8/3/2023 0 Comments Dentist michael schwartz![]() The policy indicates that dentists may use HSATs to define the optimal target position of the mandible.īy building on the ADA policy and recognizing that qualified dentists have the training and education necessary to order or administer HSATs, qualified dentists can provide a more streamlined and cost-effective model of care. 4 In their policy, the ADA suggests that all dentists screen patients for OSA as part of a comprehensive medical and dental history and refer as needed to the appropriate physicians for diagnosis. In 2017, the ADA recognized that dentists should play an essential role in addressing the public burden of OSA. 3 If 80% of these adults also have undiagnosed OSA, there could be as many as 43 million adults with undiagnosed OSA. New studies published in 2019 indicate that approximately 54 million adults in the United States have sleep apnea. It goes on to further explain that the most significant barrier to treatment of OSA is patients’ disregard of symptoms and their failure to report them to primary care physicians and that once an individual is screened or informed about OSA, a significant financial and personal time investment is often necessary to address the problem. The same report indicated that OSA is also linked to comorbidities, mental health, productivity, and accidents. ![]() 2 This report indicates that there were 29.4 million adults with obstructive sleep apnea, and in 80% of that group the condition was undiagnosed - costing the United States approximately $149.6 billion per year. In 2016, the American Academy of Sleep Medicine commissioned a report from Frost & Sullivan. Given the public burden of obstructive sleep apnea (OSA), dentists must embrace that it is within their scope of practice to order and administer HSATs. ![]() Dentists also routinely take blood pressure and some test hemoglobin A1C levels. In some states, dentists with training provide flu vaccinations. Dentists routinely administer oxygen and anesthesia and prescribe drugs, including controlled substances. Dentists screen and perform biopsies for oral cancer. There are other medical conditions for which dentists order and dispense medical tests. The AADSM maintains a list of these states on its website and will be actively encouraging them to reconsider their policies. For the few states where the use of HSATs is prohibited, dentists should abide by state guidance. Based on this, it is the AADSM’s interpretation that it is within the scope of practice for dentists to order and administer HSATs in states where it is not specifically prohibited. They tend to be more specific only when prohibiting a practice or use of equipment. It is commonly understood that practice acts are intentionally broad in nature. Historically, state dental practice acts have not addressed the dentist’s role in using HSATs. Data from HSATs should be interpreted by a licensed medical provider for initial diagnosis and verification of treatment efficacy. It is the position of the American Academy of Dental Sleep Medicine (AADSM) that it is within the scope of practice for a qualified dentist, defined by the American Dental Association (ADA) as a dentist treating sleep-related breathing disorders who continually updates his or her knowledge and training of dental sleep medicine with related continuing education, to order or administer home sleep apnea tests (HSATs). Advertisement Special Article 1, Issue 7.4 American Academy of Dental Sleep Medicine Position on the Scope of Practice for Dentists Ordering or Administering Home Sleep Apnea Testsĭavid Schwartz, DDS 1 Michael Adame, DDS 2 Nancy Addy, DDS 3 Michelle Cantwell, DMD 4 James Hogg, DDS 5 Nelly Huynh, PhD 6 Paul Jacobs, DDS 7 Mitchell Levine, DMD 8 Kevin Postol, DDS 9 Rosemarie Rohatgi, DMD 10ġNorth Shore Family Dentistry, Skokie, IL 2Adame Dental Sleep Medicine 3Snoring and Sleep Apnea Dental Treatment Center, Leawood, KS 4Wellspan Pulmonary and Sleep Medicine, Lancaster, PA 5Carolina Smiles Family Dentistry, Brevard, NC 6Faculty of Dentistry, Universite de Montreal, Montreal, Canada 7Upper Peninsula Sleep Dentistry, Escabana, MI 8Department of Orthodontics, University of Tennessee Health Science Center, Memphis, Tennessee 9Sleep Disordered Dentistry, Ballwin, Missouri 10San Diego Sleep Therapy, San Diego, CA
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