Australasian Dentist Issue 93

34 AUSTRALASIAN DENTIST EVENTS 1800 806 450 www.amalgadent.com.au Resin-Modified Calcium Silicate Pulp Protectant/Liner AWARD WINNING PULPAL PROTECTANT 10 YEARS IN A ROW See Inside Front Cover for special offer! TheraCal Footer #93.indd 1 19/04/2022 3:57:22 PM O bstructive sleep apnoea (OSA) is a common condition where the upper airway partially or completely obstructs during sleep, causing loud snoring, disturbed sleep, daytime symptoms of tiredness, and sleepiness, and increased consequences including cardiovascular disease and other metabolic complications. OSA is a frequently underdiagnosed condition due to the condition coming on slowly, occurring predominantly during sleep, or the symptoms are misinterpreted due to our busy lives and chronic sleep deprivation. Predisposing factors for OSA are increasing age, a narrow upper airway, obesity, male gender and a family history of sleep apnoea, though sleep apnoea can occur at any age, in women and in the non- obese. The symptoms of sleep apnoea include snoring, witnessed apnoeas, waking chok- ing, unrefreshing sleep, and daytime leth- argy and somnolence. Mood changes, noc- turia, impotence and insomnia may also be presenting symptoms. Many patients present late, or justify their symptoms of daytime lethargy and somnolence due to busy lives, working long hours, children and other commitments. The most effective treatment is nasal CPAP (continuous positive airways pres- sure), however not all patients can tolerate CPAP or are prepared to use it. Mandibular advancement splints can be an effective alternative in the majority of patients. The role of the dentist in diagnosing and treating sleep apnoea Dentists have an important role in identifying patients with sleep apnoea during dental examinations. This may be due to routine dental examinations in people who don’t usually attend doctors’ appointments, or recognising risk factors and commencing the discussion with these patients. Risk factors for sleep apnoea can be identified easily during a dental examina- tion such as crowding of the posterior pha- ryngeal space, a small airway and other an- atomical risk factors for sleep apnoea. Central obesity, and enlarged neck diameter can also be identified at this regular dental examination. Simple screening questionnaires can also be administered at this time, or brochures around snoring and sleep apnoea can be put around the waiting room, and then discussed with staff as required. If suspected, the dentist can suggest to the patient that a diagnostic sleep study, or sleep screening test can be performed. The dentist or their staff can also administer the test at a time that is convenient for the patient. Once the patient has been diagnosed with snoring, or sleep apnoea, the dentist also has a role in treating sleep apnoea. Initially an assessment of the patient as to the suitability of a mandibular advancement splint, the appropriate mandibular advancement splint, adjusting the MAS appliance and assessing the patient for complications or adverse events. Dr Linda Schachter, Respiratory and Sleep physician, and medical director of Sleep Services Australia. Linda has been a Respiratory and Sleep physician for more than 25 years with an interest in the diagnosis and treatment of all sleep disorders. A/Prof Michael Stubbs Michael is a dental and oral surgeon who specialises in diagnosing and managing sleep apnoea / snoring with the use of custom-made dental devices. He also specialises in the diagnosis and treatment of patients with facial or jaw pain that is not derived from the teeth. Follow-up of the patient and the control of OSA and symptoms can also be done during follow up regular dental examinations. Dentists can assist with the problem under diagnosis of OSA, by commencing the discussion if the patient has signs or symptoms of sleep apnoea, can organise sleep studies, or sleep screening tests, can discuss the results with the patient and implement treatment with a mandibular advancement splint if appropriate.They can also follow these patients and make sure that symptoms and OSA is appropriately treated. u For online introductory and advanced courses on Dental Sleep Medicine, Phone: 0419 409 044 admin@respiratorydentalinstitute.com https://respiratorydentalinstitute.com/