One of the things that Dr. Dawson has taught us over the years is that part of being a complete dentist is really being a physician of the masticatory system.
So one of the things that we have been doing for our patients at our complete exam appointments is evaluating them for potential sleep disorders.
- We check the Mallampati score, and there's a beautiful page, with photographs, in the wizard that helps you evaluate that opening at the back of their oropharynx to get their Mallampati score.
- We do a neck measurement. We actually keep a tape measure in each of the operatories because we know that if women have a neck measurement over 16 inches - and men, over 17 inches - that there's a 90% correlation with airway obstruction.
- We also check for presence or absence of tonsils.
- We evaluate them to see if they snore or if their partner tells them that they snore.
- And oftentimes, we'll even do the Epworth sleepiness survey.
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And then for patients that have positive feedback in several of these categories, we work with a company that will send in a sleep screening form, and the company will file the patient's medical insurance for them. And they'll send them a device that they use in their home for three nights.
They'll sleep with this device on. And then we get a beautiful report back from an MD physician, who's board certified in sleep medicine, and it will give us feedback on their apnea and hypopnea scores. And then if it comes back that they do indeed have some apnea, we'll refer them to an ENT, then, for a full sleep screening.
So I think this is something that we've been able to do for our patients that not only can improve their dental health - and some things that can cause them to protrude and wear - but also improve their overall physical health.