AIRWAY HEALTH: Screening Under the New Airway Imperative

TO RECAP FROM THE LAST POST, incorporating the New Airway Imperative into your practice plan begins with asking the question: “Am I providing my patients – ALL my patients – with the best opportunity for continued and optimum airway health.”

Once educated in the essentials of sleep and airway, the actual patient process involves the assessment and incorporation of the following into your standard operational practices:

1) Screening 

2) Making the Diagnosis 

3) Discussion of Treatment Options and Team Coordination

4) Completing a Thorough Exam

5) Appliance Selection and Delivery

6) Follow up

Screening

When we think of the typical person who struggles from sleep apnea, the picture most of us conjure up is of an overweight, middle-aged man who snores and thinks that snoring really isn’t a problem… at least for him.

The truth is anyone at any age can be affected by sleep disordered breathing. Don’t assume that because someone is “just a child” or they are a “thin, young, athletic girl” that they couldn’t be negatively affected by a Sleep Disordered Breathing issue. Because you just can’t tell at first glance, it becomes imperative you screen every patient in your practice regardless of their age or gender.

Screening becomes even more important because most patients don’t know the quality of their sleep can affect every aspect of their health. Putting it another way, they don’t know they may have a serious health problem and that you may be able to help them. This is also a time to do what we do best… educate our patients.

Another point to clarify, is that Screening is not the same as making a diagnosis!  Instead, it is the first step in determining whether or not you should have a patient undergo a true diagnostic sleep test called a polysomnogram.

The screening process should be composed of two parts: standardized written screening questionnaires and an actual physical screening exam.

The Screening tool must be easily administered and incorporated into your clinic and have the highest level of sensitivity and specificity. Two of the adult screening tools widely recognized as being fairly easy to administer are the: STOP-BANG (SB), and the Epworth Sleepiness Scale (ESS). 

For children, several questionnaires have also been developed. One of the best validated questionnaires is the Sleep-Related Breathing Disorder (SRBD) scale from the Pediatric Sleep Questionnaire (PSQ). Another questionnaire is the eight-item screening tool, I'M SLEEPY. Currently an ADA task force is in the process of setting up questionnaires and screening exam criteria for children.

In our next Blog we will discuss the physical screening exam for adults and children.

Click this link for the complete text of The Role of Dentistry in the Treatment of Sleep Related Breathing Disorders. – or visit ADA.org/sleepapnea for more information. 

SML – Your Source for All Things Airway™