The role of the dentist in the interdisciplinary approach of obstructive sleep apnea treatment
Introduction: Healthy sleep is a synonymous term for the quality of life of the individual. Sleep disorders lead to socially significant diseases, which are a global epidemiological problem. In recent years, the role of the interdisciplinary teams of physicians and dentists has been highlighted in many clinical trials. Those trials involve patients with obstructive sleep apnea. Sleep disorders affect not only the quality of life, but also the physical, mental and emotional health of the individual.
Material and methods: During the last 14 years at the Faculty of Dental Medicine in Varna and the University Audio-Vestibular and Sleep Laboratory, a significant number of patients with obstructive sleep apnea and snoring have been examined, diagnosed and treated. These patients were examined by specialists in dentistry and otorhinolaryngology. Where comorbidity of the disease was found, consultations with pulmonologists, neurologists and other specialists were done. The interdisciplinary team has implemented the guidelines of the World Sleep Association, the American Academy of Sleep Medicine, and the American Academy of Dental Sleep Medicine. The diagnosis of obstructive sleep apnea of our patients was proven by a polygraph examination of their sleep at night.
Discussion: In order to put a correct diagnosis of the sleep disorder, patients should undergo a complete examination by otorhinolaryngologist, an endoscopic examination to determine the location of the obstruction in the upper respiratory tract, a dental examination, an imaging and a polygraph examination of sleep. Patients diagnosed with a mild obstructive sleep apnea case were offered a treatment with intraoral devices or a radiofrequency soft palate surgery with correction of nasal conchas and nasal septum, if necessary. The use of CPAP devices in moderate to severe obstructive sleep apnea does not preclude the use of intraoral devices.
Conclusion: Our experience during a large period of time has proven the need to establish an interdisciplinary approach to detect and treat sleep-disordered breathing. In the modern diagnosis and treatment of the stated disorders, and in particular, in obstructive sleep apnea and snoring, the role of the dentist is crucial.
Key words: obstructive sleep apnea, snoring, sleep medicine, intraoral devices, polygraphy, polysomnography