Good morning. This is More Than Teeth. The newsletter that helps dental sleep professionals get 1% better every week.

In this week’s issue:

• Cognitive Deficits Found In Men with OSA

• How Your Anatomy Influences Sleep Apnea Severity

• A Scoping Review: What Patients Think About Oral Appliance Therapy

• Free - 2 CE Hour Course

• Where's Your Energy Leak: Re-Energize Your Dental Sleep Team

This is a 5-minute read today. Let’s dive in👇

Clinical Corner

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

1/ Cognitive Deficits Found In Men with OSA

Even without existing comorbidities, obstructive sleep apnea (OSA) sufferers can experience cognitive changes. While some have argued that these deficits are driven by cardiovascular and metabolic comorbidities, new research suggests otherwise.

🌎 OSA's Global Impact: Affecting around 1 billion people worldwide, OSA is a chronic sleep disorder that results in cognitive deficits like impaired attention, executive function, episodic memory, and more. It's also linked to depression, anxiety, and other psychiatric issues.

🔬 The Study: A small pilot study published in Frontiers Sleep aimed to settle the debate over whether OSA-driven processes contribute to cognitive deficits. The study compared 27 middle-aged men with untreated OSA and no comorbidities to 7 healthy participants without OSA. They used the Cambridge neuropsychological test automated battery (CANTAB) to assess 11 cognitive domains.

💡 Results: Participants with severe OSA showed poorer executive-functioning, visuospatial memory, and deficits in vigilance sustained attention, psychomotor, and impulse control. This is the first study to report effects on social cognition in middle-aged OSA patients. Participants with mild OSA performed better than those with severe OSA and were rarely worse than the control group.

⚠️ Takeaway: These findings suggest that OSA-driven processes alone may cause cognitive deficits in middle-aged, otherwise healthy individuals. Researchers encourage prompt attention and treatment for patients experiencing OSA and its associated deficits.

🔍 What's Next: While this study is just a small pilot, it sheds new light on the potential cognitive consequences of OSA. Further research will help to solidify these findings and inform dental sleep professionals about the importance of treating OSA in their patients.

2/ How Your Anatomy Influences Sleep Apnea Severity

A study investigated how craniofacial and upper airway anatomy affects Obstructive Sleep Apnea (OSA) severity. Grab a cup of coffee ☕ and let's dive into the details.

🔬Study Overview The study analyzed 95 adult OSA patients and used Cone Beam Computed Tomography (CBCT) to measure craniofacial and upper airway anatomical variables. They found a significant relationship between these variables and OSA severity.

📊Key Findings

1. Retropalatal Airway Length: Longer retropalatal airway length (the distance from the posterior nasal spine to the tip of the uvula) was associated with increased OSA severity.

2. Mandibular Body Length: Shorter mandibular body length was linked to more severe OSA symptoms.

These results suggest that retropalatal airway length and mandibular body length are essential factors in OSA severity, and could help identify severe OSA patients and determine the most suitable treatment options.

🔍Study Limitations There are a few limitations to consider. Firstly, the study's CBCT images were taken in a supine position, which doesn't exactly replicate the real sleeping condition. Secondly, CBCT images have low soft tissue resolution, making it difficult to analyze surrounding soft tissue structures. Lastly, static images cannot capture real functional disorders.

🦷Takeaways for Dental Sleep Professionals Understanding the impact of craniofacial and upper airway anatomy on OSA severity can help dental sleep professionals recognize severe OSA patients and choose the most appropriate treatment options. Keep an eye on retropalatal airway length and mandibular body length when evaluating OSA patients!

3/ A Scoping Review: What Patients Think About Oral Appliance Therapy

Are you up to date with the latest research on dental treatment-related patient-reported outcomes (dPROs) for oral appliances in obstructive sleep apnea (OSA) management? We've got you covered.

🔍 The Study

A scoping review aimed to explore dPROs, including quality of life (QoL), side effects, patient satisfaction, and experience with treatment, as well as perceptions of occlusal or dental changes after OSA treatment with oral appliances.

📚 The Method

The researchers scoured available literature, with no restrictions on year or country, and examined clinical studies that assessed dPROs in children and adults with OSA managed through oral appliances.

📊 The Results

• The search identified 1,718 citations, with 45 studies ultimately included.

• A total of 3,498 adults were part of these 42 primary studies.

• No data was found for dPROs in children.

• In adults, QoL was mostly reported as improved or sometimes unchanged.

• Most patients were satisfied with treatment, experienced mild side effects, and perceived endured occlusal disturbances after OA treatment.

🧪 The Takeaway

While dPROs seem to be a secondary focus in OSA severity research, the results suggest that OAs are generally well-tolerated by adults, with some mild discomfort and occlusal disturbances reported. QoL tends to improve, but consistent agreement remains elusive. Further research on dPROs in children is needed.

The type of appliance use and other treatment modalities were not included in the review.

We know oral appliances work, aka “most patients were satisfied with treatment”, but the side effects are real and something to notify the patients of prior to treatment.

Free - 2 CE Hour Course

When it comes to your Dental Sleep Medicine goals, you know where you want to go, but it can be difficult to get there. This course is designed to deliver the skills you need to efficiently navigate the processes of screening, testing, treating, and billing for sleep apnea treatment and offers 2 hours of CE.

Business of Sleep

📈Better businesses = more lives saved!

Where's Your Energy Leak: Re-Energize Your Dental Sleep Team

Motivation may seem like an emotional aspect, but it's actually structural. To re-energize your dental sleep team or dental lab staff, you need to identify the factors causing energy leaks. Here are the 8 typical culprits to check:

1/ The Mission

• Alignment -> Does your team care about the goals of your dental sleep practice or lab?

• Reward -> Do they believe they'll benefit if the practice or lab succeeds?

2/ The Work

• Impact -> Does their effort contribute to the overall mission of your practice or lab?

• Efficient -> What's their ratio of productive time vs unproductive time?

• Reasonable -> Does your team have enough capacity to handle their workload?

3/ The Individual

• Connected -> Do they have friends in the workplace? (It makes them 7x more likely to stay.)

• Growth -> Is their work helping them grow and achieve their personal goals?

• Life -> Does your practice or lab provide support when external factors affect their work-life balance?

Identifying the most significant energy leak in your team is crucial for turning things around. By focusing on the largest issue, you can create a more energized and motivated team.

Something Sweet

🍭Stuff so sweet you might get a cavity..

Space X was able to fully launch the new Star Ship. It exploded.

Regardless… to build a completely new space vehicle from scratch that is capable of carrying a 100-ton payload and get it as far as they did.. Incredible.