If you’re a hammer, all you see are nails. You’re familiar with the expression, I am sure. Sleep Apnea is not dentistry, it is medicine. As a graduate of the University of Pennsylvania’s School of Dental Medicine, there was an emphasis on the medical aspects of dentistry. But Sleep Apnea was not part of the dental school curriculum. My journey into Sleep Apnea has been serendipitous and I realize now that sleep disorders were not on my radar screen. In today’s modern dental office, it is essential to have the entire tool set. Sleep Disorders and Apnea should be part of the dental examination. Every dentist does not need to treat this disease,of course, but every dentist should be able to recognize it and be able to make the proper referral.
A few years ago I was at LVI (Las Vegas Institute for Advanced Dental Studies). I stayed at the Marriott nearby and decided to take the shuttle in the morning from the hotel to LVI. I sat next to a dentist from California on the ten minute ride to the course. When I asked what course he was taking he told me that he was taking Kent Smith’s course on sleep disorders. He then made the statement that helping people reduce or eliminate sleep apnea saves lives. I thought that it sounded a bit melodramatic. Come on, we’re dentists! Teeth. Fillings. Crowns. Saving lives? Come on.
Now that I have been properly introduced to sleep medicine (coincidentally, by Kent Smith), I find myself singing the same message. And although I love and enjoy so many aspects of dentistry, it is sleep apnea that has grabbed my attention so that I can help those patients that have sleep disordered breathing. Whether that is helping a patient become aware of a problem, making the proper referral to a physician, or making an oral appliance, helping patients with sleep issues really does save lives.
As humans, we are complex organisms in which many aspects of our physical and mental health are interconnected. If we are not sleeping properly, the implications can be vast and, unfortunately, not readily apparent. Making the connections of a sleep disorder, for example, and daytime sleepiness is not often seen by the patient. Very often a patient thinks he or she is sleeping well, and then the sleep study shows a restless night with multiple breathing cessations and oxygen desaturations.
Sleep studies are essential.. They can be done in a sleep center or at home with a monitor. Snoring is a problem. But the problem is not just the annoyance of the sound of the snoring. More than twenty percent of snorers have sleep apnea. Sleep Apnea is defined as the cessation of breathing during sleep. There is evidence that even mild apnea can have negative repercussions such as hypertension. This week a Pennsylvania State Representative died from Sleep Apnea that could probably of been prevented (see my previous blog). It is not enough to say to an obese patient that you should lose weight and the apnea will go away. Behavioral changes such as dieting are extremely difficult to achieve and more active and aggressive treatments are necessary to insure that the patient can breathe properly during sleep.
Sleep Disorders can be serious and life threatening. Stroke, Myocardial infarction, GERD (reflux), diabetes, obesity are only some of the medical complications from sleep disordered breathing. If you know of someone, or you yourself have been told, that you may have a sleep disorder, get a study.
Thanks for visiting. And sleep well. 🙂
