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March 24, 2009 | Web Exclusive

How to save a patient’s marriage

 
Oral appliance therapy allows dentists to help victims of sleep apnea live happier, healthier lives

by Stan Goff

After a number of years of focusing on restoring smiles, Dr. Lydia Sosenko has a different focus today while practicing dentistry. But what the Naperville, Ill. dentist has not stopped doing is giving her patients reasons to smile.

In fact, now that she’s dedicating the majority of her time and energy to helping patients with sleep apnea, she’s convinced she’s helped save marriages and probably kept a few roommates from becoming ex-roommates.

Dr. Sosenko, who feels both medical and dental school education falls short when it comes to teaching students about sleep apnea, stumbled upon a journal article on snoring more than 12 years ago. That article piqued  her interest in the fields of snoring and obstructive sleep apnea (OSA), and then she came across a couple of dental patients in dire need of help. Helping them overcome their problems really launched her career into dental sleep medicine.

“I did not know anything about apnea back then,” said Dr. Sosenko, a Diplomate of the American Board of Dental Sleep Medicine(ABDS). “They really don’t teach you much in dental school (about apnea), and they also don’t cover it very much in medical school.”

But when Dr. Sosenko started to learn more about how oral appliance therapy could help cure sleep apnea, she began to use this knowledge to drastically improve the lives of those who were frustrated and tired after struggling to consistently get a good night’s sleep.
“A couple came to me,” she explained. “They were married, middle-aged and they were both ready to kill each other. One of them was always snoring and the other suffered from sleep apnea. They were frustrated.”

Sleep apnea vs. snoring

Often mistaken as one in the same by patients, snoring and sleep apnea are two different things. Snoring is the harsh sound heard when a snorer inhales during sleep. It occurs when the soft palate and the uvula vibrate against the back of the throat or base of the tongue. OSA is a condition in which the tongue and the soft palate relax and close off the airway so air cannot flow into the lungs. Dr. Sosenko describes apnea as “pauses” in breathing that can occur anywhere from five times to 100 times per hour.

“Snoring is the resistance of air passage when you’re breathing. With apnea you actually stop breathing; your breathing pauses throughout the night,” she said. “One of the common symptoms of apnea is snoring.”

Treating apnea

The most common medical treatment for moderate to severe OSA is the CPAP (Continuous Positive Airway Pressure) device. While research has shown this method to be quite effective, many patients do not tolerate the device, which consists of a small air blower connected by a flexible hose to a cushioned plastic mask that covers the nose while the patient sleeps.   

According to the Dental Sleep Medicine of Illinois Web site (tiredofsnoring.com), as much as 60% of recommended CPAP patients do not follow through with their CPAP Therapy. That’s why the oral appliance therapy has really come on strong in recent years.

Learn more about it

Dr. Sosenko said there now are a number of good learning opportunities for GPs looking to get involved in providing the services, including courses conducted by Dr. Jonathan A. Parker, a national lecturer on sleep disorders. Dr. Parker, who is on staff at multiple sleep disorder centers in the Minneapolis-St. Paul area, is considered a mentor by Dr. Sosenko.

“Dr. Parker has courses year round and they are very informative. They cover the differences of the many types of appliances available, said Dr. Sosenko, who added that most insurance plans cover the oral appliance therapy if the patient is diagnosed with apnea. “I suggest interested dentists find a mentor, get involved in organizations like the American Academy of Dental Sleep Medicine and get trained properly, which is critical in the long-term management .”

For those looking to go even further, you can take extra courses, get tested and become accredited by the American Academy of Dental Sleep Medicine. Dr. Sosenko is just one of a little more than 100 dentists in the United States to have achieved this accreditation.

Working with physicians

It is critical, however, to have a good relationship with your patients’ physicians. Conditions like snoring and OSA are medical health conditions that are usually categorized as respiratory disorders of sleep. As such, they are best managed by a physician who specializes in sleep disorders.

Your patients will thank you

But once a dentist starts delivering the oral appliance therapy to patients, the results can be tremendous. Patients affected by fatigue, poor memory, restless sleep and even difficulty concentrating can become happier, healthier people once they’ve gotten their apnea under control.

“It improves their standard of living,” said Dr. Sosenko . , “I’ve had people who wouldn’t sleep in the same room and who were always tired. This is a way of improving the way they live. It’s so rewarding.”

Not only are there emotional and energy benefits from correcting sleep disorders, but the therapy reduces a number of possibly serious health concerns. According to Dr. Sosenko, recent research has linked many other health problems and consequences to sleep apnea, including: heart attacks, morning headaches, high blood pressure, devastating fatigue-related motor vehicle accidents, work accidents, and decreased sex drive.

“When we helped that first couple out they were like, ‘Wow, this is such a great thing.’ They were so thankful,” she said. “Incorporating this into your practice can reinvigorate a dentist. It’s a new way of helping patients and a new source of income.”

It’s also a new way to get the same result—smiles on your patients’ faces.

Stan Goff is Executive Editor for Dental Products Report. 

Photo: Image Source/Getty Images