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My patient has an airway disorder: where do I start?

So I think that my patient hay have an airway disorder. Where do I start? What are the first steps that need to happen in order to diagnosis and treat this?

Verify the diagnosis

Well, as always, our starting point is diagnosis, diagnosis, diagnosis. So if we suspect or the patient is aware of having an airway disorder, then we want to get a clear diagnosis of what the problem is and what's driving it. So for example, in our dental practices, we can go through our screening questionnaire that will address whether there appears to be breathing or airway disorders, sleep disorders.

And then the next thing we would want to do is to do some screening. So we can do high-resolution pulse oximetry in every dental office very easily to see if the heart rate is bouncing around or if the oxygen desaturations have wide ranges and shifts. Is the patient dropping below 90% oxygen saturation? Is the heart rate going high and then low and bouncing around through the night? Then obviously, there's an airway problem and a sleep disorder.

Test further until we know our root problem

If that were the case, then it would be appropriate to go ahead and do further testing. Now, we can do testing in our own offices if we choose to using home sleep monitors, and through that, we can get much more information about what's going on during sleep hours.

We may elect to refer that, and so it's never wrong to say, "I'm not sure. I really suspect there's something significant going on with my patient's airway and breathing. I'm going to refer them to an ENT, or to a sleep physician, or to another dentist who's really addressing these problems."

My goal for us would be that we would all learn to do a great job screening, and even testing, for airway problems and understanding them well enough that we can quickly recognize them in our patients and then know what our options are for helping them.

Learn more about this subject at Airway & Breathing Related Disorders – Evaluation, Diagnosis & Treatment.Malocclusion and breathing disoders

DeWitt Wilkerson, DMD is a senior faculty member at The Dawson Academy and co-owns DuPont & Wilkerson Dentistry in St. Petersburg, FL with fellow faculty member Dr. Glenn DuPont. He launched The Dawson Academy’s annual Airway Symposium and continues to lecture across the world about airway and TMD.