Post an Event (free) | Advertise | Subscribe 

Good Morning. We have a lot to be grateful for and from our families to yours, Happy Thanksgiving! (last Thursday)

In Today’s Edition:

• Creating More Tongue Room (Form)

• Myofunctional Therapy in OSA Treatment (Function)

• Nasal Hygiene in OSA Treatment (Rehabilitate)

• 3 Tips for Engaging Your Team

• Swallowable Capsule Can Detect Sleep Apnea from the Stomach

5- minute read today👇

Clinical Corner

🥼Use the clinical corner as your secret weapon to impress your colleagues and patients!

Key Takeaways🔑

*Please note that the suggestions and insights provided in this newsletter are for informational purposes only and are not intended to dictate or prescribe treatment. Each patient's situation is unique, and we recommend consulting with a healthcare professional for personalized advice and treatment plans.

1/ Creating More Tongue Room

Study Synopsis:

This study examines the impact of environmental factors on craniofacial development, focusing on how the maxilla's dimensions affect septal deviation. Researchers used CT imaging to assess adult sleep surgery patients. They explored the relationship between a narrow, high-arched palate (palatal height-to-width ratio) and septal deviation severity, as well as nasal obstruction. There are many ways to achieve this outcome for both adults and children. Some common methods are clear aligners (expansive) and removable tooth positioner appliances respectively.

Why It Matters:

The findings are crucial for understanding anatomical contributors to obstructive sleep apnea (OSA). They emphasize the maxilla's role in OSA symptoms. This knowledge is vital for dental sleep professionals in designing effective treatment plans, which should address both airway and craniofacial structures.

Key Takeaways:

1. Link Between Maxillary Deficiency and Septal Deviation: The study found a moderate correlation between a high palatal height-to-width ratio and septal deviation. This suggests that patients with this type of palate may be more prone to septal deviation, which can affect nasal airflow.

2. Impact on Nasal Airway: The study underlines the importance of considering both endonasal and extranasal structures in OSA patients. It shows that craniofacial development significantly affects the nasal airway.

3. Implications for OSA Treatment: The study's insights can guide more targeted OSA treatments. Addressing craniofacial anomalies could enhance treatment effectiveness.

4. Patient Demographics: The sample consisted mainly of middle-aged, obese, male, and White individuals with severe OSA. This information helps identify patients who might benefit most from comprehensive evaluations and treatments.

5. No Correlation with NOSE Score: Despite the correlation with septal deviation, the study found no significant link between palatal dimensions and the Nasal Obstruction Symptom Evaluation (NOSE) score. This indicates that palatal dimensions might not directly correlate with subjective nasal obstruction symptoms.

2/ Myofunctional Therapy in OSA Treatment

Study Synopsis:

This study reviewed the effectiveness of myofunctional therapy (MT) in treating obstructive sleep apnea (OSA) in children and adults. It analyzed nine adult studies (120 patients) and two pediatric studies (25 patients), focusing on changes in sleep apnea severity, snoring, and daytime sleepiness.

Why It Matters:

Myofunctional therapy is an emerging treatment for OSA. Understanding its impact is essential for dental sleep professionals. This study provides evidence of MT's benefits in reducing OSA symptoms, supporting its inclusion in treatment plans. MT is the ‘function’ part of the ‘form’ + ‘function’ OSA equation.

We first need to create more room for the tongue, then we need to train the tongue to stay in that new space.

Key Takeaways:

1. Reduction in Apnea-Hypopnea Index (AHI): Adults experienced about a 50% decrease in AHI, from 24.5/h to 12.3/h. In children, the reduction was approximately 62%, highlighting MT's effectiveness in reducing OSA severity.

2. Improvements in Oxygen Saturation and Snoring: Adults showed notable improvements in oxygen saturation and reduced snoring. These changes suggest better sleep quality and respiratory function.

3. Decrease in Sleepiness: The Epworth Sleepiness Scale scores decreased, indicating reduced daytime sleepiness associated with OSA.

4. Results in Pediatric Studies: One pediatric study showed a decrease in AHI among children with MT. Another study found that children who continued MT after adenotonsillectomy and palatal expansion maintained their OSA-free status, unlike those who stopped MT and experienced OSA recurrence.

5. Potential as an Adjunctive Treatment: The study suggests that MT can be a valuable addition to other OSA treatments, improving overall treatment effectiveness.

3/ Nasal Hygiene in OSA Treatment

Study Overview:

The article from the European Respiratory Journal examines how nasal obstruction affects obstructive sleep apnea (OSA). It distinguishes between variable nasal obstruction, like allergies, and fixed obstruction, such as a deviated septum. The focus is on their impact on sleep-disordered breathing (SDB).

Why It Matters:

For dental sleep professionals, understanding the link between nasal health and OSA is key. The article shows that nasal hygiene plays a significant role in managing OSA. It stresses the importance of considering nasal health in treatment plans.

Once we have created an environment where there is enough room for the tongue (form) and the tongue is staying in that new space (function) we need to solidify the treatment by training proper nasal breathing.

Key Takeaways:

1. Variable vs. Fixed Nasal Obstruction: The article distinguishes between variable nasal obstruction (such as in allergic rhinitis) and fixed obstruction (like a deviated septum). It suggests that variable obstructions might play a more significant role in OSA pathophysiology.

2. Impact of Nasal Obstruction on SDB: Studies cited in the article indicate a relationship between nasal obstruction and increased severity of SDB. This includes both subjective symptoms and objective measurements like the apnea-hypopnea index (AHI).

3. Effect of Nasal Treatments: Medical treatments for nasal obstruction, including intranasal corticosteroids and decongestants, have shown some effectiveness in reducing OSA severity. However, the success of surgical interventions for fixed nasal obstructions appears limited.

4. Future Research Directions: The author advocates for more well-designed studies to identify specific patient populations that may benefit from nasal obstruction relief. This includes randomized controlled studies with objective sleep and breathing measurements.

5. Role of Nasal Breathing in Sleep: The article emphasizes the importance of nasal breathing during sleep. It notes that nasal obstruction can lead to a switch from nasal to oral breathing, affecting sleep quality and OSA severity.

Business of Sleep

📈Better businesses = more lives saved!

3 Tips for Engaging Your Team in Dental Sleep Medicine

The Power of Teamwork in Dental Sleep Medicine

When introducing Dental Sleep Medicine (DSM) into your practice, your team's involvement is crucial. Successful DSM practices often have a well-trained, motivated team. Here's how to develop a team equipped with the skills and enthusiasm needed for this life-changing treatment.

1. Invest in Continuing Education for Your Team

It's essential to involve your key team members in continuing education for dental sleep medicine. This includes everyone who interacts with patients, from administrative to clinical staff. They should confidently and empathetically engage with patients, understanding the nuances of sleep-disordered breathing. Additionally, ensure your billing team is proficient in the relevant coding and documentation for medical insurance processes. Consider resources like Nierman Practice Management (NPM) for comprehensive DSM and medical billing seminars.

2. Personal Experience with Custom Sleep Appliances

Encourage your team members or their partners to undergo sleep-disordered breathing tests and treatments. This personal experience is an invaluable asset. It not only enhances their ability to relate to patients but also contributes to informed, empathetic discussions about oral appliance therapy. Plus, it benefits their health and well-being through better sleep.

3. Incentivize Team for Case Acceptance

While the satisfaction of improving patients' lives is a significant reward, additional incentives can further motivate your team. These don't always need to be financial. Understanding your team's motivations is key. Recognize their achievements with awards like “Sleep Champion of the Month/Quarter/Year.” This recognition can be celebrated in-office, on your website, and across social media, enhancing team spirit and showcasing your practice's commitment to quality care.

Something Sweet

🍭Stuff so sweet you might get a cavity..

Exclusives for More Than Teeth Readers

Have an event you would like to post? [ click here ]

Miscellaneous

😅P.S. … I forgot something