Opening eyes to the airway

Dr. Howard Hindin

If you’re not looking for something, you won’t see it.

In a column dedicated to engaging the topics that will shape the future of our profession, I can think of few topics more important than the dental practice’s role in raising awareness around airway health. The more researchers learn about the connections between breathing and overall wellness, the more we see critical links between airway health and everything from fatigue to food cravings, children’s behavioral issues, and even chronic infections.

The Foundation for Airway Health (FAH)-co-founded by Drs. Howard Hindin and Michael Gelb-is an interdisciplinary organization with a laser-like focus.

Dr. Michael Gelb

“Our number one goal is that every single dentist should screen every single patient for an airway problem,” said Dr. Hindin. “Not diagnosis or test, but screen. If a patient is at risk, the clinician can refer them out or they can learn more and pursue treatment-that is up to them. The goal of the Foundation is that everyone with a problem gets the information to recognize the issue. What professional spends more time with patients in the course of the year than the dentist and dental hygienist? This is the most logical place to start the conversation.”

According to the American Sleep Apnea Association, an estimated 22 million Americans suffer from sleep apnea, with 80 percent of the cases of moderate and severe obstructive sleep apnea undiagnosed. Dr. Hindin points out that almost every member of the FAH Board of Directors has a story of their own undiagnosed airway issue. 

“One member bought a cone beam imaging system for his practice and volunteered to be the first one to try it out. When he saw how small his airway was, he sought treatment,” Dr. Hindin shared. “When I lecture to doctors, I point out that half of them have problems themselves. They should start with screening themselves. If dentists start looking and see how many people this affects, it will open their eyes and they won’t be able to close them again.”

     "Our number one goal is that every single dentist should screen every single patient for an airway problem, not diagnosis or test, but screen.”

– Howard Hindin, DDS

Dr. Hindin and the FAH team understand that a critical part of raising awareness among both the public and the dental community means holding their own authority lightly.

“We don’t have to be the sole education body, we just want people to seek out information. You can’t learn it all from one teacher or the first time,” said Dr. Hindin. “We are constantly considering how to present information in a way that will move people. We have to reach the people who aren’t already at the dental sleep medicine lectures and meetings. 

“For that reason, we talk a lot about how important airway health can be in the long-term success of the dental practice,” he continues. “If you want a successful practice, you have to look at sleep because it impacts chronic health, children’s ability to learn, and is even a culprit in failed dental treatment. It is not a 100 percent cause of any of these things, but important enough that if you don’t consider it, you’ll never fully address the problem. So, whether you screen and find nothing, or screen and refer to physicians, or screen and treat in-house, you are building trust and relationships with patients that will only improve your dentistry and support other aspects of the practice.”

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At its annual meeting-the Airway Summit was held in November 2019-the FAH is doing its best to make not only the clinical, economic, and marketing case for embracing airway health screening, but also facilitating the kind of learning that comes from dental professionals engaging with other medical professionals.

  "If you want a successful practice, you have to look at sleep because it impacts chronic health, children’s ability to learn, and is even a culprit in failed dental treatment.”

– Howard Hindin, DDS

“In the 1900s, the relationship between dentistry and medicine was much closer. Dentistry evolved to be more focused on repair than health, but we are now starting to see things switch back. This is why the Foundation isn’t just for dentists,” Dr. Hindin said. “One of the compensations for not breathing well is neck bending, which causes poor posture that needs to be corrected. So, we have a lot of physical therapists engaged in this work, we even have one as part of the team. Each field can manage their piece well, but optimal care comes from working together. That is why Collaboration Cure is the theme of the annual meeting agenda, bringing an interdisciplinary team together to learn more about what one another does, and how to network.”

The Foundation is also committed to building a Corporate Roundtable that allows manufacturers to be part of the awareness-raising work, in addition to making it easier for dentists to find the goods and services that support them on their journey. Many have a footprint in the airway/sleep world, but the involvement is driven by information and helping dental professionals feel prepared and confident in discussing airway health.

Progress is being made: In 2018, the American Dental Association passed a resolution that all doctors should be screening for sleep problems. But, as Dr. Hindin points out, they never told practices how to implement the resolution.

“In response, a task force was assembled to create a screening questionnaire for children,” he shared. “One of our board members is heading it up and we will be presenting the recommendations in April.”

As a Board Member, as a clinician and as a member of the community, I am grateful for the work the Foundation is doing to help ensure that we are professionals who are informed enough to set the right priorities, and also doing the work to translate our values into action. If you are interested in helping awareness for airway health, consider joining FAH as an Airway Advocate; workshops and webinars are available throughout the year. For more information, go to airwayhealth.org.