Projects
039 - Screening of sleep disordered breathing by dental practitioners
- Chief Investigator A: Dr Mihiri Silva
- Chief Investigator B: Dr Moya Vandeleur
- Associate Investigator: Dr Sai Raksha Baskar
Introduction
Sleep-disordered breathing (SDB) includes various conditions from snoring to obstructive sleep apnoea, affecting a child's growth and development. Early detection is vital, and dentists can play a unique role in screening, even for families who might not seek medical help. However, there's limited research on dental SDB screening.
Aim
To assess patient outcomes and experiences of dental practitioners screening for paediatric SDB in children attending private dental practices in metropolitan Melbourne between the ages of 3-12.
Rationale
SDB prevalence among children is estimated at 2% to 11%, often unnoticed due to limited parental awareness of snoring's health implications. Dentists play a vital role in SDB recognition and screening. Despite polysomnography (PSG) being the diagnostic gold standard for obstructive sleep apnoea and SDB, cost and scarce testing centres lead to delays in access.
The Paediatric Sleep Questionnaire (PSQ), a validated 22-question version for ages 2 to 18, offers an accessible alternative to screen SDB risk. A PSQ score above 0.33 indicates higher risk for paediatric sleep-related breathing issues, enabling early intervention.
Using PSQ, dental practitioners can significantly aid in identifying and managing paediatric SDB, bridging a critical diagnostic gap. This research addresses the need for efficient and timely SDB detection, underscoring dentists' potential impact in improving child health outcomes.
Methodology
This will be a longitudinal mixed methods pilot study involving dental practitioners across 5 practices in metropolitan Melbourne. An advisory committee with representatives of the key stakeholders including dental practitioners, patient representatives and medical practitioners will be formed prior to inform the objectives and methodology of the study. The eligibility criteria for practices:
- The dental practice must be located within metropolitan Melbourne
- The patient demographic of the dental practice must include children between the ages of 3-12.
- The dental practice must not currently be screening for sleep-disordered breathing or obstructive sleep apnoea (OSA) or undertaking treatments for the management of SDB or OSA.
Inclusion criteria for study population:
- Children aged 3 to 12 years of age inclusive attending five private dental practices across metropolitan Melbourne, Victoria.
Exclusion criteria for study population:
- Parents and child do not consent to study inclusion and do not have sufficient level of literacy/understanding to complete forms.
- Under 3 and over 12 years of age
Parents of eligible patients will be asked to provide/complete:
- Child name and age
- Paediatric Sleep Questionnaire (PSQ)
- Parent name and phone contact information
The dentist will review the results of the PSQ:
- If the patient scores less than 0.33 on the PSQ, then no further action is required.
- If the patient scores ≥ 0.33 on the PSQ, then the patient will be provided with a summary report with the results of their screening, and a recommendation letter to follow up with their medical general practitioner.
Following the visit, parents who participated will be given an electronic link to complete an online questionnaire about their experience with the screening process. A second questionnaire link will be sent to all participants six months after their appointment to determine their experiences and the effectiveness of the dentist referral in facilitating a diagnosis or further medical assessment for SDB.
What are the expected outcomes?
It is anticipated this project will:
- Determine the prevalence of sleep-disordered breathing risk amongst the sample of patients attending private dental practices.
- Determine the feasibility of dental SDB screening.
- Improve access to screening and more timely identification of SDB risk.
