Screening for OSA in the Dental Practice

By Chad Wooters

If a dentist had helped identify my sleep apnea, I could have avoided 18 occurrences of tonsillitis. 

I had my wisdom teeth removed in the summer of 2015 as a young adult and was not diagnosed with sleep apnea until the summer of 2018! I bring this up because this was shortly before I had entered the dental industry myself and was seeing my regular dentist from childhood until my mid 20’s. In those three years, I had tonsillitis about five to six times a year, struggled with drowsy driving, and would be sick most of the time.

Doctors didn’t know what to do with me because I had nothing that seemed to be causing me to be sick. I was a healthy young man! It wasn’t until I treated my sleep apnea that I stopped having tonsillitis. This eventually led to a tonsillectomy and apparently it’s impossible to get tonsillitis without tonsils.

When I was having work done in the dental chair, there were many signs and symptoms evident in my mouth, in my behavior, as well as in the stories that I shared that could have triggered a conversation about airway with my hygienist or dentist. 

That’s why I share this message with the dental community. As a dental professional, YOU are in a unique position to have a lasting impact in your patient’s life!

Signs and Symptoms of an Airway Concern

Many patients have signs and symptoms that are indicating an airway issue. Some of these are intraoral signs like bruxism, macroglossia, and tongue scalloping. Others include symptoms in the patient’s health history such as hypertension, stroke, and diabetes. Lastly, behavior such as drowsy driving, extreme caffeine consumption, and falling asleep in the dental chair. 

The things that should have been noticed in my dental visits were:

  • Bruxism
  • Falling asleep in the dental chair
  • Chronic sickness (i.e. tonsillitis)

Many of your patients are suffering from these signs and symptoms.

There are many more signs and symptoms; you just need to know what to look for!

The important thing is that you start the conversation and help them understand what is going on. The point of this conversation is not to diagnose them or treat them with a sleep disorder but to help facilitate a test that can diagnose them.

If you want to learn how to start the airway conversation with your patients, you can get our FREE eBook on “Screening for OSA in the Dental Practice” Here!

The Airway Conversation and Next Steps

For patients that present those signs and symptoms, it is important that you and your team understand how you’re communicating with patients, what you’re communicating to them, and the protocol of next steps you’ll recommend.

How and What to Communicate With Patients

When we attempt to connect with our patients about their airway health, we can often find many things that are pointing to the need for further testing. We have to be careful not to insult them by creating a laundry list of things they need to fix. This is how we can hurt feelings and potentially lose patients!

Instead we recommend taking the time to learn the soft skills necessary to relay your genuine concern for patients who are considered at risk for an airway concern. We have a protocol called the “3 Favorite Things” protocol that is designed to connect with patients in a meaningful way while helping them feel valued and empowered to move forward with a test.

Note: When we say “test” we mean a home sleep test or a polysomnogram. The best test for a patient is not just the one they need but the one they are willing to do!

To learn the “3 Favorite Things” Protocol we have included it in our “Screening for OSA in the Dental Practice” Ebook.

Screening Protocol and Next Steps

If you have ever attempted to implement dental sleep medicine in your practice, then you know about the significant amount of hurdles that exist. Most of these hurdles can be grouped into a couple main challenges.

Not every problem fits into these categories but most do!

As you explore the possibilities of helping patients with obstructive sleep apnea, you need to make sure that you and your team are on the same page about the protocol that takes place in the dental chair as well as the next steps that happen (usually) at the front desk. If everyone understands these components, we can start our sleep program on the right foot.

The end goal of screening is a test. Whether that patient is opting to do an in-lab test or they want to do a home sleep test, make sure they have everything they need to move towards that decision.

It is not your job to diagnose patients with a sleep disorder (unless you are a physician licensed to practice medicine) but it is your calling as a healthcare provider to start the conversation.

The teams that have the largest impact on their existing patients and community are those that understand what they are doing, how it affects their patients, and what the results of starting these conversations look like!

Do yourself and your patients a favor, get your team on the same page! Your team can be saving lives and increasing the quality of life for many patients.

Helping dental teams screen patients and have a larger impact is why we wrote “Screening for OSA in the Dental Practice” eBook! Grab your free copy and share it with your team, we are even giving a CE Credit away with it!

You are one conversation away from seeing the life change that comes from helping a patient with their obstructive sleep apnea. So let’s get started!