Continuing Education

Sleep Related Breathing Disorders and the Use of High Resolution Oximetry for Screening

by Craig Pickerill Sleep related breathing disorders place a substantial monetary burden on the economy in the form of decreased productivity, work accidents, and health-related complications.1 Experts in dentistry, pre-surgical screening, cardiology, occupational health, and primary care find that their respective fields would benefit from screening, but polysomnography is often too expensive and impractical. However, recent technological advancements in high resolution pulse oximetry make it a straightforward, cost-effective tool, allowing more patients to be willingly evaluated. Overnight pulse oximetry monitoring …

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It’s the Air that We Breathe

by Allen J. Moses, DDS; Elizabeth T. Kalliath, DMD; and Gloria Pacini, RDH Introduction OSA is a breathing disorder. Breathing is essential to support life. Air must get to and from the lungs for oxygenation and physiological exchange and conditioning of gases. Noses and lungs have a very rich blood supply consisting of venules, arterioles and capillaries. Each one of these is a smooth muscle-controlled group regulated by CO2 levels. The Physiological Consequences of Mouth Breathing Breathing supplies oxygen to …

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Evaluating and Treating OSA

The Tools that Make a Difference for the Practitioner and the Patient by Stephen D. Poss, DDS Introduction When the American Dental Association released a policy in October 2017 that encouraged dental professionals to screen for obstructive sleep apnea (OSA) and other sleep-related breathing disorders (SRBD)1, it created a dramatic shift in the role dentists play in SRBD treatment. In addition, the public’s awareness of the comorbidities associated with OSA – high blood pressure, diabetes, gastric reflux, weight gain, atrial …

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Incision and Coagulation/Hemostasis Depth Control During a CO2 Laser Lingual Frenectomy

by Cara Riek, DNP, RN, FNP-BC, IBCLC, DABLS and Peter Vitruk, PhD, MInstP, CPhys, DABLS Introduction The treatment for ankyloglossia is a lingual frenectomy,1 which leaves a diamond-shaped surgical wound (see Figure 1), the edges of which are either approximated and sutured or left to heal by secondary intention. Caution should be taken to control bleeding and not to disturb nerves and the salivary glands. With a CO2 laser frenectomy, patients reported less post-operative pain and discomfort than with the …

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Evolution of the Human Oral Airway and Apnea

By Allen J. Moses, DDS, Elizabeth T. Kalliath, DMD, and Gloria Pacini, RDH Introduction Overwhelmingly, patients diagnosed with obstructive sleep apnea (OSA) receive treatment with continuous positive air pressure (CPAP), a pneumatic stent for maintaining airway patency during sleep. A significant problem is that patients do not comply at a rate substantial enough to indicate anywhere near universal acceptance of CPAP. The compliance rate reported in the literature is 40%. There are a multitude of reasons for CPAP noncompliance with …

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