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Supporting Your Practice

How Do You Advise a Patient Who Can’t Tolerate CPAP?

Dr. John Viviano
General Dentist, Mississauga

Approximately one quarter of patients attending a typical dental office in Canada suffer from some level of sleep apnea. Most of these cases are left undiagnosed, which can result in a broad range of wider health issues including heart attacks and strokes, diabetes, a reduced quality of life, and a shortened life span.

For those who do seek treatment in the form of CPAP, the results are often underwhelming: 83% of patients do not tolerate CPAP after 5 years.

In this episode of CDA Oasis Live, Dr. John O’Keefe, Director of Knowledge Networks CDA, invites Dr. John Viviano, General Dentist and sleep dentistry specialist, to discuss oral appliance therapy as an alternative to CPAP and to offer his guidance on how to best advise patients who cannot tolerate CPAP.

“It is important for patients to realize that it’s not an option to ignore their sleep apnea and that there are alternatives to CPAP.”

Here are some of the key takeaways from the conversation…

  • 1 in 4 adult patients in dental offices suffer from some level of sleep apnea, a significant proportion of which are undiagnosed.
  • Approximately 50% of CPAP patients have stopped wearing the device after 6 months because they have difficulty tolerating it. After 5 years 83% of patients no longer wear it.
  • Unmanaged sleep apnea can have a significantly detrimental effect on health and quality of life. Comorbidities associated with sleep apnea include cardiovascular health, hypertension, diabetes, glaucoma, issues with hearing.
  • Official guidelines state that oral appliances are indicated as a standard of care for moderate or severe sleep apnea where the patient prefers it to CPAP or cannot tolerate CPAP.
  • Dentists have a role to play in advising patients who suffer from sleep apnea:
    • It is not an option to ignore sleep apnea.
    • There are alternatives to CPAP.
    • Dentists can provide referral options to other dentists who are qualified to manage oral appliances.

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

Full Conversation (10.18")

1 Comment

  1. Vasant Ramlaggan May 27, 2021

    Great conversation! We need to help our patients more! Looking forward to the day we can refer directly to a sleep clinic and doctor!

    Reply

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