Obstructive slumber apnea (OSA) is characterized by a cessation of breathing during sleep, associated with the relaxation of the oropharyngeal muscles and the lingua collapsing connected the airway causing the idiosyncratic to temporarily halt breathing. This cessation of breathing is manifested by a assortment of behaviors specified arsenic snoring, choking, gasping, and waking from slumber aggregate times during the night, each of which forestall those with OSA from getting capable deep, restful, and restorative sleep.
OSA is overmuch much than an inconvenience for the afflicted idiosyncratic oregon their bedmate. OSA is linked to a plethora of systemic wellness risks specified arsenic an accrued hazard for benignant 2 diabetes, cardiovascular disease, obesity, and cancer.1-5
Daytime sleepiness, which is straight associated with OSA, has besides been linked with an expanding fig of postulation and wide transit accidents and fatalities.6-8
There’s besides been caller probe indicating determination mightiness beryllium an summation successful the severity of COVID-19 for those who person OSA. “Among patients with COVID, obstructive slumber apnea was associated with accrued hazard of hospitalization and astir treble the hazard of processing respiratory failure.”9
Teledentistry enhances slumber dentistry workflow
OSA is diagnosed by physicians done a slumber survey perfect for medical-dental integration and collaboration. Dental slumber medicine and teledentistry whitethorn seamlessly complement each different for the payment of patients and allied health-care practitioners alike. It is important to enactment that teledentistry is simply an enhancement to in-office dental slumber medicine attraction and not a replacement.
Dental slumber therapy: It's a mathematics problem
5 ways teledentistry tin amended the oral wellness system
A professional-grade teledentistry level expands the scope of dental slumber medicine providers, makes it easier to consult with aesculapian providers who measure and diagnose sleep-related breathing disorders, and improves convenience for patients. So wherever does teledentistry acceptable wrong the workflow of a dental slumber medicine practice? Here are 3 applications to consider.
Virtual screenings
It’s casual to behaviour the archetypal diligent screening for OSA via teledentistry. You tin reappraisal the patient’s aesculapian past and slumber surveys virtually. Surveys specified arsenic the Epworth Sleepiness Scale and the STOP-BANG questionnaire are commonly used. If the patient’s survey answers suggest that the diligent whitethorn beryllium astatine hazard for OSA, you tin notation the diligent to a slumber medicine doc for further evaluation.
Medical-dental collaboration
If you are offering dental slumber medicine services successful your practice, found adjacent moving relationships with section slumber medicine physicians who tin measure patients and diagnose sleep-related breathing disorders.
Utilizing teledentistry for virtual introductions, comanagement huddles, and collaborative attraction readying tin fortify those moving relationships with the physicians successful your community, arsenic good arsenic respective attraction teams.
Depending connected the physician’s preference, slumber studies whitethorn beryllium conducted astatine the patient’s location oregon successful a dedicated slumber lab. Traditionally, a slumber survey successful the laboratory is considered much accurate, but successful the COVID era, location slumber studies are getting to beryllium much fashionable among clinicians and patients alike.10
Virtual post-sleep study consultation
Teledentistry whitethorn beryllium utilized to behaviour virtual consultations with your referring slumber doc to sermon your communal patient’s aesculapian history, survey scores, airway radiographs, etc. You tin besides usage this virtual accidental to sermon continuous affirmative airway unit (CPAP) versus oral appliance attraction options. CPAP is inactive considered the golden standard, but much and much physicians are prescribing mandibular advancement devices for patients who cannot tolerate CPAPs for mild to mean OSA.11
After this virtual visit, you tin person the diligent docket an in-office sojourn to execute a broad oral valuation and caput and cervix exam, instrumentality due radiographs, instrumentality impressions, and wound registration to fabricate the oral appliance.
Mandibular advancement devices whitethorn origin immoderate broadside effects, specified arsenic occlusal changes, which is wherefore it is indispensable to found a continuous diligent monitoring protocol.
Conclusion
Dental slumber medicine and teledentistry are experiencing a parallel maturation trajectory. Teledentistry is not a substitute for in-office visits, but it tin complement a increasing slumber medicine practice.
Editor's note: This nonfiction appeared successful the November 2022 people variation of Dental Economics magazine. Dentists successful North America are eligible for a complimentary people subscription. Sign up here.
References
1. Campos-Rodriguez F, Martinez-Garcia MA, Martinez M, et al. Association betwixt obstructive slumber apnea and crab incidence successful a ample multicenter Spanish cohort. Am J Respir Crit Care Med. 2013;187(1):99-105. doi:10.1164/rccm.201209-1671OC
2. Dopp JM, Reichmuth KJ, Morgan BJ. Obstructive slumber apnea and hypertension: mechanisms, evaluation, and management. Curr Hypertens Rep. 2007;9(6):529-534. doi:10.1007/s11906-007-0095-2. PMID: 18367017.
3. Khattak HK, Hayat F, Pamboukian SV, Hahn HS, Schwartz BP, Stein PK. Obstructive slumber apnea successful bosom failure: reappraisal of prevalence, attraction with continuous affirmative airway pressure, and prognosis. Tex Heart Inst J. 2018;45(3):151-161. doi:10.14503/THIJ-15-5678
4. Little JW, Falace DA, Miller CS, Rhodus NL. Dental Management of the Medically Compromised Patient. Mosby; 2008.
5. Nagai M, Hoshide S, Kario K. Sleep duration arsenic a hazard origin for cardiovascular disease—a reappraisal of the caller literature. Curr Cardiol Rev. 2010;6(1):54-61. doi:10.2174/157340310790231635
6. Kalsi J, Tervo T, Bachour A, Partinen M. Sleep versus non-sleep-related fatal roadworthy accidents.Sleep Med. 2018;51:148-152. doi:10.1016/j.sleep.2018.04.017
7. Garbarino S, Durando P, Guglielmi O, et al. Sleep apnea, slumber indebtedness and daytime sleepiness are independently associated with roadworthy accidents. A cross-sectional survey connected motortruck drivers. PloS One. 2016;11(11):e0166262. doi:10.1371/journal.pone.0166262
8. Joseph E. Sleep apnea led to bushed engineers and 2 bid crashes, NTSB says. CNN. Updated February 6, 2018. https://www.cnn.com/2018/02/06/us/sleep-apnea-railroad-accidents/index.html
9. Maas MB, Kim M, Malkani RG, Abbott SM, Zee PC. Obstructive slumber apnea and hazard of COVID-19 infection, hospitalization and respiratory failure. Sleep Breath. 2021;25(2):1155-1157. doi:10.1007/s11325-020-02203-0
10. Peters B. What is simply a slumber survey (polysomnogram)? Verywell Health. Updated September 17, 2022. www.verywellhealth.com/what-to-expect-in-a-sleep-study-3015121
11. Sangalli L, Yanez-Regonesi F, Fernandez-Vial D, Martinez-Porras A, Moreno-Hay I. Comparison of 3 mandibular advancement instrumentality designs successful the absorption of obstructive slumber apnea: a retrospective study. J Dent Sleep Med. 2021;9(3). doi:10.15331/jdsm.7250
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