A 2014 study in the American Academy of Sleep Medicine (AASM) estimates that as many as 26 percent of adults between 30 and 70 have sleep apnea. As new scientific research comes to light on sleep-disordered breathing (SDB) and human development, it becomes increasingly evident that dentists play a critical role in ending the sleep apnea epidemic. This is because the orofacial structure and upper airway development are directly linked to the development of SDB and other comorbidities such as hypertension, diabetes, exhaustion, depression, and heart disease.
The first step in treating sleep apnea is to screen patients. This involves a standard set of questions discussed with patients during routine hygiene visits. While it may seem out of the norm for dentists to ask about a patient’s sleep health, it shouldn’t be. Oral health says a lot about a patient’s overall health and wellness and is a vital indicator of an airway issue.
Let’s discuss the five essential questions to ask your dental patients about sleep.
How Would You Describe Your Level of Health?
Modern healthcare should be collaborative, and patients like it when their providers respect their opinions, research, and ideas. After all, patients understand their body best. When it comes to dentistry, dentists are the front line for screening and sleep-test referrals. And with companies such as Vivos Therapeutics, dentists can now provide their patients with access to sleep technology in the form of a VivoScore ring. This simple at-home test monitors the duration spent in each of the various sleep cycles, wakefulness, periods of apnea, and more. Before advancing to this step, however, dentists must ask their patients a series of questions to paint a thorough picture.
First, ask your patient how they would describe their level of health. Allow them the time and space to reflect and answer in their own words. Pay special attention to the following signs and symptoms:
- Morning headaches
Take notes. From here, move on to the next question.
Does Your Partner Say You Snore?
Snoring is the leading indicator of SDB. It is one of the most commonly reported symptoms in individuals suffering from obstructive sleep apnea (OSA). This type of sleep apnea occurs when the muscles in the throat relax and block the airway, resulting in lapses in breathing. While this is not always the case, a bed partner often notices snoring. Asking this simple question and receiving a yes is suspicion enough to test your patient for OSA.
Another audible sign of OSA is bruxism, or clenching and grinding. Espire Dental shares that around 25 percent of individuals with OSA exhibit bruxism. This is a natural response to insufficient breathing as the body desperately tries to create more space in the mouth to breathe and draw in oxygen. An individual’s bed partner may mention this, but a sleep test is the best next step if you see wear and tear, chipped teeth, and worn enamel.
How Would You Rate Your Quality of Sleep?
This is an excellent numerical question to ask your patients: “On a scale of 1-10, how would you rate your overall sleep quality?” Some excellent questions to expand upon in this area are as follows:
- Do you wake up feeling well rested?
- Do you dream at night?
- Do you toss and turn, or are you sleeping soundly?
As a dental professional, understanding your patient’s self-reported sleep quality rating is helpful not only up front but after a sleep assessment is completed. By understanding their baseline, you can begin to develop a better gauge for the results of your sleep treatment. This makes you a better provider in the future as you set realistic expectations.
Are You Experiencing Any of the Following Comorbidities?
In addition to the signs and symptoms noted above, there are many known comorbidities of OSA, such as the following:
- Cardiovascular disease
If a patient suffers from one or many associated diseases, it is essential to have them complete an at-home sleep test. These comorbidities are downstream effects of untreated OSA and, in some cases, are life-threatening. While discussing this with your patient, watch for mouth breathing and difficulty breathing through one or both nostrils. Each of these symptoms plays a role in their overall health and wellness.
Think about it this way. If you temporarily cut off or reduce the oxygen supply to the brain or heart, it might not make a difference. It’s just like holding your breath underwater, right? But, after a while of this, you’re facing a patient that is vastly under-oxygenated. This is the ultimate cause of many of the above comorbidities, so it is essential to be mindful of this.
Would You Be Interested in an At-Home Sleep Test?
By now, you should have developed a profile of each patient and identified the clear indicators of whether or not they might be a good candidate for a sleep test. Therefore, our fifth and final essential question to ask your dental patients about sleep is whether or not they’re interested in an at-home sleep test.
Suppose they answer “yes”: great! If they answer “no,” you should provide them with more information on sleep apnea and other forms of SDB and make sure they understand the risk factors. After all, it’s always better to know and understand the risks versus being in the dark on personal health.
Suppose your patients are hesitant about treatment or the costs associated. In that case, it is essential to be transparent, explain the medical billing and insurance coverage, and offer various options based on their wants and needs. By returning to this collaborative nature, you will ensure your patients feel comfortable and confident that you understand them.
As a dentist, you are the frontline when it comes to identifying and combating sleep apnea. By asking these five questions, you can get your patients started on the path to greater sleep health. For more information on dental sleep, visit our website at thevivosinstitute.com.