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An orthodontist at UNLV School of Dental Medicine is leading a trio of research studies that may add checking for sleep breathing issues to standard clinical screenings.
“People who snore usually know they do, but those who may be susceptible to or have sleep apnea, which is a more serious condition, may not,” said Dr. Tanya Al-Talib. “And unless a person expresses concern about his or her sleeping habits, a medical professional won’t automatically check for signs of the disorder.”
According to Dr. Al-Talib, without treatment, sleep apnea may increase the risk of several conditions, including heart attack, stroke, diabetes, heart failure and irregular heartbeat. Hence, the need for early and accurate diagnosis of the condition.
“Most comprehensive dental screenings check blood pressure, height and weight, and check for issues in the neck and jaw. I see an opportunity to look for potential indicators of sleep disorders that could lead to earlier diagnoses before serious symptoms manifest.”
Dr. Al-Talib began her first sleep disorder research study during her orthodontic residency program. Her inspiration arose close to home when a toddler in her family began to snore lightly and complain of slight headaches after a night’s rest. In that first study, she evaluated the non-nutritional sucking habits and feeding habits of pediatric patients and sought a correlation to breathing problems during sleep. The initial findings uncovered a connection to feeding habits.
When she joined UNLV, Dr. Al-Talib wanted to continue the study within an adult population. In one of her studies, she uses the Epworth Sleepiness Scale to calculate a person’s daytime drowsiness and determines airway volume with cone beam computed tomography (CT).
“Since we use CT machines to identify the amount of work needed for our orthodontic patients, I have included scans of their necks to measure the narrowest part of their airways,” Dr. Al-Talib said. “I also look at height, weight, neck circumference, tongue size, jaw alignment, enlarged tonsils, and skeletal make-up. We then combine data from the Epworth survey, airway measurements, and jaw discrepancy. So far, we have found an interaction between daytime sleepiness and skeletal make-up.”
As she continues the studies, Dr. Al-Talib is clear that her proposed screening tests will not diagnose breathing problems.
“Diagnosing sleep apnea and similar conditions requires specialized exams and the expertise of trained professionals,” she said. “Additionally, an overnight sleep test in a certified sleep lab, which is the gold standard for diagnosis, is critical for accurate diagnoses.
“What I am seeking is a reliable method for examining patients during a standard screening appointment that identifies risks for having or developing this disorder. Then, the dental office can issue a referral to the patient’s primary care physician or sleep specialist for additional tests.”
Dr. Al-Talib also explained that dental offices are becoming more involved with treatment options for those with sleep apnea or other sleep breathing disorders, including snoring.
“The standard of care for sleep apnea patients is the Continuous Positive Airway Pressure (CPAP) mask. For those patients who have mild sleep apnea or don’t tolerate the mask well, there are dental sleep medicine specialists who can prescribe an oral appliance that can help. The appliance, which looks similar to a retainer, can also aid those who snore.”
Dr. Al-Talib expects to implement the screening tests for adults and children at UNLV School of Dental Medicine within a few months. She also plans to establish a clinic that will offer oral appliances to candidate patients who suffer from sleep apnea. In the meantime, if you snore, or are concerned about your sleeping habits, talk to your dentist.
Photo: Dr. Al-Talib, orthodontist at UNLV School of Dental Medicine
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