Obstructive sleep apnoea: dental considerations

For the medical management of obstructive sleep apnoea, see Obstructive sleep apnoea in adults.

Dentists have an important role in the multidisciplinary management of obstructive sleep apnoea, including the diagnosis of facial skeletal retrusion (eg retrognathia) and the construction of mandibular advancement splints. Some patients with obstructive sleep apnoea can be effectively treated with a mandibular advancement splint, but this must be done in association with a multidisciplinary team led by a specialist respiratory physician. The use of oral appliances for management of obstructive sleep apnoea are reviewed in detail in the American Academy of Sleep Medicine and the American Academy of Dental Sleep Medicine guidelines¹.

Snoring may or may not be a sign of obstructive sleep apnoea. It is not possible to diagnose the cause of snoring without a medical examination and sleep laboratory investigation. Use of oral devices to treat snoring without such investigations is not appropriate. If obstructive sleep apnoea is suspected, refer the patient for medical assessment.

Patients with obstructive sleep apnoea are at increased risk of respiratory arrest from sedation and general anaesthesia. Dental procedures requiring sedation or general anaesthesia in a patient with obstructive sleep apnoea should be undertaken in a hospital with an anaesthetist present.