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Helping patients breathe better

September 05, 2019

By Kimber Solana

Photo of sleep medicine attendees
Classroom learning: Drs. Ubonwan Saeling, left, and Earl Bogrow take notes during the ADA Dental Sleep Medicine Conference Wednesday. Photos by EZ Event Photography
Healthier children. Partners who stopped snoring moving back into the bedroom. Patients who are more productive at work. And people who no longer drive home tired at night.

Dentists practicing dental sleep medicine can expect thanks for all of the above.

Sleep-related breathing disorders — the disruption in airflow through the upper airway — can also potentially decrease a person's life by 15 years, said Dr. Ken Berley, one of the speakers at the ADA Dental Sleep Medicine Conference (4113) Wednesday.

"This is serious," said Dr. Berley. "You can save your patients' lives."

Photo of Dr. Berley speaking
Photo of Dr. Carstensen speaking
Talking sleep: Drs. Ken Berley, top, and Steve Carstensen discuss sleep-related breathing disorder during the first day of the two-day conference. 
In collaboration with the ADA Council on Dental Practice, the conference drew about 100 dentists and dental team members on Wednesday — the first day of the two-day conference, where attendees earn 14 hours of continuing education credits.

Airway problems can increase the likelihood of depression, stroke, heart failure, severe obesity, drug-resistant hypertension, coronary artery disease and Type 2 diabetes, said Dr. Steve Carstensen, the Washington state-based cofounder of Premier Sleep Associates, a dental practice dedicated to treating obstructive sleep apnea and snoring, and conference speaker.

The American Academy of Dental Sleep Medicine estimates that about 30 million adults in the U.S. have obstructive sleep apnea, making dental sleep medicine one of the hot topics at this year's ADA FDI World Dental Congress. Dr. Berley added that chronic sleep disorder costs Americans $20 billion a year in expenses and $100 billion a year in lost productivity.

Participants, on the first day, heard leading experts in dental sleep medicine explain the reasons people have sleep-related breathing disorders, how to screen and test for it, its risk factors and each point in the ADA policy statement on sleep-related breathing disorders while supporting practical wisdom and the latest in medical science, professional guidelines and protocols.

In 2017, the ADA House of Delegates had approved a policy statement addressing dentistry's role in sleep-related breathing disorders. The adopted policy emphasizes that "dentists are the only health care provider with the knowledge and expertise to provide oral appliance therapy."

During the conference, Drs. Berley and Carstensen were joined by Glennine Varga, a sleep medicine coach and expert.

Ms. Varga told the audience that she believes dentists and dental teams need to be trained in identifying and managing sleep disorders and should collaborate with physicians on the best treatment plan.

"The most attractive thing with this conference is that the ADA is able to gather the best information on the topic and pass it along efficiently to dentists," said Dr. Carol Anderson, of Brandt, South Dakota, and conference attendee.

Dr. Anderson, a former Wyoming Dental Association president, has been in practice for 25 years and said she's interested in implementing dental sleep medicine in her practice.

"I would definitely like to do it, but it's good to be familiar with all the aspects before jumping right in," she said. "It's a very important aspect of dentistry. We're talking about helping people breathe."

Dr. Berley, who is also a licensed attorney with over 22 years of legal experience and a member of the bar in Arkansas and Texas, discussed the legal ramifications of the ADA policy statement at the conference.

Dr. Carstensen said, despite the ADA policy, there's no rule dentists have to practice dental sleep medicine.

"The word they use is encourage," he said. "But once you learn about it, it's difficult to go back to your practice and not see it in your patient population because we're dentists and we want our patients to be healthier."

Key components of the 2017 policy include assessing a patient's risk for the disorder as part of a comprehensive medical and dental history and referring affected patients to appropriate physicians. In children, the dentist's recognition of suboptimal early craniofacial growth and development or other risk factors may lead to medical referral or orthodontic/orthopedic intervention to treat and/or prevent the disorders.

The policy also covers evaluating the appropriateness of oral appliance therapy as prescribed by a physician; recognizing and managing appliance side effects; continually updating dental sleep medicine knowledge and training; and communicating patients' treatment progress with the referring physician and other health care providers.