Loube M D, Strauss A M
Pulmonary and Critical Care Medicine Service, Walter Reed Army Medical Center, Washington, DC, USA.
Chest. 1997 Feb;111(2):382-6. doi: 10.1378/chest.111.2.382.
Oral appliances (OAs) are used to treat obstructive sleep apnea (OSA). This study seeks to quantify the patterns of practice of OA use among dentists.
Survey mailed to dentists.
Members of the Sleep Disorders Dental Society (SDDS).
Dentists were asked questions regarding number of patients treated, types of OA used, average total OA cost to the patient excluding reimbursement, percentages of patients receiving pretreatment and posttreatment nocturnal polysomnography (NPSG), and whether they believe subjective patient reports alone or nocturnal pulse oximetry alone is an adequate substitute for NPSG to assess OSA treatment response. Summary statistics for the absolute value and percentage data are presented with the median, maximum, and minimum range.
Three hundred fifty-five surveys were mailed, of which 124 (35%) were returned. These dentists treat a median of 27 OSA patients with OAs (range, 2 to 300) annually. Patients receive pretreatment NPSG in 95% of cases (range, 0 to 100%), and posttreatment NPSG in 18% of cases (range, 0 to 100%). Only 7% of dentists believe subjective patient reports alone are an adequate substitute for NPSG. Nocturnal pulse oximetry was perceived to be an adequate substitute for NPSG by 37%. Dentists who believe nocturnal pulse oximetry to be an adequate substitute for posttreatment NPSG are less likely to obtain pretreatment or posttreatment NPSG (Mann-Whitney U test, two-tailed; p = 0.001, p = 0.02).
Most SDDS dentists believe subjective reports and nocturnal pulse oximetry are inadequate to assess OA treatment response in OSA patients, yet posttreatment PSG is obtained infrequently.
口腔矫治器（OAs）用于治疗阻塞性睡眠呼吸暂停（OSA）。本研究旨在量化牙医使用口腔矫治器的实践模式。
向牙医邮寄调查问卷。
睡眠障碍牙科协会（SDDS）成员。
询问牙医关于治疗患者数量、使用的口腔矫治器类型、患者排除报销后的口腔矫治器平均总费用、接受治疗前和治疗后夜间多导睡眠图（NPSG）的患者百分比，以及他们是否认为仅患者主观报告或仅夜间脉搏血氧饱和度测定足以替代NPSG来评估OSA治疗反应。给出绝对值和百分比数据的汇总统计，包括中位数、最大值和最小值范围。
共邮寄355份调查问卷，其中124份（35%）被退回。这些牙医每年使用口腔矫治器治疗OSA患者的中位数为27例（范围为2至300例）。95%的病例（范围为0至100%）患者接受治疗前NPSG，18%的病例（范围为0至100%）患者接受治疗后NPSG。只有7%的牙医认为仅患者主观报告足以替代NPSG。37%的牙医认为夜间脉搏血氧饱和度测定足以替代NPSG。认为夜间脉搏血氧饱和度测定足以替代治疗后NPSG的牙医获得治疗前或治疗后NPSG的可能性较小（曼-惠特尼U检验，双侧；p = 0.001，p = 0.02）。
大多数SDDS牙医认为主观报告和夜间脉搏血氧饱和度测定不足以评估OSA患者口腔矫治器的治疗反应，但治疗后多导睡眠图检查很少进行。
