A. The team comfort level will be the determinant for when they
add screening for airway to the office protocol. They will choose
how many patients they see and when they want to see them.
1. The staff needs to learn how treatments affect airway, why dentists are
adding airway focus to the treatment protocol, and what they need to
know to be able to inform and educate patients.
• Team lunch-and-learns using e-books and other internet resources to
gain basic understanding of dental signs and symptoms and terminology
• If available, interested team members will use a home sleep monitoring
system to assimilate the patient experience. For 30 days after the initial
program begins, team members are encouraged to test family mem-
bers and friends to develop techniques and vocabulary in a low-risk
setting. Usually within a few trials, one team member will present with
the passion to become the office sleep champion.
2. Patient history forms mailed to new patients will now include a question-
naire that screens for airway issues.
• Include StopBang, Dawson, or Epworth Sleepiness Scale questionnaire
in all new-patient packets.
B. The dentist needs to build a patient referral base with medical
physicians and ENTs.
1. The dentist will want to find medical experts in his area, and gain a better
understanding of their medical process.
• Ask about the medical experts’ preferred process for testing and diag-
nosing patients with airway issues.
• What system does the medical group test with, and will the group accept
data from a home monitoring system.
• Ask companies selling home monitoring systems to share medical
contact information in the dentist’s area.
2. For any team member with airway issues, dentist should schedule ap-
pointment for dentist and staff member to meet a medical physician.
• Schedule appointment for team member and dentist.
• Possibly schedule appointment with a different medical physician to
learn different medical protocols.
• If applicable, request medical read of data from company selling home
monitoring system if medical doctor does not use that specific system.
C. The medical expert may prefer to schedule the patient’s airway
test or accept data from dentists. (At this time, dentists in New
Jersey and Georgia are allowed only to screen dental patients,
not use data from systems providing AHI information.)
1. If medical expert prefers to test, refer patient to medical professional.
• Write referral to medical professional for patient and document in file.
• Follow up on referral at next patient visit.
2. Dentists administering tests in the office will need to research home sleep
monitoring systems that provide AHI numbers and supply data that is ac-
cepted by local sleep physicians.
• Check out Whip Mix Nox T3 home sleep monitoring system, a system
recommended by medical physicians, at whipmix.com/products/
• Check out product reviews such as this one from the Sleep Review
Journal. ( a360-wp-uploads.s3.amazonaws.com/wp-content/uploads/
• Ask medical physicians about the different systems on the market.
• Purchase a system that will work best for your office.
• Ensure that free adequate staff training is included with system purchase.
D. Patient airway concerns will be reviewed by the dental assistant
who completes the new-patient initial exam.
1. For patients scoring high on the sleep questionnaire, the dental assistant
will screen for four additional symptoms during the initial exam. (Two ad-
ditional minutes are needed.)
• Screen for tongue size, scalloped tongue, Mallampati score, and size of
• For patients with these symptoms, the assistant will share how the
dentist is addressing airway concerns, and recommend that the patient
set up a separate free appointment to meet with dentist.
2. At this point, the airway treatment may follow a separate schedule than
the dental treatment.
• Make a separate appointment for the patient to meet with the dentist
on airway issues.
E. Dentist meets with patient specifically on airway concerns.
Recommended treatment plan presented.
1. Explain impact of airway issues and dental connection.
• Review patient signs and symptoms of airway issues.
• Present treatment plan, including home sleep monitoring system and fees.
• Set up patient in software, document reason for test, and whether any
appliances will be worn.
• Show patient how to use monitor at home.
• Have patient return system after one- or two-night study.
• Schedule dentist to call patient for follow-up within one week after
study has been returned.
3. If treatment plan is not accepted, refer patient to sleep physician.
• Give patient referral to sleep physician.
• Send letter to sleep physician regarding patient referral.
• Document patient data and response in file.
F. Dentist to review results of home sleep study. Dentists may
screen for airway issues but a diagnosis MUST come from a
1. If no airway issues appear to exist, continue with current dental treatment
• Call patient to continue with treatment plan.
• Document study results in patient file.
2. If airway issues appear to exist, option one is to send raw data to a medical
doctor in specific state for professional read and report including prescription. (This is usually coordinated through company that sells home monitoring system.)
• Send data to medical professional for read and report.
• Follow treatment prescription from medical professional.
• Call patient with medical report results.
3. If airway issues appear to exist, option two is to send raw data to medical
doctor in the area that can review the data, see the patient, and give
• Refer patient to medical doctor.
• Send letter with patient data to medical doctor.
• Request follow-up from medical doctor on patient treatment plan.
Once the process is running smoothly and office time is scheduled to cover airway
issues, ensure that both existing and new patients are included in the work flow.
Checklist provided by Whip Mix Corporation. For questions, call (800) 626-5651 or
KEEP YOUR TEAM BREATHING
they step out of their comfort zone to implement
airway screening in the dental practice.
This dentist is committed to adding a focus
on airway into his practice, and acknowledges
the work that needs to be done to help his
team accept and embrace change.
For those of you considering this,
I wish you well on your journey. May
your dental procedures be predictable, your office traffic considerable,
and your airway screening processes
LORENA LIGHTHART is the product
manager for the Clinical Products Division
at Whip Mix. She has worked in the dental
industry for more than 30 years. Lorena
works with a myriad of experts in the field
to bring new products to market that
support functional occlusion, esthetics, and
AIRWAY PROTOCOL CHECKLIST