Waking up to Sleep Issues

It's no secret that obstructive sleep apnea (OSA) and snoring affect a great number of patients who visit dentists every day. It's also no secret that dental providers can, in turn, play a crucial role in the identification and management of these burdensome and potentially dangerous conditions.

This issue of Compendium is dedicated to the diagnosis and treatment of sleep disorders in dentistry. As healthcare professionals responsible for inspecting the teeth and oral cavity, dentists are adept at examining the oropharyngeal airway and other anatomic risk factors for OSA and able to identify those patients who may benefit from treatment, whether conservative or more invasive. In this special issue, we delve into the various ways dental clinicians can participate in sleep dentistry.

The first continuing education (CE) article explores OSA, including its epidemiology and pathophysiology and the role of the dentist in evaluating and diagnosing this disorder. The article examines oral appliance therapy (OAT), which is used to advance the mandible while the user is sleeping, and describes the various styles of appliances available, comparing and contrasting OAT to continuous positive airway pressure therapy. The second CE article elucidates the mechanism of action of oral appliances while explaining the nuances of appliance design and materials.

A variety of reports discuss several other approaches to alleviate sleep-disordered breathing. One reviews Elevoplasty^®, a minimally invasive procedure for the treatment of snoring in which small resorbable polydioxanone barbed sutures are buried in the tissues of the soft palate. These sutures are then activated to "lift" the soft palatal tissues and uvula. A case report demonstrates maxillomandibular advancement surgery, an invasive but potentially effective treatment for OSA. And yet another report describes hypoglossal nerve stimulation therapy, an innovative hybrid medical-surgical approach. Additionally, our Special Report highlights clear aligner therapy's impact on the treatment of sleep issues.

As the role of dentists in the oral-systemic health of patients continues to be debated, recognition of sleep-disordered breathing and subsequent referral and/or treatment can contribute greatly to our patients' interdisciplinary care-and quality of life. Please enjoy this special issue of Compendium!

Sincerely,

Markus B. Blatz, DMD, PhD
Editor-in-Chief
markus.blatz@broadcastmed.com

Gary Orentlicher, DMD
Guest Editor