How Dentists Can Add Sleep Apnea Screening and Testing to Their Practice

Nearly 30 million people in the U.S. have obstructive sleep apnea (OSA), and 80% of people with obstructive sleep apnea (OSA) remain undiagnosed. 

But do you know who can help identify those who might be living with it? Dentists.

Many patients with sleep apnea go undiagnosed simply because they don't have a clear pathway to screening — and dentists are uniquely positioned to change that. Let's explore how oral care practitioners can add sleep apnea screening and testing to their practice, helping more patients get the answers and care they need, without stepping outside of your scope of practice.

Why Dental Practices Are Well-Positioned For OSA Screening

Before diving into how, it helps to establish why dental practices are well-positioned to add OSA screening. 

Dentists See Their Patients More Frequently

Worldwide, it’s recommended that patients have dental visits at least every 6 months, though many are now tailoring visit intervals based on individual risk. 

Somnologists, or sleep specialists, on the other hand, are typically sought on an as-needed basis and via referral from a primary care physician (PCP), whom patients typically see annually for a check-up. This approach is often more reactive, as patients may only be referred if they report loud snoring, waking up with shortness of breath, or still feeling tired after a night of rest. 

Oral Clinical Exams Can Reveal OSA Risk Factors

Dentists have a direct view of the airway anatomy during oral exams, allowing them to identify physical OSA-related risk factors, including: 

• Receding chin 

• Undersized lower jaw 

• Large neck circumference 

• High arched palate

• Large tongue or tonsils 

Since these physical markers are already visible during a routine exam, flagging them gives dentists an opportunity to improve patients' quality of life and increase their clinic's bottom line. 

Referrals Already Occur

Dentists routinely refer patients to physicians and specialists for conditions outside their scope, from oral cancer to TMJ disorders. Therefore, adding OSA to that referral network isn’t exactly a new workflow. It’s simply an extension of a process dental practices already run. 

How Dentists Can Add Sleep Apnea Screening and Testing 

Let’s explore the different screening and testing pathways dentists can offer. 

Screen For OSA In Your Intake or Questionnaire

The process for medical referral to a PCP or specialist can begin before the patient even sits in a chair or arrives at your office. An intake questionnaire can help flag patients with sleep concerns by asking whether they: 

• Snore

• Have been witnessed gasping or stopping breathing during sleep

• Wake up with headaches or a dry mouth

• Feel excessively tired during the day, even after a full night’s sleep 

Towards the bottom of the form, you could ask if they’re open to a referral based on their answers. 

Have Proper Workflows in Place to Support OSA Screening and Testing

To successfully implement this at your dental practice, it’s important to have proper processes in place. You should know when and how to initiate intake, how to handle flagging and referring positive responses, and how to ensure defensible documentation, for example. 

The latter is crucial for multiple reasons, including addressing potential scope-of-practice concerns and supporting insurance claims later. Keep in mind that dental insurance doesn’t typically cover HSAT. Medical insurance does, and it’s tied to the physician visit. 

Build a Local Outbound Referral Network 

Dentists can’t diagnose sleep disorders, and the American Dental Association (ADA) frames OSA care as a collaborative effort.

Consider having an outbound referral network that, at a minimum, includes: 

• Board-certified sleep medicine physicians 

• ENT specialists for structural airway issues 

• PCPs who can order home sleep apnea tests (HSATs) 

HSATs cannot be ordered or interpreted by dentists in most states. Therefore, be sure to review your state’s specific rules before facilitating any testing logistics. 

Inbound Referrals for Oral Appliance Therapy

Once a patient has a confirmed OSA diagnosis, they’re occasionally referred back to a dentist for oral appliance therapy. 

The handoff from physician to dentist typically includes: 

• A written diagnosis and severity classification (mild, moderate, or severe OSA) 

• A physician's prescription of referral specifically for oral appliance therapy 

• Any relevant CPAP trial history 

From there, the dentist takes over fitting and adjusting the custom mandibular advancement device. The referring physician can then conduct follow-up testing to confirm that the appliance is effectively managing the patient’s condition. 

Work With a White-label Telehealth Provider

In areas with limited access to in-person specialists or if you simply want to extend a convenient option to patients, a white-label telehealth partnership is worth considering. Rather than sending patients to a separate, unfamiliar service, a dental clinic could offer virtual sleep testing under its own brand. This approach keeps the patient experience under the dental practice’s own brand, while licensed medical providers handle diagnosis and testing.

This process could look like: 

• A dentist completes the OSA screening and sends at-risk patients to the telehealth vendor’s network of remote sleep medicine providers.

• A provider ordering HSATs, reviewing results, confirming diagnosis, and recommending treatment. 

  • Patients who can’t tolerate CPAP machines can be referred back to the dentist for oral appliance therapy fitting. 

Ready To Offer OSA Screening and Testing to Your Patients? 

Dentists already have patient access, assess OSA-related risk factors, and have a referral framework in place to make sleep apnea screening and testing work.  

So, adding OSA screening is less of a leap than it sounds, since most of the patients who need it are already sitting in your chair.

OpenLoop can make expanding your patient network and extending customer lifetime value possible, with its white-label, whole-health virtual care infrastructure. Talk with our team to learn more about adding sleep screening to your practice. 

*This content is intended for general informational purposes only and should not be construed as legal advice. For guidance on your specific situation, please consult a licensed attorney.