We are bombarded weekly with ads for this or that course in “airway management” or “how to make money treating sleep apnea.” And, we are dealing with airway management every day whether we like it or not.  

Who has not had a patient come in with a worn dentition who claims, “Doc, I can’t ever remember grinding my teeth.” How about the patient who keeps fracturing restorations and says the same thing? You might want to question these folks or their partners about sleep habits. It is very likely you will find they are members of the population with some form of sleep-disordered breathing.  

Do you remember why we learned to fabricate and adjust bite splints?  

Have you had parents ask you about what it means when they can hear their young child grinding his or her teeth at night? Childhood bruxing is almost always a symptom of some sort of airway issue. What is happening in a child who presents with proclined incisors and an anterior tongue position? Do you think putting the child in headgear is going to solve the underlying reason the tongue has to be forward so they can breathe? 

We don’t have to treat all these issues, but we certainly should be able to communicate with our specialists and medical community for appropriate diagnosis and treatment of underlying issues that have a direct impact on the success or failure of our restorative care. 

The American Sleep Apnea Association estimates that 22 million Americans suffer from sleep apnea. Since we see our patient base, on average, two times a year, it makes sense that we should be doing at least a basic screening for sleep-disordered breathing. This can be anything from mild snoring to serious sleep apnea.  

Basic diagnostics would include paying attention to a person’s body mass index, neck size, asking whether they snore, and providing the Epworth sleepiness scale as part of your standard health history. Be aware that some folks with the worst sleep apnea or narcolepsy are not overweight. These are often the very fit appearing folks who are serious bruxers. 

If you really want to get involved in treating these people, you need to get more education.

Either at The Pankey Institute or somewhere that has a multi–day course. You need to commit to going into the process deeply, as there is much to learn and treatment is not simple. You will quickly learn that unless you develop great systems and team members, it is not an easy way to make money. However, you will be truly saving lives. 

If that does not sound right for you, commit to being a good diagnostician and develop an excellent referral network with some ENT doctors in your area. Most of these doctors are looking desperately for a dental colleague with whom they can discuss cases and develop treatments beyond just the use of CPAP. If you can refer just one child for early treatment each year and help prevent a heart attack or stroke for a person with undiagnosed sleep apnea, you will have done great service whether you get involved in active treatment or not. 

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Sleep issues and sleep apnea is a very serious concern today for our patients’ health. I have been giving patients an Epworth sleepiness self-assessment for several years. It is a great way to find out if patients should pursue their sleep with a physician and inquire about having a sleep study.

Another incredible indicator of apnea is if someone else hears you stop breathing. Of course, there are challenges with this approach. First, there has to be someone near you when you sleep to hear what is happening. Second, someone has to be awake in order to listen and watch while you are sleeping. Third, someone has to interpret what is happening. I recommend the SnoreLab app that records and evaluates the sounds made while sleeping. It can even show you graphs of what was happening. Not only is this a great self-learning tool, but the recordings can be taken to the doctor as part of the information to determine if a sleep study is indicated. The product is available on the web and through the App Store.

Several of my patients have used the SnoreLab app and had follow-up studies in a sleep lab. Within my Glendale, AZ practice, I have a Dental Sleep Medicine practice and treat patients with sleep apnea appliances.

To serve patients to the best of their ability, I recommend general dentists learn how to competently develop a Sleep Dental Medicine niche within their practice. I can honestly and wholeheartedly say that The Pankey Institute’s 5-day immersion Dental Sleep Medicine course is one of the best programs in the nation. It is uniquely designed to give dentists the experience of being a sleep apnea patient themselves.