Twenty years ago the issue of sleep disordered breathing was on few radar screens. A roll for the dentist in the identification and treatment of sleep disordered breathing has evolved over time. In 2006 the American Academy of Sleep Medicine (AASM) adopted a position paper that supported the use of Oral Appliance Therapy in the treatment or snoring and sleep apnea. There is however one very significant issue. Is the creation of appliances for and the case management of the sleep apnea patient within the scope of practice of the general dentist?
The CDS guidelines on the involvement of dentists in treatment of snoring and sleep apnea are very clear. Sleep Apnea can be a “life threatening” condition. - Dentists working in the field must work in collaboration with the patient’s physician, and preferably a sleep specialist. The Practice Parameters of the AASM were very helpful in validating Oral Appliance Therapy. However, the AASM position paper also states that dentists involved in the treatment of sleep disordered breathing must have “serious training” in sleep medicine. Nowhere is it defined as to what is “serious training” in sleep medicine. At this time the onus is placed on the individual practitioner to self adjudicate and deem whether or not he/she is able to satisfy this requirement. If something goes wrong where will the dentist stand who is unable to satisfy this requirement in the eyes of a court? In many jurisdictions, BC included, in order to keep a drivers license sleep apnea patients may have to prove that they have undergone and are able to maintain successful therapy. Could there be liability for a dentist who may have treated a patient outside of the guidelines and recommendations of the regulatory bodies? Sleepy drivers can be the cause of fatal accidents. In the USA sleepy drivers involved in fatal accidents have been charged with vehicular homicide.
All dentists of the province are invited, along with all other related health professionals, to attend the Thompson Rivers University "Sleep Science Conference" in Kamoops, BC. An announcement as to the creation of an education program for dentistry in sleep medicine will be forthcoming. I would be pleased to answer any questions for members of the BCDA @ 604-876-8993.
Dr. Wayne Halstrom B.A., D.D.S., D-A.D.S.M., F.I.C.D, F.A.C.D., F.P.F.A., F.A.D.I Diplomate - The American Academy of Dental sleep Medicine Adjunct Professor - Thompson Rivers University Faculty of Science
Thompson Rivers University
900 McGill Road
Kamloops, BC, V2C 0C8
March 6- 8, 2014
Contact: Les Matthews
Associate Professor of Respiratory Therapy
Faculty of Science
Thompson Rivers University
250 828 5434