Oral health problems linked to obstructive sleep apnea are not always recognized within dental care-As described by dental professionals.

Kristina Berggren,Allen Firestone,Anders Broström,Eva Josefsson,Ulrika Lindmark,Bridget Wright

doi:10.1002/cre2.517

Abstract

ObjectivesObstructive sleep apnea (OSA) has an impact on an individual's quality of life and general health, and can also affect their oral health. The patient's experiences, together with intraoral signs and symptoms could indicate the presence of OSA. Knowledge that the patient has, or is at high risk for having OSA can help the dental healthcare provider maintain the oral health and general health for these patients. The purpose was to explore dentists and dental hygienists' experiences when encountering adult patients with potential, untreated and treated OSA.MethodsA qualitative inductive approach was used. Experienced dentists and dental hygienists working within Swedish Public Dental Service were strategically selected. Semi‐structured face‐to‐face interviews were performed followed by qualitative content analysis.ResultsInterviews from 13 participants, seven dental hygienist and six dentists, led to three areas describing varied experience: Importance of the patient encounter and identifying intraoral signs both of which describe experiences related to the importance of the initial unstructured conversation and focused clinical assessments, and strategies for nurturing care which point to interest about care, treatment, and collaborations with medical health care providers.ConclusionsDental professionals are not able to consistently recognize patients who have, or are at high risk for OSA. During the patient encounter, is it important to determine if a patient is at risk for, or has oral signs of OSA.

Highlights

Obstructive sleep apnea (OSA) is a multifaceted sleep-related breathing disorder (Heinzer et al, 2015; Senaratna et al, 2017)
The results showed that dental professionals' experiences with OSA varied and that possible oral health conditions as a result of OSA, were not always recognized
These results are in agreement with other studies (Bian, 2004; Jauhar et al, 2010; Reibel et al, 2019), showing that lack of knowledge among dentists and dental hygienists about OSA and its treatment may result in difficulties detecting the condition and related oral health problems

Summary

Introduction

Obstructive sleep apnea (OSA) is a multifaceted sleep-related breathing disorder (Heinzer et al, 2015; Senaratna et al, 2017). Symptoms during sleep are loud snoring and consider interruptions of breathing, such as apneas (i.e., total obstructions of the upper airway) and/or hypopneas (i.e., partial obstructions of the upper airway) despite continued respiratory movements (George & Ferraro, 2015). The severity of OSA is expressed as the average number of apneas and hypopneas per hour of sleep, i.e., the ApneaHypopnea Index (AHI). Moderate and severe OSA are defined as AHI 5-14.9, 15-29.9 or ≥30, respectively (Epstein et al, 2009). The prevalence of OSA in a general adult population has previously been described to be as high as 40% (Franklin & Lindberg, 2015; Senaratna et al, 2017), but due to its close association to obesity, OSA is likely to be an even larger future health problem (Franklin & Lindberg, 2015)

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