Dentists nowadays are very much at the forefront of patient selection and pre-screening when it comes to Obstructive Sleep Apnoea. With a few simple questions and observations, people at risk of this dangerous sleep disorder can easily be identified and referred for a sleep study to confirm your or their suspicions.

Dentists have traditionally referred suspected sufferers to the patient's GP or a local NHS sleep clinic but with Oral Appliance Therapy (OAT) not fully understood and supported by the goverment, patients would end up on the traditional form of therapy, CPAP. As a result, the patient may be forced to wait unnecessarily long for their sleep study and subsequent therapy and of course, the dentist would not be able to help these patients and grow their practise.

With OAT now internationally seen as a viable alternative to CPAP for mild-to-moderate OSA sufferers, dentists now have a key role to play in the sleep services pathway and are able to cut the total time it takes for patients to be treated.

A serious concern when treating an OSA patient with a splint is the possible creation of a ‘silent apneic' (no more snoring but still breathing lapses), so it is essential that careful screening be carried out. If a patient claims to "just snore", fitting any appliance may do more harm than good. It is necessary to confirm whether a patient is only snoring or whether he or she actually stops breathing too, which they often cannot tell themselves as they are asleep! Intus Healthcare are one of the UK's leading providers of education and homecare solutions to private sleep-disordered breathing patients and an integral part of the solutions we provide are sleep screening services for snorers and potential sleep apnoea sufferers.

There are a variety of options available:

1. Use of a free online sleep screening questionnaire based on the Epworth / Berlin questionnaires. A printed questionnaire can also be used in your practice.

2. Patients can purchase a 'SleepStrip', which is a single channel screening device placed between the nose and mouth for the duration of one night. Its sensors detect respiratory flow or air coming from both the nose as well as the mouth and has a tiny built-in 'computer' which records and analyses these breathing patterns and gives a score of between 0-3. (Unlikely to likely - this test is an indicator not a conclusive test)

3. Patients can hire a Finger Pulse Oximeter which is a two channel device again used overnight. After the study is complete, the results are analysed by a sleep technician or other qualified professional. This offers a higher accuracy than the SleepStrip and can generally speaking be used to rule patients ‘IN' for Obstructive Sleep Apnoea, but not to rule them ‘OUT'.

4. Patients may also order a multi-channel respiratory sleep study, which as above is worn overnight, downloaded and then scored by a sleep professional. The accuracy of a multi-channel device is often greater but is more costly. For complex medical histories, a full PSG may be required, in which case the patients should be referred back to their GP or Local Sleep Clinic.

Intus Healthcare have trained and assisted many dentists in the field of Dental Sleep Medicine. Our sleep study services and therapy provision are in line with the latest guidelines including those of Dental Protection and the British Society for Dental Sleep Medicine. If you want to find out more about how you can make a difference for your patients and how to grow your practise through OAT, please contact us or continue reading other sections on this and our other websites.