Policy Statement on a Dentist's Role in Treating Sleep-Related Breathing Disorders

Abstract

Dr. Schwartz reports serving in an advisory capacity as part of Resmed's dental panel, owning public stock in Resmed, serving as part of an advisory group for Prosomnus, and having a financial stake in Prosomnus. The other authors report no conflicts of interest.

Sleep-Disordered Breathing: The Dentists’ Role – A Systematic Review

“…-Dentists/orthodontists/prosthodontists should screen for potential patients with SDB/OSA. 4,9,[29][30][31][32][33]11,13,15,20,22,24,27,28 -Screening could include questionnaires, such as the validated tool for OSA risk assessment STOP-Bang questionnaire, the Epworth Sleepiness Scale, Friedman Tongue Classification System, Kushida Index, or Berlin Questionnaire for Sleep Apnea; evaluation of neck size and body mass index; modified Mallampati classification to describe the patency of oral airway. 33 -Refer to the sleep physician or otolaryngologist when SDB/OSA is suspected.…”

“…4,11,13,15,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Recommendations made by the studies included in this systematic review were for the dentists' clinical practice in patients with OSA, SDB or snoring. Most of the included studies were based on or were the guideline itself from an accredited dental or medical association as follows: American Association of Orthodontics (AAO) 33 ; American Academy of Dental Sleep Medicine (AADSM) 4,21 ; American Academy of Sleep Medicine (AASM) 22,23 ; AADSM + AASM 24 ; AASM + German Sleep Society 25 ; American Academy of Craniofacial Pain; 26 Canadian Sleep Society; 27 American College of Prosthodontists; 15 American Dental Association (ADA); 11 German Society of Otorhinolaryngology, Head and Neck Surgery + Association of Scientific Medical Societies in Germany. 28 A group of Italian dental societies also involved with the Italian Association of Sleep Medicine 13 ; and British Society of Dental Sleep Medicine.…”

“…3 It is estimated that approximately 23 million adults in the United States have undiagnosed or untreated moderate to severe obstructive sleep apnea (OSA). 4,5 The main problem in patients with SDB/OSA is the pharyngeal collapse occurring in hypopnea (reduction in ventilation) or apnea (complete respiratory cessation). 6 According to Guillerminault and Huang "the upper airway is a collapsible tube, and its collapsibility increases during sleep".…”

“…7 The increased levels of carbon dioxide (hypercapnia) and the low concentration of oxygen (hypoxemia) in the blood in these patients may lead to hypertension, cardiac diseases, and even premature death. 4,6 SDB is also related to snoring, mood disorder, disruptive behavior, and depletion of quality of life. 2,4,8,9 Some oral anatomic features associated with SDB may include high arched or narrow hard palate and retrognathia.…”

“…4,6 SDB is also related to snoring, mood disorder, disruptive behavior, and depletion of quality of life. 2,4,8,9 Some oral anatomic features associated with SDB may include high arched or narrow hard palate and retrognathia. 2,8 The most common risk factor for sleep apnea in children is the airway constriction associated with enlarged tonsils and/or adenoids.…”