Dentists’ role in treating sleep related breathing disorders
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Sleep related breathing disorders are potentially serious medical conditions caused by anatomical airway collapse and altered respiratory control mechanisms. Common sleep related breathing disorders include snoring, upper airway resistance syndrome and obstructive sleep apnea. Sleep apnea in particular has been associated with metabolic, cardiovascular, respiratory, dental and other diseases. The causes of sleep related breathing disorders are multifactorial and should be treated using a collaboration of medicine and dentistry.1
The role of dentists in caring for patients with sleep related breathing disorders is a subject that raises risk management concerns. The dentist should assess all patients for signs of sleep disorders during their comprehensive medical and dental history. Any patient indicating signs of a sleep disorder should be referred to an appropriate physician for diagnosis. After an oral appliance is prescribed by a physician, the patient is sent to a qualified dentist for an oral appliance evaluation.
Dentists can screen for sleep disorders but cannot diagnose and then treat patients. The American Association of Sleep Medicine, American Medical Association, and American Dental Association all state that sleep breathing disorders must
be diagnosed by a physician.1-3
All state dental boards have regulations governing the scope of dentistry in their respective states, and clearly show that the diagnosing of such disorders falls outside of permitted services.4
There are many continuing education (CE) courses on the dentist’s role in sleep disorder treatment. Several of these courses have been reported to instruct dentists in how to diagnose and treat patients. Dentists should evaluate course content and check state board regulations prior to taking, or relying on information gained from, a sleep disorder CE course.
For more information, refer to the resources listed below, or the American Academy of Dental Sleep Medicine
- American Dental Association (ADA). (2017). The Role of Dentistry in the Treatment of sleep Related Breathing Disorders. Retrieved from: https://www.ada.org/en/~/media/ADA/Member%20Center/FIles/The-Role-of-Dentistry-in-Sleep-Related-Breathing-Disorders
- American Medical Association (AMA). (2017). Appropriate Use of Objective Tests for Obstructive Sleep Apnea H-35.963. Retrieved from: https://policysearch.ama-assn.org/policyfinder/detail/sleep%20apnea?uri=%2FAMADoc%2FHOD.xml-H-35.963.xml
- American Academy of Sleep Medicine (AASM). (2017). AMA resolution and AASM advocacy defend the sleep profession. Retrieved from: https://aasm.org/ama-resolution-and-aasm-advocacy-defend-the-sleep-profession/
- American Academy of Sleep Medicine (AASM). (2017). State Medical & Dental Scope of Practice. Retrieved from: https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/State-Medical-Dental-Practice-Acts.pdf