BACKGROUND

The current pathway for MAS treatment in patients with Obstructive Sleep Apnoea (OSA) requires referral to Orthodontics by the Respiratory department. A significant proportion of patients are not dentally fit on presentation to the orthodontic department, resulting in delayed treatment.

AIM

Improve efficiency of referrals for MAS treatment.

Objectives:

1.Identify and reduce the proportion of cases where MAS treatment is delayed due to dental treatment need.
2.Implement a dental screening tool for respiratory clinicians to use during assessment to predict the likelihood of dental treatment being needed prior to MAS provision.

METHODS AND RESULTS

A first cycle was conducted within the Orthodontic department to identify all patients seen for MAS assessment between 1/11/21-1/11/22. 40 patients were identified for inclusion in the audit. 65% (26) were accepted for MAS treatment. 22% (9) MAS treatment was delayed until required dental treatment was completed.The average delay for MAS treatment was 65 days.

A locally-developed dental screening tool was implemented for use by respiratory clinicians to supplement OSA assessment, categorising patients into three outcomes:

1.Dental treatment required, referred to their Dentist and then referred to Orthodontics.
2.Advised to see their Dentist and referred to Orthodontics.
3.Referred to Orthodontics.

A second cycle is currently ongoing and encouraging early data shows an 80% (5) accuracy of predicting if dental treatment is likely needed before MAS construction.

CONCLUSIONS

1.Treatable dental disease delayed the provision of MAS treatment.
2.A complete second cycle audit is ongoing to ascertain the screening tool effectiveness.