Sleep Medicine: The Dentist’s Role
The importance of Sleep Medicine (SM) in the profession of dentistry presents many potential opportunities. SM is a broad field of medicine dedicated to the understanding and management of a wide variety of sleep disorders, many of which do not directly involve the dentist. It is widely accepted that sleep disorders can negatively impact health and quality of life, and therefore anyone involved in patient care should have a sound understanding of sleep and its importance in health. In addition, it is well known that poor sleep can negatively impact outcomes in pain management, and a bidirectional relationship between pain and sleep has been suggested.
Dentists, and especially those involved in Orofacial Pain (OFP) management, should have an understanding of sleep disorders for the purpose of enhanced care for pain patients, many of which have complex comorbidities. There are several sleep disorders that might be most likely encountered by the OFP dentist. Some of them are:
● Sleep Breathing Disorders (SBD) – snoring and sleep apnea are classic examples but also includes chronic mouth breathing.
● Insomnia – the most common sleep disorder, and frequently encountered when pain and anxiety is present.
● Movement Disorders – most notable is Sleep Bruxism but other conditions such as Restless Leg Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD) during sleep can impact and be disruptive to sleep.
The recent recognition of OFP as a specialty in Dentistry highlights the importance of recognition of SM training, knowledge and expertise by the OFP dentist. The OFP specialist is a dentist who is capable of identifying the patient who is at risk for a sleep disorder, and qualified to manage the sleep disorder when it is within the scope of his/her practice. This is most often associated with SBDs and typically involves the use of an oral appliance specifically designed to manage and resolve the SBD and improve the patient’s quality of life.
Involvement in SM also involves a working relationship with physician colleagues as well as other healthcare providers for enhanced and total patient care. This ultimately is intended to improve health outcomes and an improve quality of life.