The Faculty of General Dental Practice UK (FGDP(UK)) has written to the National Institute for Health and Care Excellence (NICE) to make it aware of the role of dentists in managing obstructive sleep apnoea (OSA).
It is estimated that 5% of adults in the UK - over 2.5 million people - have undiagnosed OSA, which results in reduced oxygen levels, dysfunction of the nervous system and fragmented sleep, and in turn can affect work performance, the ability to drive safely and overall quality of life.
NHS England has asked NICE to develop clinical guidance on sleep-disordered breathing, and FGDP(UK) has responded to a consultation on the scope of the work, drawing attention to existing advice, highlighting the role of oral appliance therapy, and noting the importance of GDPs in making and receiving referrals.
The Faculty says patients who self-diagnose, or are persuaded by their partners to seek help for their snoring, often speak to their dentist, and that GDPs also receive referrals from GPs, ENT surgeons and respiratory physicians. It requests the inclusion of guidance on the symptoms of OSA, advice on to whom to make referrals and what information to supply, and recognition that referrals to NHS services can come from private as well as NHS practitioners.
FGDP also highlights the growing number of GDPs and orthodontists trained to treat and manage OSA through the use of oral appliance therapy, and while welcoming the reference within the draft to mandibular advancement devices, calls for the inclusion of tongue-retaining and palatal positioning devices as well.
The Faculty says oral appliance therapy is used as both a diagnostic tool and a management strategy for OSA in many other countries, citing the Dutch national guideline and guidance from the American Academies of Sleep Medicine and Dental Sleep Medicine, and encouraging NICE to consider the care pathways in Belgium, Germany and the Scandinavian countries.
Quentin Jones, FGDP(UK) lead on dental sleep medicine, said:
"In America, Europe and Japan, trained GDPs can support their medical colleagues in providing much-needed relief to snorers, sleep apnoea sufferers and their bed partners through carefully targeted use of oral appliances. We urge NICE, in developing its guidance for the UK, to consider the full range of oral appliances, and the evidence from around the world of their effectiveness when delivered through collaborative healthcare frameworks."
The full response is available in Policy, Reports and Consultations.