As a dentist, you can offer your patients oral appliances to ensure accuracy and provide the best results.

Take charge of your practice and help your patients get a better night’s sleep while also improving their overall health and well-being by screening for sleep apnea. At the end of the day, if you’re not saving your patient’s life through sleep apnea screening, then who is?

The future of dental sleep medicine is bright. With numerous opportunities to provide value through improved patient care, your options are endless, so take charge as soon as possible and start screening your patients for sleep apnea.

The ABCs of Advanced Dentistry: Airway, Bruxism and Craniofacial Pain

It has become increasingly clear that there is a link between sleep apnea (airway), bruxism and craniofacial pain, in some patients and dentists should be knowledgeable in all three areas. Most dentists are not knowledgeable or well-versed in dental sleep medicine, etiologies of bruxism or craniofacial pain conditions. For this reason many dentists are unable to recognize the risk of sleep apnea, let alone manage patients with oral appliances.

The same goes for craniofacial pain and bruxism. While bruxism is often more noticeable, it is often overlooked. By understanding the unique connections between the airway, bruxism, craniofacial pain and other conditions, dentists can open their practice to more services for diagnosis and treatment options for their patients. Here are the ABCs of advanced dentistry are Airway, Bruxism and Craniofacial Pain.

Airway (Sleep Apnea)

Dental practices are in a unique position to identify patients at risk for conditions involving the airway, such as sleep disordered breathing (SDB). There are many levels of diagnosis a patient may receive once testing has been completed to evaluate a suspect compromised airway, which is where continuing education comes into play. Understanding the airway and how it can affect a patient’s sleeping patterns due to sleep apnea and other sleep disordered breathing conditions is vital in maintaining your patients’ health and improving service offerings.

Bruxism

The gnashing and grinding of the teeth that occurs without a functional purpose is called Bruxism, which can cause a lot of problems for our patients. Whether a patient has a nervous habit, is experiencing stress or is unknowingly grinding their teeth at night, bruxism can cause a lot of damage to not only their teeth, but their overall health as well. Due to the breakage of dental restorations, tooth damage, induction of temporal headaches and temporomandibular joint disorders (TMD) can occur.

Craniofacial Pain (TMD)

And now it comes full circle with craniofacial pain. Covering a wide spectrum of symptoms, Craniofacial pain can be exhibited in many areas of the head and neck. In particular, a majority of craniofacial pain complications can be associated with temporomandibular joint disorder (TMD). Because of this, an essential part of routine dental examinations for all patients should include evaluation for TMD. This includes the gold standard for the diagnosis of TMD, which is based on history, clinical examination, and imaging when appropriate.

There appears to be a relationship apparent in some individuals between the airway, bruxism and craniofacial pain. While it is not found in every patient, there still remain some individuals that require further attention because the connection seems apparent. As a dentist, it is important to understand that clenching or grinding of one’s teeth can be a way for the brain to protect itself from suffocation during sleep.

Each condition can be a sign for a deeper problem, but what do you do about it? Educate yourself. The more you know, the more you can help your patients if this apparent connection arises in various cases. And, while it might not occur in every case, it is vital that we understand it for those certain individuals suffering from all three conditions.