Why Every Dental Practice Should Screen for Airway and Sleep Disorders
We’re dealing with a health crisis hiding in plain sight. Did you know that your dental practice may be the only place equipped to catch it?
Millions of Americans struggle with sleep-disordered breathing, but recent studies show that only 15% are ever screened.
The consequences of that lack of screening mean millions are living with chronic fatigue, metabolic dysfunction, cardiovascular disease, and, in tragic cases, preventable death.
As dental professionals, we have a unique vantage point on this crisis. We see inside the mouth regularly. We notice tongue ties, enlarged tonsils, scalloped tongues, and airway restrictions.
But far too often, we risk missing the connection between what we’re seeing and the systemic health crisis it represents. It’s time that we reevaluate how we screen for airway and sleep disorders in our practice.
Why? Because the difference could be life or death for many.
Understand Airway's Role In Dentistry at Dawson
The Hidden Costs of Missing Airway Issues
Ask anyone who is consistently getting less sleep than necessary, and they’ll tell you: they are tired and exhausted.
Science shows that a lack of quality sleep throws off your metabolism and promotes fat storage. It slows down our brain’s ability to process thoughts and make important decisions. We can’t heal without our natural rest.
Studies show that the systemic failure to connect the dots between oral health and whole-body wellness may be one of the most impactful issues of our generation. Of the 30-40 million people in the United States estimated to have sleep apnea, only 15% are being screened.
Not treated, just screened.
How to Start With Simple Screening
The risks are high – but the answer isn’t that complicated.
Most dental professionals don’t need to become a sleep medicine expert overnight. They simply need to take note of the need and start using the tools that are available right now.
Begin with paper screening forms that take patients two minutes to complete – and you’ll suddenly gain immediate insight into potential breathing disorders.
Paper Screening
The Epworth Sleepiness Scale is the most widely utilized screening form for breathing disorders in the world.
Physicians globally use this form, and you can download it online and put it on your office stationery today. The STOP-BANG questionnaire is another screening that is designed specifically for men over 50 and is equally simple to administer.
Hand these forms to every patient at hygiene appointments. Explain the basics of the connection between sleep disorders and oral health, which will help to raise patient awareness.
Clinical Observation
Once you start gathering data in paper screenings, it’s time to turn those insights into action. Train yourself and your team to look for red flags in both the screening and the exam itself.
To make screening systematic rather than random, use an Integrative Dental Medicine (IDM) checklist during your clinical exam:
- Inflammation/Infection – Signs of systemic inflammatory issues
- Airway–Breathing–Sleep – The focus of airway screening
- TMD/Occlusion – Traditional areas of concern that may overlap
For the airway column, ask targeted questions during your exam:
- Are you a mouth breather?
- Do you snore at night?
- Have you been diagnosed with sleep apnea?
- Are you sleepy during the day?
- Is the quality of your sleep poor?
- Do you have nasal congestion?
- Do you find yourself in a forward head posture?
- Do your nostrils collapse when you breathe in?
- Do you have a chronic cough (possibly related to reflux)?
Then observe for tongue ties, scalloped tongue margins, enlarged tonsils, and deviated septum. This entire assessment takes only a few minutes but provides a comprehensive snapshot of potential airway issues.
Overnight Screening Tools
If you have noticed red flags that are concerning, it may be time to help patients take the next step.
You can invest in high-resolution pulse oximetry devices (many of which cost less than $500) that can be sent home with patients for 2-3 nights.
These devices are easy to use and measure oxygen saturation and heart rate variability every second throughout the night – the same data one would gain with sleep center polysomnography.
The SnoreLab app is another powerful co-discovery tool. Patients download it for free, place their phone on the bedside table, and record their sleep.
They wake up to a visual graph showing snoring volume and frequency throughout the night. This objective data eliminates denial and creates urgency for treatment.
Creating a Systematic Approach for Your Practice
So, how do you start integrating airway screening into your practice? You’ll need to learn and adapt protocols that your entire dental team can follow.
In short, don’t try to solve every case yourself. Your role is to screen, test, trial, and refer appropriately.
Screen Every Patient
Screen every patient using paper forms and clinical observation during routine appointments. Test high-risk patients with overnight screening tools like pulse oximetry.
Trial Potential Interventions Safely
Trial conservative interventions like mouth taping and over-the-counter oral appliances while measuring results objectively.
You may need to refer patients appropriately to ENT specialists, allergists, sleep physicians, or oral surgeons when cases require medical intervention or surgical correction.
Document Everything
Document everything. Create a simple workflow sheet that guides your team through the screening and testing process.
Reevaluate your processes and make airway assessment part of your standard hygiene appointments, not an add-on service you offer only when symptoms are obvious.
The TMD Connection
Here’s where airway screening becomes particularly relevant for Dawson-trained dentists. Many patients presenting with TMD symptoms are actually suffering from airway-related sleep disruption.
Consider a classic presentation: a patient presents with morning headaches, jaw pain, chronic fatigue, and reports of nighttime bruxism.
For decades, many dental professionals may have labeled this as “acrylic insufficiency” and made a splint.
But what if we’re treating symptoms instead of the root cause?
This “clenching” may be a protective function. It could be the body’s attempt to open the airway during sleep by engaging jaw muscles.
When you screen these patients, you may find that oxygen desaturations and heart rate spikes indicate sympathetic nervous system activation throughout the night.
Before defaulting to traditional TMD treatment protocols, screen for airway issues. If the pulse oximetry shows everything in the green (no oxygen drops, no heart rate spikes), then proceed with classic TMD diagnosis and treatment.
But if you see red flags in the data, address the airway problem first. You may find that the TMD symptoms resolve when patients can breathe properly during sleep.
Moving Forward Toward Holistic and Complete Dentistry
Dentists can and should effectively screen, identify, and often treat sleep-disordered breathing. The tools are accessible and affordable, and the patient need is enormous.
The question isn’t whether you should incorporate airway screening into your practice. It’s how quickly you can implement it. Or, in the Dawson way of putting it – what if there’s a better way?
Taking the time to understand the connection between oral health and airway health is key to providing complete dental care.
As dentists, we have a unique opportunity to not only improve our patients’ oral health but also enhance their entire livelihood.
Your patients are counting on you – even if they don’t know it yet. You’re positioned to catch a crisis that everyone else is missing.