Table 1 and referred patients with positive findings to a local sleep center for further evaluation. After writing 51 consecutive referrals, I decided to evaluate how many patients got tested and what the outcome was. Out of those 51 referrals, 21 got tested with a fullnight PSG study. What was interesting is that only one patient (arrow) did not have an AHI greater than 5 (dotted line) (figure 1). I decided to repeat the same process in 2011, and out of 55 consecutive referrals, 26 got tested with a full-night PSG study. This set showed two patients (arrows) that did not have an AHI greater than 5 (figure 2). The findings from this internal analysis prove to be very powerful in that these visual indicators during our oral examination can help identify patients suffering from OSA, without considering age, BMI, medical history, gender, or even sleep questionnaires (Berlin, Epworth Sleepiness Scale). If we add these visual indicators to our tool box, more patients can be identified and treated for OSA.
Expand Your Patient Pool
The ability to efficiently communicate with your medical community is crucial, not only to a successful practice but to ensure that our patients get tested and that comorbidities are addressed. Where I see many of my dental colleagues struggle in this arena is in building relationships with local sleep physicians. We keep these relationships intact is by consistently communicating with physicians. Our system is very efficient in that we enter the patient symptoms, clinical
findings, assessment, and plan into DentalWriter software and share our cloud-based narrative reports with our mutual patients’ physicians. My staff also sends progress reports with post-treatment AHI’s which helps to promote awareness of the successes we have with OSA and TMD oral appliances. All of our physician reports are in a “medical-model” format and have proven to be essential to developing and maintaining referrals and relationships. As we all know, SDB can lead to many secondary health conditions, which means treatment is essential. While we can ask our patients if they snore until we’re blue in the face, we might not get the answers we need until we can spot those commonly overlooked signs and symptoms of OSA. Dentists continue to remain in a unique position to screen patients for SDB, so take charge of your practice through continuing education and expanded screening tools for SBD.
We need to take a strong stand and become more active in assisting our medical colleagues in identifying potential patients at risk.
Having a limited practice to Craniofacial Pain and Dental Sleep Medicine, Dr. Mayoor Patel, DDS, MS, RPSGT, D.ABDSM, DABCP, DABCDSM, DABOP, utilizes his experience and expertise to help dentists across the country excel in these areas within their dental practices. As Clinical Education Director with Nierman Practice Management, Dr. Patel develops upto-date curriculum for their sleep apnea and craniofacial pain programs. Dr. Patel serves as a board member with the Georgia Association of Sleep Professionals, the American Board of Craniofacial Dental Sleep Medicine, American Board of Craniofacial Pain and American Academy of Craniofacial Pain. He also has taken the role as examination chair for the American Board of Craniofacial Dental Sleep Medicine and American Board of Craniofacial Pain.