Dentistry’s effect on the systemic health of the human condition is undeniable. Past and current literature is replete with how dental and periodontal diseases can be risk factors for many conditions such as cardiovascular disease, GI conditions, high blood pressure and diabetes, to name a few. Our role as health professionals in the human condition is continuing to grow and expand as we find ourselves intersecting between classic dental treatments and the fields of medicine, pain management and most recently, dental sleep medicine. Newer concepts and techniques for diagnoses and analyses are changing the very nature of how we practice dentistry, and in turn challenging current methods of teaching in our nation’s dental schools.
As educators, we find ourselves caught in the middle of the ‘big bang theory’ with information generation accelerating at an ever-increasing rate, while practicality has forced us to maintain the generations-old four-year dental curriculum. Regardless of how the educational institutions may want to change, they are caught between the accreditation processes of the ADA and the requirements of individual and regional dental boards. Nowhere is this clearer than in the emerging fields of orofacial pain and dental sleep medicine. Since these fields are not currently part of the required ADA accreditation process or a part of any board requirement in dental licensing examinations, they fall into the category of ‘orphan diseases’ given minimal time in the mainstream curriculum.
Even specialty training programs cannot keep up with the interprofessional nature of information that is required to treat the myriad of complex cases we are seeing in all of our specialties. For instance, it is known that inflammatory processes in periodontal disease can affect the cardiovascular system, and it has also been implicated in diabetes and high blood pressure. However, newer information is also pointing to sleep disordered breathing as being part of that same process, and may be implicated in turn, driving the severity of the periodontal condition. Sleep disordered breathing is also of concern in pediatric and geriatric populations requiring that the pediatric, orthodontic, restorative and prosthetic programs pay attention to the assessment and management of the posterior airway.
While each institution has to make its own decision as to what to teach in this field, I am happy to state that CRANIO has done its part by recently incorporating a major section on sleep disorders to go along with its craniofacial pain section.