The Paradox of a Pair of Docs
A paradox can be defined as a situation, person, or thing that combines contradictory features or qualities. Sleep itself is complex, and dealing with the doctors who treat the complexities of sleep can be even more challenging. Even though the physician and the dentist come from different perspectives, they both can help the same patient. This “pair of docs” might be considered a paradox in the treatment of patients with sleep disordered breathing.
Among other things, physicians look at sleep as measured by a compilation of biometric data points that determine sleep efficiency and quality, yet often struggle to succeed in optimizing those data points to improve quality of life with CPAP and surgery. Similarly, dentists trained in sleep medicine have their own perspective, which is often much different from their medical colleagues. In addition, there is often a vast difference in the approach of dentists based on their training and perspective on dentistry. Dentists have both difficult challenges and amazing opportunities to improve the quality of life for patients with sleep disordered breathing.
Dentists can evaluate, treat and monitor the effects of both non-treatment and therapeutic interventions as they routinely see their patients at least twice per year. The challenge of providing optimal patient care comes in understanding that treating the patient with complex needs requires more than just fabricating a dental sleep appliance and treating to an improvement in oxygen saturation data.
Understanding the neurologic implications of a poorly fitting appliance or the potential complications to the jaw joint, muscles, function and neurology of the craniofacial complex takes a significant amount of training and dedication. If the dentist does not understand these concepts and is not willing to manage the complications, they might unknowingly create illness while claiming to create wellness. Dentists who pass the rigorous standards of becoming board certified in craniofacial dental sleep medicine are required to understand the complexities of treating the many facets of the patient with sleep disordered breathing. They often approach patient care from a more comprehensive perspective than exclusively focusing on reducing the patient’s AHI with dental appliance therapy.