Dealing with a Patient Who Does Not Want to See an MD for a Sleep Study
July 28, 2021
Dr. John Viviano
General practitioner, Mississauga ON
What can a dentist do when a patient requests oral appliance therapy but refuses to attend a physician for a sleep study. In this latest episode in a continuing series on dental sleep medicine, Dr. John Viviano, a general practitioner from Mississauga ON, walks through this specific scenario, highlighting both the obligations and the limitations of the dentist’s role in the management of sleep apnea.
Here are some of the key takeaways from the conversation:
- Sleep apnea is a medical disorder and it is outside of the dentist’s scope of practice to initiate oral appliance therapy without the direction of a physician. It is the obligation of the dentist to explain this to the patient.
- Some patients do not want to consult a sleep physician because they do not want to be prescribed CPAP. In these cases it is standard of care to prescribe OAT as an alternative and it should not be difficult to find a physician who will write a prescription.
- Other patients do not want to be subjected to a sleep test. In this case home sleep tests are an option, though they are usually not covered by provincial health insurance. Dentists in Ontario are not licenced to dispense home sleep testing for diagnosis, but it is within their scope of practice to order a home sleep test.
- It is advisable for dentists interested in getting involved in sleep apnea management to consult with their own dental regulatory authority for specific guidelines in their region.
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team
Good topic about patients requesting oral appliance therapy without an attending physician. The huge problem here in my province is that many patients no longer have a physician. There are over 70,000 people registered who are waiting for a physician in NS. We do have several very reputable companies who will perform a sleep study from a dentist’s referral. However, I feel it is only advisable to recommend OST if the sleep apnea is low or absent. Sleep apnea is indeed a serious medical problem that dentists can help identify.