Hygiene Tribune U.S. Edition

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Edition Publisher & Chairman Torsten Oemus t.oemus@dental-tribune.com Chief Operating Officer Eric Seid e.seid@dental-tribune.com Group Editor & Designer Robin Goodman r.goodman@dental-tribune.com Editor in Chief Hygiene Tribune Angie Stone, RDH, BS a.stone@dental-tribune.com Managing Editor/Designer Implant, Endo & Lab Tribunes Sierra Rendon s.rendon@dental-tribune.com Managing Editor/Designer Ortho Tribune & Show Dailies Kristine Colker k.colker@dental-tribune.com Online Editor Fred Michmershuizen f.michmershuizen@dental-tribune. com Account Manager Mark Eisen m.eisen@dental-tribune.com Marketing Manager Anna Wlodarczyk a.wlodarczyk@dental-tribune.com Sales & Marketing Assistant Lorrie Young l.young@dental-tribune.com C.E. Manager Julia E. Wehkamp j.wehkamp@dental-tribune.com C.E. International Sales Manager Christiane Ferret c.ferret@dtstudyclub.com Dental Tribune America, LLC 116 West 23rd Street, Suite 500 New York, NY 10011 Tel.: (212) 244-7181 Fax: (212) 244-7185 Published by Dental Tribune America © 2011 Dental Tribune America, LLC All rights reserved. Hygiene Tribune strives to maintain utmost accuracy in its news and clinical reports. If you find a factual error or content that requires clarification, please contact Group Editor Robin Goodman at r.goodman@dental-tribune.com. Hygiene Tribune cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume responsibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune America. f HT page 1D Flying with Hilda Flying can be a wonderful or stressful situation, and more often than not I find it brings stress. On a recent trip, I found myself on the edge. The first leg of my flight was delayed due to issues with the plane, which then cut into my layover time, which was only 45 minutes to begin with. When my first flight landed, there was no one available to drive the jet bridge next to the plane, so another 15 minutes ticked off my connection time. Once I deplaned, I had exactly 10 minutes to get to another terminal and, of course, the gate was the last gate in the cor- ridor. I walked as fast as I could, pulling my wheeled bag behind me. I was not about to run (what a sight that would be). Images of O.J. Simpson running through the airport for a commercial some 35 years ago sped through my head. I knew I would never be able to pull off what O.J. had. As I got to the gate and the attendant scanned my boarding pass she said, “Run, we are closing the door to the plane.” This comment struck what might have been my last nerve, and I was upset. I reached my seat with a second to spare. Of course, I always want the win- dow seat so I can sleep by propping my head against the wall of the plane, so I disrupted the two women who were all buckled in and ready to go. “Ugh,” I thought to myself as I climbed in, “this is going to prompt a conversation.” I like to use my air travel as down time, but it was soon obvious that was not going to be the case this time. The woman next to me said hello, I responded, and before I knew it, I was telling her my travel woes of the day. The conversation contin- ued and I enjoyed every minute of it. As we talked freely, I realized this woman was amazing. She was talking about traveling, buying her tickets on line, printing off boarding passes, e-mailing with her friends, using her cell phone and many other technically savvy pursuits. She also shared some of her life story, which was no less amazing to me than her technical abilities. I couldn’t help it, I wanted to know her age. I thought she was probably in her late 60s and to hear her speak of all the modern technological she used in her daily life was astound- ing. Finally, I mustered up the cour- age to ask her age and she proudly announced, “I am 84 years old.” I could not believe it. I have given lectures to dental hygienists who do not own a cell phone. I have been in dental offices that still do not have a computer. And here I was sitting next to a woman that has embraced progress to the fullest extent at age 84. When we landed, I thanked Hilda for the conversation we had. I also told her she had inspired me to keep educating people about progress in technology. As dental professionals, we are being asked and we are asking others to take advantage of technological progress every day. Even though we may be resistant to change, we can do it. If a woman who is 84 years old can do it, so can we. We have no excuse. We need to get with the program or we will be left behind wondering where every- one else went. I guess there was a reason my flights were delayed after all. HT Best Regards, Angie Stone, RDH, BS Editor’s Letter HYGIENE TRIBUNE | July 20112D ing systems and offering solutions. The questions should start at the front desk when a patient checks in for their recall appointment. The following questions should be added to your patient history update form: • Have you been told you snore? • Are you excessively tired dur- ing the day? • Have you ever had a sleep study? • Have you been diagnosed with sleep apnea? • Do you wear a CPAP? If a patient answers yes to any of these questions, the conversa- tion should be picked up by the hygienist. There are also some tell- tale clinical signs to look for in these patients such as wear facets (bruxing), periodontal disease, a large neck, obesity, scalloped large tongue, red and inflamed uvula and enlarged tonsils. On identifying any of these clinical signs, the patient should be directed to fill in a question- naire called the Epworth Sleepi- ness Scale. This will identify how “sleepy” the patient is in his or her regular daily routine. It is likely that patients will tell you “Oh, I just snore when I am tired, I do not have sleep apnea.” However, how would the patient know this if he or she hasn’t been tested? Snoring is the beginning of a disease continuum that will develop into apnea if therapy is not initiated. Apnea will get worse with age, bad diet, weight gain and an unhealthy stressful, lifestyle, which these days can be so common. Unfortunately, many people do not realize that they suffer from sleep apnea unless someone else brings it to their attention. Following the screening process, a dentist cannot diagnose OSA. The gold standard in care is to refer your patient to a sleep laboratory for a diagnostic sleep study known as a polysomnogram (PSG). This is where you will start to build a mutual referral relationship with your local laboratory and reporting sleep physician. The multidisciplinary referral pathway should be that you refer your patients for a diagnosis and — providing the results fall within the American Academy of Sleep Med- icine (AASM) guidelines for oral appliance therapy, mild to moder- ate apnea with no co-morbidity — the patient should be referred back to you with a prescription for an oral appliance. This is important for reimbursement too. Oral appli- ances are also recommended for severe OSA patients if they cannot tolerate their CPAP, although they should always try CPAP first. Home sleep testing (HST) is becoming more popular and there are companies that offer an inter- pretation service for patients who will not or cannot to go to a sleep laboratory. There are a wide range of HST devices available to the dental market that can be used for screening, diagnosis (provid- ing they have a certified physician interpret the report and sign off When a patient is finally able to get a good night’s sleep, oral appliance therapy can be truly life changing. (Photo/IonaGrecu,www.dreamstime.com)