John Sarno DMD
This article first appeared in the newsletter, DE’s Breakthrough Clinical with Stacey Simmons, DDS .
As a dental sleep medication practitioner, my collaboration with sleep physicians allows me to provide the highest quality of care for patients who may not otherwise treat their obstructive sleep apnea( OSA ). It is estimated that approximately 25 million Americans suffer from OSA, and up to half of treated patients don’t adhere to continuous positive airway pressure( CPAP) therapy–leaving a significant therapy gap. Qualified dentists are uniquely positioned to work alongside sleep physicians to help shut this gap.
Teamwork between dentists and sleep physicians when offering oral gadget therapy is essential because OSA is a medical disorder. As dentists, the moment we broach the subject of sleep apnea with our patients, we are entering a medical surrounding filled with diagnosis requirements, medical insurance billing, potential medical liabilities, and more. Dental sleep medication is an exciting realm to be employed in and a vital service that dentists can provide, but it needs to be coordinated in tandem with a medical counterpart to be truly impactful. Additionally, the dentist must be prepared through education to use the proper protocols in order to be a valued part of a medical team.
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The interdisciplinary approach for oral gadget therapy be compatible with research and has been reaffirmed by successful patient outcomes for years. In this model, the physician is principally in charge of the patient’s medical evaluation, diagnosis, and longer-term management, while the dentist plays a necessary and collaborative part of the therapy team.
There are two primary roles a dentist can play in helping address the growing outbreak of untreated sleep apnea in our society, each requiring a different level of education, skill, and involvement :
1. Identify at-risk patients : Dentists can and should be on the front line to identify patients with potential sleep apnea and sleep-disordered breathing. Because we realize patients routinely, dentists are well-positioned to pinpoint those who are at risk for OSA and refer them to a knowledgeable sleep physician for a consultation and possible diagnosis.
2. Treat with oral gadget therapy : Once a patient has been diagnosed by a board-certified physician, dentists who are competent in dental sleep medication can then treat individual patients with oral gadget therapy. Continued communications and teamwork between sleep physicians and dentists during follow-up visits are imperative to confirm efficacy and increase therapy success.
Without collaborative relationships with physicians, dentists’ efforts to provide an acceptable standard of care are compromised. For example, to fit an oral gadget without a proper medical evaluation commits patients a false sense of diagnosis, deterring them from pursuing a comprehensive quiz with a licensed physician. This seemingly innocuous action has the potential to increase patients’ vulnerability to the adverse health effects and comorbidities of OSA.
Indicative of the necessary collaboration between qualified dentists and physicians, the American Academy of Dental Sleep Medicine( AADSM) and the American Academy of Sleep Medicine( AASM) released the first official joint guideline on oral gadget therapy in July 2015. The six evidence-based recommendations in the guideline elucidate the individual roles of the dentist and sleep physician to ensure an effective working relationship. This relationship involves collaboration from the beginning so that patients understand the process of diagnosis, therapy options, and the roles of their care providers. By accentuating the vital importance of this physician-dentist squad, the AADSM-AASM guideline establishes oral gadget therapy as a patient-focused solution that necessitates a multidisciplinary approach to successfully treat the growing OSA epidemic.
Partnerships between qualified dentists and physicians are not simply key for optimal patient care; they also increase the breadth of a dentist’s dental sleep medication practice. Many dentists–myself included–have been so successful with providing oral gadget therapy that it is now the sole service of their practice, allowing their business to grow and reach exponentially more sleep apnea patients in need of treatment.
Sleep physicians want to work with dentists who are educated about OSA and who understand the value of teamwork. I often hear complaints from physicians that they cannot find a local dentist who is qualified in the comprehensive therapy of OSA. To be an outstanding dental sleep medication practitioner, you must network and ensure that your abilities are known within the medical community. Ultimately–for the best medical interests of patients–the dental sleep medication model relies on a collaborative, referral-based concerning the relationship between a sleep physician and a dentist.