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Transcript

Sleep and Oral Health · Talking FACS

• 0:01
  Welcome to talking facts and thank you for tuning into Kentucky smiles on talking facts.
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  A podcast collaboration between the University of Kentucky College of dentistry and the U.
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  K.
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  College of Agriculture,
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  Food and Environment.
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  Cooperative Extension service Kentucky smiles offers listeners information on maintaining oral health advancements and dental treatments research and more.
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  Hello and welcome to Kentucky smiles on talking facts.
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  I am your host,
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  Mindy McCulley family and consumer sciences extension specialist for instructional support at the University of Kentucky.
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  I am pleased to welcome DR Isabel Marino.
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  Hey,
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  to our show today.
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  Dr marina,
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  hey is the division chief and director of the World facial Pain Clinic here at UK.
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  So welcome DR marina.
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  Hey,
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  we're going to talk about a topic today that I probably can guess that most of our listeners would not have assumed would be related to oral facial pain,
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  but we're gonna talk about sleep disorders.
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  Let's just jump right in with both feet and talk to me about how sleep disorders are related to the oral facial pain clinic that you are director.
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  Thank you so much for that question because actually,
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  you know,
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  just or a facial pain doesn't sound like one of those things that we would be managing sleep disorders right at first,
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  I completely agree with that,
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  but the reality is that usually pain and sleep are very much interconnected.
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  So we When we have patients that come with pain complaints.
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  One of the essential parts of our evaluation is to screen for sleep disorders and that can include typically insomnia.
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  I can include some sleep disorders in general,
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  but one of the ones we also look for is obstructive sleep apnea.
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  And actually my clinic is dedicated 50% of the time to the management of complex or official pain patients.
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  But the other 50% of the time I'm dedicated exclusively to what we call dental sleep medicine,
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  which basically is how the what dentists can do for patients that suffer from sleep disorders.
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  Now obviously we have a patient that have a sleep disorder,
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  what we or we suspect that might have a sleep disorder,
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  What we should be doing is referring them to a sleep physician and it's all of the sleep physician,
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  the ones who will look into the diagnosis of that sleep disorder.
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  So let's say we suspect that our patient might suffer from obstructive sleep apnea.
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  Why what we will do as dentist is our responsibilities to refer that patient to the physician,
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  have them checked.
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  And if it's confirmed that they have that specific diagnosis,
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  then we can help as well in the management.
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  We can be,
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  we play an important role as part of the team that can manage those that type of sleep related disorder.
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  And that's one of the things as I mentioned before,
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  we started recording,
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  I am one of those persons who has a sleep disorder and I never thought to talk to my dentist about,
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  you know,
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  the this issue.
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  Um and so I think that that's something that we can certainly educate our listeners on that if they are having issues and they need to talk to their dentist just as well as they need to talk to their physician about it.
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  Absolutely correct.
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  I think it's very important and and the reason why dentists play a very important role is because we play an important role in two things.
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  The first thing that we can help with is we can help with the screening uh since we are already working always on the oral cavity the same way that when we do an exam on the teeth and exam on the gams,
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  the mucosa as we can also look already into the foreign tissues into the throat.
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  So we can have an idea if there's any uh predisposition for obstruction.
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  But then we can also provide some screening tools to our patients.
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  Something as simple as a a simple questionnaire and there's one that can be easily accessing the internet is called Epworth sleepiness Scale.
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  S uh something that just takes a few minutes to complete can also give us an idea of if we are at high risk for obstructive.
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  So if you suspect that you might be it's and you have the opportunity to maybe see your dentist.
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  It's worth exploring that with the dentist.
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  Now,
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  as I mentioned before,
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  the dentist will not make the diagnosis,
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  then they will probably provide you a referral and a recommendation to maybe you should go and have a check or you know and and and guide you in the right direction.
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  But then the reason why as dentists we are involved in it is also because we can help manage this condition.
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  So traditionally patients that suffer from sleep apnea,
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  meaning that they stop breathing in the middle of the night have been treated usually with sePA.
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  So that would be a machine that can cover either the nose or the mouth or both and pushes air through the nose and through the mouth in order to keep the airway open So that airway doesn't start doesn't block through the night.
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  Now there is in the last probably 20 years there's been a recognition that we can also use oral appliances instead of the sepa.
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  So the oral appliance would be very similar to a mouth guard.
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  Like you know what we use when we are playing sports,
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  it will be apple on the upper and lower jaw and it will help guide the job forward.
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  So we keep the airway open.
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  We kind of bring the tongue forward and we create space between the back of the tongue and the back of the throat which which is the area that typically collapses when we are having an apnea event we stop breathing through the night.
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  And then this can help with that.
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  And the evidence that has come throughout these years of using this type of appliances have shown that in cases mild to moderate,
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  meaning that they don't have more than 50 events per hour,
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  that they're not too severe.
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  They work as good as a cpap.
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  Now,
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  if we have a very severe case,
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  then the other appliance can work very well for those patients that cannot tolerate.
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  Because unfortunately the CPAC works well.
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  But you have to be able to wear it.
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  And and and some patients first of all cannot wear it at all because it's very uncomfortable or even if they wear it,
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  they might not wear it all night.
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  So if you don't wear it all night,
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  you cannot lose a little bit the efficacy of it.
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  And the normal appliance can be a good alternative in patients that cannot tolerate a CPAC when they are very severe.
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  So,
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  because of that dentists are receiving more and more training and it's becoming more and more common in dental office to be able to offer these treatments to our patients.
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  Think that this is all fascinating.
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  And I love love that you are talking to me about this because I'm learning something new every day.
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  And that's one of the things that we love about this podcast,
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  because it does give us the opportunity to learn something new.
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  So,
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  we certainly hope that our listeners are learning new things as well.
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  Dr Marino.
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  Hey,
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  before we finish up,
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  are there any last words that we need to share about the um oral facial pain clinic or the sleep disorder portion of the oral facial pain clinic.
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  No,
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  I think we have covered very nicely.
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  Uh maybe just give our our audience just a little hint of you know that we are located here in the Kentucky clinic on campus.
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  We are,
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  you know a multidisciplinary clinic.
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  So when our patients come to our clinic,
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  they're going to be evaluated by different providers.
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  We are not only dentist which is uh you know,
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  our our training program designed for but we also have psychologists onboard that help us a lot in the screening of these patients.
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  We also have physical therapist on board.
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  So it's a multidisciplinary clinic in which we try to provide this multidisciplinary approach to patients that are suffering with either or official pain or sleep disorders.
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  I think that's wonderful.
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  In our show notes,
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  we will make sure to provide links to your website and facebook page and everything so that people will be able to access your information and get to you in all the ways that they possibly can if they need more information.
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  Dr Marino.
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  Hey thanks for taking the time to share with us today.
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  I know that this is important information and the more people that will learn about it,
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  the better that we will all be is thank you so much for for taking your time to talk to me.
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  Thank you and to our listeners.
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  I hope that you will join us again,
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  Kentucky smiles is available monthly on the talking facts podcast,
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  which you can find on all major podcast providers.
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  Thank you for listening to Kentucky smiles on talking facts.
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  Our goal is to provide you with knowledge to support your oral health needs.
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  If you have suggestions for future topics,
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  please message us on the UK College of Dentistry facebook page at facebook dot com forward slash u k y dentistry or visit our website at UK healthcare dot u k Y dot e d u forward slash dentistry for more information.