Obstructive sleep apnea (OSA) is characterized by the cessation of breathing during sleep, associated with the relaxation of the oropharyngeal muscles and the drooping of the tongue on the airways causing a temporary cessation of breathing. This cessation of breathing manifests in a variety of behaviors such as snoring, choking, gasping, and waking from sleep multiple times throughout the night, all of which prevent people with OSA from getting enough deep sleep. , repairer and repairman.
OSA is much more than an inconvenience for the person affected or their bed companion. OSA is linked to a plethora of systemic health risks, such as an increased risk of type 2 diabetes, cardiovascular disease, obesity, and cancer.1-5
Daytime sleepiness, which is directly associated with OSA, has also been linked to an increasing number of traffic and transit accidents and fatalities.6-8
There has also been recent research indicating that there may be an increased severity of COVID-19 for those with OSA. “Among patients with COVID, obstructive sleep apnea was associated with an increased risk of hospitalization and approximately double the risk of developing respiratory failure.”9
Teledentistry improves sleep dentistry workflow
OSA is diagnosed by physicians through a sleep study ideal for integration and medical-dental collaboration. Sleep dentistry and teledentistry can complement each other perfectly for the benefit of patients and healthcare professionals. It is important to note that teledentistry is merely an enhancement to in-office dental sleep medicine treatment and not a replacement.
Dental sleep therapy: it’s a math problem
5 ways teledentistry can improve the oral health system
A professional-grade teledentistry platform expands the reach of dental sleep medicine providers, makes it easier to see medical providers who assess and diagnose sleep-related breathing disorders, and improves convenience for patients. So where does teledentistry fit into the workflow of a dental sleep medicine practice? Here are three apps to consider.
Virtual screenings
It is easy to perform the initial screening of the patient for OSA via teledentistry. You can virtually view the patient’s medical history and sleep surveys. Surveys such as the Epworth Sleepiness Scale and the STOP-BANG Questionnaire are commonly used. If the patient’s survey responses suggest the patient may be at risk for OSA, you may refer the patient to a sleep physician for further evaluation.
Medical-dental collaboration
If you offer dental sleep medicine services in your practice, establish close working relationships with local sleep doctors who can assess patients and diagnose sleep-related breathing disorders.
Using teledentistry for virtual presentations, co-management meetings, and collaborative treatment planning can strengthen these working relationships with physicians in your community, as well as the respective care teams.
Depending on the physician’s preference, sleep studies can be conducted in the patient’s home or in a dedicated sleep laboratory. Traditionally, a lab-based sleep study is considered more accurate, but in the age of COVID, home sleep studies are becoming increasingly popular among clinicians and patients.ten
Post-Sleep Study Virtual Consultation
Teledentistry can be used to conduct virtual consultations with your referring sleep physician to discuss your mutual patient’s medical history, investigation results, respiratory x-rays, etc. You can also use this virtual opportunity to discuss continuous positive airway pressure (CPAP) versus oral appliance treatment options. CPAP is still considered the gold standard, but more and more doctors are prescribing mandibular advancement devices for patients who cannot tolerate CPAPs for mild to moderate OSAS.11
After this virtual visit, you can have the patient schedule an office visit to perform a full oral assessment and head and neck exam, take appropriate x-rays, take impressions and register the bite to fabricate the device. oral.
Mandibular advancement devices can cause certain side effects, such as occlusal changes, which is why it is essential to establish a protocol for ongoing patient monitoring.
Conclusion
Sleep dentistry and teledentistry are on a parallel growth trajectory. Teledentistry does not replace office visits, but it can complement a growing sleep medicine practice.
Editor’s note: This article originally appeared in the November 2022 print edition of Dental economy magazine. Dentists in North America can take advantage of a free print subscription. Register here.
References
1. Campos-Rodriguez F, Martinez-Garcia MA, Martinez M, et al. Association between obstructive sleep apnea and cancer incidence in a large 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 sleep 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 sleep apnea in heart failure: review of prevalence, continuous positive airway pressure therapy and prognosis. Tex Heart Inst J. 2018;45(3):151-161. doi:10.14503/THIJ-15-5678
4. Little JW, Falace DA, Miller CS, Rhodes NL. Dental care of the medically compromised patient. Mosby; 2008.
5. Nagai M, Hoshide S, Kario K. Sleep duration as a risk factor for cardiovascular disease – a review of recent literature. Curr Cardiol Rev. 2010;6(1):54-61. doi:10.2174/157340310790231635
6. Kalsi J, Tervo T, Bachour A, Partinen M. Sleep in relation to non-sleep related fatal road accidents.Medical Sleep. 2018;51:148-152. doi:10.1016/j.sleep.2018.04.017
7. Garbarino S, Durando P, Guglielmi O, et al. Sleep apnea, sleep debt and daytime sleepiness are independently associated with road crashes. A cross-sectional study on truck drivers. PloS One. 2016;11(11):e0166262. doi:10.1371/journal.pone.0166262
8. Joseph E. Sleep apnea led to engineer fatigue and 2 train crashes, according to the NTSB. 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 sleep apnea and the risk of COVID-19 infection, hospitalization and respiratory failure. breath of sleep. 2021;25(2):1155-1157. doi:10.1007/s11325-020-02203-0
10. Peters B. What is a sleep study (polysomnogram)? Very good 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 three designs of mandibular advancement devices in the management of obstructive sleep apnea: a study retrospective. J Dent Medical Sleep. 2021;9(3). doi:10.15331/jdsm.7250
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