Screening for obstructive sleep apnea by orthodontists in the United States - A survey study

Abstract

Background Obstructive Sleep Apnea (OSA), a sleep-related breathing disorder that can affect both children and adults with systemic co-morbidities beyond disrupted sleep yet remains underdiagnosed in a substantial portion of the pediatric and adult orthodontic patient populations. The objective of this study was to assess the prevalance of orthodontists screening patients for OSA, their confidence level in screening, and to identify the various screening methods most commonly used in practice. Material and Methods A survey on screening for OSA was emailed to 6,675 members of the American Association of Orthodontists (AAO) in the United States. Frequency distribution of different responses and their association with various demographic factors was assessed. Results Out of 234 orthodontists completing the survey, 62% reported screening all of their patients for OSA, while 38% reported doing no OSA screening at all. More hours of continuing education (CE) and younger ages were observed to be statistically significantly associated with practice of screening for OSA ( p <0.001 and 0.034, respectively, on regression analysis). Role of longer practice duration observed to be significant on univariate analysis, lost its statistical significance on regression analysis. Conclusions CE hours on OSA seemed to be the most important factor that motivated the orthodontist to screen for OSA. A majority of orthodontists in the 35-54 year old age-group were screening their patients for OSA. Key words: Orthodontics, obstructive sleep apnea, screening, survey study.

Perceptions of mental health screening and referral to treatment in National Dental‐Practice Based Research Network practices: A qualitative study

“…Even if dental offices establish new mental health screening and referral to treatment procedures, participants emphasized the crucial need for continuous training and education on mental health. This is consistent with previous literature on screening for various health-related concerns in dental practices, where there is a clear emphasis on the importance of having support and follow-up resources, and ongoing training opportunities [20][21][22][23]40].…”

“…The strong relationship with patients underscores the desire to contribute to the overall health of their patients beyond oral care, including utilizing active methods for identifying and responding to mental health concerns. This aligns with prior research findings that dentists exhibit the willingness to engage in screening endeavors for healthcare concerns, provided they are equipped with appropriate training, support, and resources, ensuring effective implementation within a suitable timeframe [20–23, 39, 40, 45–48].…”

“…However, there are challenges associated with implementing screening and referral practices. Factors such as time constraints, costs, patient willingness, training, beliefs about job scope, perceptions of risk, and reimbursement issues provide potential obstacles to the execution of such protocols [20][21][22][23][39][40][41][42][43][44]. To address these challenges, various facilitators have been identified, including continuing education (CE) and training, prior knowledge, training during professional schooling, supportive follow-up practices, and approaches like screening, brief intervention, and referral to treatment [20-22, 42, 43, 45].…”