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Should Regular Dentists be Front Line Diagnosticians for OSA?
I am not taking a position on this one way or another. just want to open the debate. the video below seems to be of a regular dentist diagnosing and treating Sleep Apnea in his dental office:
Views: 279
Replies to This Discussion
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Permalink Reply by Jennifer on
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I'm a little bit concerned with the patient only being diagnosed and treated by a dentist. I'm a RT who works in sleep therapy and granted there are some patients who do not tolerate a CPAP or BIPAP and the route of a dental appliance is a great way to help treat the sleep apnea when otherwise they would use nothing. I don't like the idea of a dentist diagnosing someone with sleep apnea, they aren't doing a sleep test. The rationale behind the treatment makes perfect sense to me but would hope no one out there would do this just on the advice of their dentist but look further with a referral to an ENT.
Jennifer
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Permalink Reply by Tanina Agosto on
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I hate to burst your bubble Rock but a dentist IS a doctor. They specialize not just in the treatment of teeth, but the head and neck as well. They have to go through the same type of schooling as a medical doctor. Would you say that a podiatrist is not a doctor because they only treat the feet? How about an opthamologist, they only deal with the eyes.
Now, in response to the video that's in question, should dentists make a final diagnosis on OSA? Absolutely not, HOWEVER, a dentist is MORE THAN QUALIFIED to make a pre-diagnosis and then refer a patient to a sleep center for a comprehensive sleep study. That has ALWAYS been the protocol in the dental office that I manage and we have wonderful relationships with the sleep clinics we work with.
Rock Hinkle said:You guys crack me up with this stuff. A dentist works on teeth. Only orthadontist and oral surgeons have medical licenses. A normal dentist should not Dx anything but bad teeth. At least the vet went to medical school.
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Permalink Reply by Mack D Jones, MD, SAAN on
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I hate to burst Tanina's bubble, but dentists do not go through the same schooling as medical physicians. But I have to give her a thumbs up for the prompt referral of their patients to the sleep specialist when they suspect sleep apnea.
Tanina Agosto said:I hate to burst your bubble Rock but a dentist IS a doctor. They specialize not just in the treatment of teeth, but the head and neck as well. They have to go through the same type of schooling as a medical doctor. Would you say that a podiatrist is not a doctor because they only treat the feet? How about an opthamologist, they only deal with the eyes.
Now, in response to the video that's in question, should dentists make a final diagnosis on OSA? Absolutely not, HOWEVER, a dentist is MORE THAN QUALIFIED to make a pre-diagnosis and then refer a patient to a sleep center for a comprehensive sleep study. That has ALWAYS been the protocol in the dental office that I manage and we have wonderful relationships with the sleep clinics we work with.
Rock Hinkle said:You guys crack me up with this stuff. A dentist works on teeth. Only orthadontist and oral surgeons have medical licenses. A normal dentist should not Dx anything but bad teeth. At least the vet went to medical school.
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99 spotted Dr Salama's stressed face, a sure sign of OSA. Perhaps he should use his own devices on himself to diagnose his own OSA, see a sleep doc for an in-lab PSG or a home sleep test and begin PAP treatment right away.
Once he recovers, he will see that his ideas were, how can I say, not so great after all. He may even thank this site for saving his life.
I feel sorry for the patient he did the demonstration on. The guy needs a sleep test and a prescription for a PAP machine ASAP.
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Permalink Reply by 99 on
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i understand certain persons have failed medschool but qualfy for diffrent medical jobs like a pharmacist or dentist
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Permalink Reply by Rooster on
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Forget the degrees. If you don't have enough sense to get a decent haircut before appearing in that video, you don't have enough sense to put your hands in my mouth.
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Permalink Reply by Melinda Hertel on
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The dentist reminds me of John Malcovich (did I spell that right?).
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An interesting concept for a dentist to do some evaluation of a patient for OSA. However, I really wonder how many dentists who practice in the common dental setting would spend the money for the equipment or take the time to do such screenings on a patient during a regular dental exam. (I'll think about asking my nephew and niece-in-law since they are practicing dentists.) Since a dentist spends a lot of time looking into a person's mouth, they might see some possible signs of OSA if they knew what they were looking for. However, they most likely don't look for them on a regular basis. Mostly, it would seem that this guy is into fitting dental devices.
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There are a lot of different doctors out there. One of my nephews and niece-in-law are both doctors. They both a Doctor of Dental Surgery degrees (D.D.S.). They both practice dentistry. Another nephew became a doctor this past spring. But, as his mother says, don't go to him for help unless you have an emergency case of "sonnet-opathy" as he has a Doctorate in Philosophy in literature (his area of emphasis, poetry.) A veterinarian is a Doctor of Veterinary Medicine. In the United States, the doctors who practice the full range of human medicine are either Doctors of Medicine (M.D.) or Doctors of Osteopathic Medicine (D.O.) In the US, orthodontists have earned a D.D.S. and have taken extra coursework in the field of orthodontics. They study at dental colleges. Doctors of Podiatric Medicine (D.P.M.) study at medical colleges along with students who are earning their M.D. or D.O. degrees.
An ophthalmologist IS an M.D. or a D.O. who has specialized in ophthalmology. An optometrist is not an M.D. or a D.O. and can only measure your eyes for correction and prescribe glasses and the such. An optician is a specialist who grinds lenses for glasses and similar things.
Mack D Jones, MD, SAAN said:I hate to burst Tanina's bubble, but dentists do not go through the same schooling as medical physicians. But I have to give her a thumbs up for the prompt referral of their patients to the sleep specialist when they suspect sleep apnea.
Tanina Agosto said:I hate to burst your bubble Rock but a dentist IS a doctor. They specialize not just in the treatment of teeth, but the head and neck as well. They have to go through the same type of schooling as a medical doctor. Would you say that a podiatrist is not a doctor because they only treat the feet? How about an opthamologist, they only deal with the eyes.
Now, in response to the video that's in question, should dentists make a final diagnosis on OSA? Absolutely not, HOWEVER, a dentist is MORE THAN QUALIFIED to make a pre-diagnosis and then refer a patient to a sleep center for a comprehensive sleep study. That has ALWAYS been the protocol in the dental office that I manage and we have wonderful relationships with the sleep clinics we work with.
Rock Hinkle said:You guys crack me up with this stuff. A dentist works on teeth. Only orthadontist and oral surgeons have medical licenses. A normal dentist should not Dx anything but bad teeth. At least the vet went to medical school.
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Linda,
Have you considered having a UPPP? I had a UPPP and I am very happy that I did. If you have a Mallampati class of III or IV, you might very well benefit from it. I know some people are afraid of the surgery and some people make a huge deal of the pain, but I felt the benefit was well worth the pain. And it isn't necessarily as painful as so many people make it out to be. If you have a good ENT and s/he advises you that you are a good candidate for the surgery, I would urge you to seriously consider it.
The dental device is not the next greatest thing. Dental devices have been around for some time. If you have even a tiny TMJ issue, avoid dental appliances for OSA. Repositioning the jaw can cause TMJ problems in people who don't have them, and can wreak havoc in those who do have them.
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J N K
I know of the discussions about UPPP. It is not right for everyone. My ENT told me I was an excellent candidate for UPPP. He was right. I was a good candidate and it helped me so tremendously. I am very happy that I underwent the surgery. He also told me that if my OSA did not improve enough, I might consider having my lingual tonsils out. If that was not enough, I might consider having a portion of my tongue (besides the lingual tonsils) removed. He did not recommend those surgeries for me unless I was really desperate. Having the lingual tonsils out is a bit more dangerous than a UPPP and more painful. Having a portion of the tongue removed is more dangerous than having the lingual tonsils removed and way, way, way more painful. He did say that I was a good candidate for those surgeries if I needed them, but he did not recommend them for any but those with severe OSA.
I did not say that Linda should HAVE a UPPP. What I did say was that she should CONSIDER having a UPPP. It IS a valid treatment for some patients.
J N K: There is a definite difference in meaning between HAVE and CONSIDER. You respect theopinion of those guys (who agree that it is a viable treatment for some patients) and I respect the opinion of my ENT who said it was a good choice for me.
j n k said:On UPPP, here is an interesting and fairly recent exchange between two men whose opinions on the subject I personally respect:
http://sleepapneaed.blogspot.com/2009/10/finding-place-for-surgical...
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