Our school curriculum covers a range of techniques we will use to address patient concerns throughout our careers. But, did you know that many of us are not properly taught how to address a significant medical condition that affects about 18 million people across the nation?
Sleep apnea is a chronic medical condition characterized by a cycle of airway collapse and sleep disruption. According to the American Academy of Sleep Medicine, this condition has increased in prevalence in the last 20 years alone. In fact, approximately 26% of adults between ages 30 and 70 in the United States suffer from sleep apnea.
There are currently three main types of sleep apnea: obstructive sleep apnea, central sleep apnea, and complex sleep apnea syndrome. All three types share some common signs, such as snoring, gasping or choking during sleep, memory loss, depression and excessive daytime sleepiness (called hypersomnia). In fact, hypersomnia from undiagnosed sleep apnea has been a cause of several major plane, train and car accidents. Without chronic management, these symptoms can lead to long-term consequences such as hypertension, stroke, diabetes or cardiovascular disease.
Diagnosis of this condition is performed using a sleep study called a polysomnography. Patients diagnosed with obstructive sleep apnea, the most common type, are either prescribed a continuous positive airway pressure (CPAP) machine or a custom-made oral appliance, depending on the severity of their condition. While CPAP therapy is reserved for severe cases, an oral appliance is usually prescribed for mild to moderate cases. This is where we as dentists come in. A well-made oral appliance works by pulling the mandible forward, keeping the airway open during sleep. It is comfortable, portable, adjustable and is considered an effective treatment with minimal side effects.
I had the opportunity to attend the 25th annual American Academy of Dental Sleep Medicine Conference held in Denver this past June. I saw first-hand how expansive the field of dentistry has become. I walked through aisles and aisles of booths, all showcasing the latest innovations in at-home sleep tests and oral appliance designs. I was even able to get fitted for my own temporary oral sleep appliance on the spot.
The highlight of the meeting was being able to sit in on lectures given by various dentists, physicians, psychiatrists and oral surgeons. Though we’ve made many scientific breakthroughs to better understand sleep apnea, there is still so much that is unknown, unresolved and under-researched. I left the meeting feeling inspired by all the undiscovered possibilities within this burgeoning field. This experience is what led me to direct my efforts towards integrating dental sleep medicine into the predoctoral curriculum at my own dental school.
As dentists, we are in a unique position to screen patients for obstructive sleep apnea. Patients often see their dentists more often than their primary care physicians, and our intimate knowledge of the anatomy of the oral cavity and airway puts us at the forefront of making these diagnoses. Even simply by bringing an increased awareness of dental sleep medicine to our colleagues and our patients, we can develop a significant skillset enabling us not only to improve the quality of life for our patients, but also potentially to save them.
~Rebecca Binder, Buffalo ’18, chapter web administrator