Survey of oral appliance practice among dentists treating obstructive sleep apnea patients

Abstract

Purpose: Oral appliances (OAs) are used to treat obstructive sleep apnea (OSA). This study seeks to quantify the patterns of practice of OA use among dentists.

Design: Survey mailed to dentists.

Participants: Members of the Sleep Disorders Dental Society (SDDS).

Measurements: Dentists were asked questions regarding number of patients treated, types of OA used, average total OA cost to the patient excluding reimbursement, percentages of patients receiving pretreatment and posttreatment nocturnal polysomnography (NPSG), and whether they believe subjective patient reports alone or nocturnal pulse oximetry alone is an adequate substitute for NPSG to assess OSA treatment response. Summary statistics for the absolute value and percentage data are presented with the median, maximum, and minimum range.

Results: Three hundred fifty-five surveys were mailed, of which 124 (35%) were returned. These dentists treat a median of 27 OSA patients with OAs (range, 2 to 300) annually. Patients receive pretreatment NPSG in 95% of cases (range, 0 to 100%), and posttreatment NPSG in 18% of cases (range, 0 to 100%). Only 7% of dentists believe subjective patient reports alone are an adequate substitute for NPSG. Nocturnal pulse oximetry was perceived to be an adequate substitute for NPSG by 37%. Dentists who believe nocturnal pulse oximetry to be an adequate substitute for posttreatment NPSG are less likely to obtain pretreatment or posttreatment NPSG (Mann-Whitney U test, two-tailed; p = 0.001, p = 0.02).

Conclusions: Most SDDS dentists believe subjective reports and nocturnal pulse oximetry are inadequate to assess OA treatment response in OSA patients, yet posttreatment PSG is obtained infrequently.