An Orthophos SL 3D scan of the patient's upper airway, visualized in SICAT Air. (Image: Dentsply Sirona)
Role of dental professionals in sleep medicine
POST FALLS, Idaho, U.S.: Patients often neglect discussing sleeping issues with their dentist because they are not aware of the role that the dentist can have in helping to diagnose and treat underlying problems such as sleep apnea. Three-dimensional imaging can help patients to visualize this connection. It improves communication with the patient, as well as helps him or her to understand the proposed treatment plan.
A 61-year-old female patient came to our practice for a checkup as a new patient. Upon scanning, we found a large periapical radiolucency resulting from an infection after root canal therapy. This had created considerable bone loss near the sinus. The patient had not been aware of the problem, as she had not experienced noticeable symptoms. We referred her to an endodontist for further treatment.
As part of the initial consultation with every new patient, a detailed history is taken. During the conversation with this patient, she mentioned that she had trouble sleeping and often experienced migraines but had never considered the possibility that she might be suffering from sleep apnea. I specialize in dental sleep medicine and have treated sleep apnea for nearly a decade and therefore was able to recommend a plan for diagnosis and treatment if warranted.
The patient had dental signs and symptoms of sleep apnea, including a narrow arch form, a scalloped tongue, clenching and a narrow airway. Viewing the Orthophos SL 3D scan in SICAT Air (Fig. 1) helped the patient to better understand the connection between the upper airway and dentistry. The next step involved a home sleep study that, indeed, revealed moderate sleep apnea.
Fig. 1: Upper airway visualized in SICAT Air. (Images: Dentsply Sirona)
3D examination in Sidexis 4.
Final situation of lower jaw in therapeutic position (OPTISLEEP appliance in situ).
Comparison of the upper airways in habitual and therapeutic positions of the lower jaw.
For the treatment plan, we utilized 3D imaging data to create an OPTISLEEP oral appliance. The fully digital workflow is efficient and the appliance can be ordered directly through the SICAT Air software, with the end result being a very happy patient. This was a particularly rewarding case because, after wearing the appliance, the patient remarked that she had not had a restful night’s sleep for so long that she had forgotten what it was like to wake up feeling rested.
As a dental practice that sees patients across all aspects of dentistry, the addition of a Dentsply Sirona Orthophos SL unit just over a year ago has improved our patients’ understanding of diagnoses and treatment plans. This in turn helps to create awareness about a particular issue as well as a sense of urgency for why it is important to move forward with treatment. In the specific area of dental sleep medicine, 3D imaging helps to start the conversation with our patients about why we as dental professionals care about sleep and how we can help.