THE VALUE OF A PULSE OXIMETER IN A DENTAL EXAM

In your New Patient Exam are you missing an opportunity to discover an illness that your patient is not aware of … and that you may be able to treat?

United States’ Medical professionals have noted the increase of patients with Sleep Apnea. A recent study shows that 34% of the population have symptoms of Sleep Apnea.  Air pollution, lack of exercise and greater public awareness may contribute to this increase. In order to combat Sleep Apnea the conditions must be monitored and reported to trained, qualified doctors for evaluation.
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Pulse oximetry, along with a clinical score (Epworth Sleepiness Score, for example), is an effective screening tool for Sleep Apnea and other sleep disordered breathing. This approach, though not as accurate or comprehensive as polysomnography, is an effective screening tool.  The oximeter provides the necessary information relating to how well air is getting into the lungs,
and consequently oxygen into the blood stream.

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Fingertip pulse oximeters are very inexpensive and are available at local pharmacies and on-line.
Every dental practice can make this two minute test part of their patient exam.

How pulse oximetry works in evidencing sleep apnea is very simple. When a person has sleep apnea, s/he experiences moments when s/he does not breathe (apnea events). When this happens the oxygen that circulates in the blood drops to an abnormally low level. A pulse oximeter will detect the drop in the oxygen saturation of the blood.

Significant oxygen saturation change is defined as a drop in oxygen saturation of greater or equal to 4 percent and to a level of 90% or below. Each series of changes represents an apnea episode.


The pulse oximeter is an important part of a sleep study because it monitors the blood oxygen levels. The mechanism of the device uses infrared light that passes through the finger, or sometimes the earlobe, and measures the difference between the oxygen-bound and unbound hemoglobin. The oxygen-bound hemoglobin have the wavelength of red light, and the oxygen-unbound hemoglobin have the wavelength of blue light. The oximeter measures the difference between these two hemoglobin compositions, and the value of their difference displays whether the oxygen saturation in the blood is normal or not.

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Pulse oximeters also give readings of pulse rates. Research has shown that obstructive sleep apnea changes heart rate dynamics. During periods of prolonged obstructive sleep apnea, the heart rate typically shows cyclic fluctuation associated with the apneic phase and the resumption of breathing. By analyzing the heart rate, a study has shown that obstructive sleep apnea could be detected in over 93% of the test cases.

Sources
http://www.ncbi.nlm.nih.gov/pubmed/17283346
http://EzineArticles.com/5828493

 

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