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Introduction: Dental sleep medicine is an emerging field within dentistry. While limited education in sleep medicine has been reported among US predoctoral dental schools, no study has been conducted among postgraduate dental programs. This study compared the extent and exposure to sleep medicine education among US postgraduate programs in orthodontics, pediatric dentistry, orofacial pain (OFP), general practice residency (GPR), and advanced education in general dentistry (AEGD)., Methods: A REDCap survey was distributed among N = 391 US postgraduate programs investigating the nature, content, and modality of sleep education during the 2023-24 academic year., Results: Among 68 responding programs (43.1% GPR, 18.5% AEGD, 18.5% orthodontics, 12.3% pediatric dentistry, and 7.7% OFP), faculty with sleep training constituted 7.5%, with 2.6% being board certified in sleep medicine. Approximately 41.8% of programs offered sleep medicine courses, with differences among specialties (100% OFP, 42.9% GPR, 37.5% pediatric dentistry, 33.3% orthodontics, 16.7% AEGD; p = 0.032). Didactic teaching comprised 7.8 ± 14.6 h/year (range 0 h/year in 21.5% to 80 h/year in 1.5%), with differences across programs (OFP = 44.0 ± 17.7, orthodontics = 8.7 ± 11.0, GPR = 5.0 ± 8.0, pediatric dentistry = 2.1 ± 1.9, and AEGD = 2.9 ± 5.4; p < 0.001), and constituted the primary modality of instruction (mainly obstructive sleep apnea, bruxism, sleep physiology). Screening and treatment for sleep-related disorders were provided by 35.9% and 37.9% of programs, respectively, with variations among specialties (p = 0.004)., Conclusion: Our findings revealed an average of 7.8 h/year of didactic sleep medicine instruction, which differed across specialties. OFP offered the highest level of didactic and clinical training. These findings emphasize the need for increased dental sleep medicine education to address the increasing involvement of dental professionals in managing sleep-related disorders., (© 2024 American Dental Education Association.)

Coronavirus disease 2019 (COVID-19) was declared a global pandemic in March 2020, which precipitated urgent public health responses. The causative agent, SARS-CoV-2, spreads primarily via respiratory droplets, necessitating precautions to mitigate transmission risks. Biopharmaceutical industries and academic institutions worldwide swiftly redirected their research endeavors towards developing therapeutic interventions, focusing on monoclonal antibodies, antiviral agents, and immunomodulatory therapies. The evolving body of evidence surrounding these treatments has prompted successive updates and revisions from the FDA, delineating the evolving landscape of COVID-19 therapeutics. This review comprehensively examines each treatment modality within the context of their developmental trajectories and regulatory approvals throughout the pandemic. Furthermore, it elucidates their mechanisms of action and presents clinical data underpinning their utility in combating the COVID-19 crisis., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To examine the influence of acute stress on salivary flow using a validated stressor paradigm., Study Design: This uniform crossover study consisted of 40 healthy adults who underwent the Trier Social Stress Test, consisting of a 5-minute mental arithmetic task (MAT), and a nonstressful task (NST), consisting of a 5-minute free speech task. The order of the tasks was counterbalanced and unstimulated whole saliva (UWS) was measured in 2 groups of 20 participants during each 5-minute task condition, with a 10-minute washout period between tasks. At baseline, mathematical ability was self-reported and psychological distress was measured using the Symptom Checklist-90-Revised. Heart rate (HR) and breathing rate (BR) were recorded during each task., Results: Age, sex, HR, BR, and psychological distress were similar between groups at baseline (P > .05). During the MAT, HR increased significantly and mean UWS flow rate decreased significantly compared with the NST (P < .001)., Conclusions: An acute psychobiological stressor task was associated with a rapid decrease in salivary flow in adults. Thus, stress can contribute to reduced salivary flow and should be considered as a factor during the diagnostic workup of patients who complain of a dry mouth., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Study Objectives: Mandibular advancement devices (MAD) constitute a feasible option for management of mild-to-moderate obstructive sleep apnea (OSA) and in severe cases, when indicated. As a chronic condition, the management of OSA with MAD requires long-term patient adherence to treatment. The aim of the study was to investigate adherence to MAD therapy during a 36-month observation period in relation to changes in self-reported symptoms and objective response to therapy., Methods: Retrospective chart review of patients referred to the Orofacial Pain Clinic (University of Kentucky) between 2016 and 2021 for management of OSA with MAD was performed. Based on a posttreatment sleep study with MAD in situ, participants were subdivided into optimal response (> 50% reduction of baseline apnea-hypopnea index) and suboptimal response (< 50% reduction of baseline apnea-hypopnea index) groups. Outcomes included self-reported adherence to MAD use, self-reported OSA symptoms including snoring, apneic episodes, tiredness upon awakening, fatigue, and sleep quality (on a 100-mm numerical rating scale), and daytime sleepiness (0-24 on the Epworth Sleepiness Scale). Intragroup and intergroup differences at different time points over a 36-month observation period were assessed with one-way and repeated-measures analysis of variance., Results: Of 54 participants included (46.3% female, age 64.4 ± 10.71 years), 30 (55.6%) achieved optimal response and 24 (44.4%) achieved suboptimal response. At baseline, participants with optimal response differed from those with suboptimal response in apnea-hypopnea index ( P = .007), snoring ( P = .026), and sleep quality ( P = .042). Although fluctuating in both groups, no difference was found over time in adherence (7 nights/wk, 7 h/night) and in OSA symptoms (all P > .05)., Conclusions: Adherence to MAD was maintained over 36 months regardless of fluctuation in self-reported OSA symptoms and effectiveness of MAD therapy., Citation: Sangalli L, Yanez-Regonesi F, Moreno-Hay I. Evolution of adherence and self-reported symptoms over 36 months with mandibular advancement device therapy for obstructive sleep apnea: a retrospective study. J Clin Sleep Med . 2024;20(4):487-496., (© 2024 American Academy of Sleep Medicine.)

Introduction: Bruxism has historically been of particular interest to the field of dentistry, primarily due to the inferred damage it may cause to the dentition and supporting periodontal structures. The definition of bruxism itself has undergone multiple changes over time. In addition, the effects of bruxism as it relates to oro-facial pain conditions has remained a debatable topic., Purpose: To review the available literature relating to bruxism and non-temporomandibular disorder (TMD) pain conditions., Methods: A literature search was conducted with the assistance of an expert librarian. The following databases were reviewed: PubMed, MEDLINE, EMBASE and Google Scholar. For additional references, articles were also retrieved by hand search from the selected papers. Any articles that were not published in English, or the focus were related to temporomandibular disorders were excluded., Conclusions: While bruxism and certain headache conditions do tend to occur together frequently, evidence relating to any clear common pathophysiological mechanism has yet to be fully elucidated. Robust evidence as it relates to the relationship between bruxism and other non-TMD oro-facial pains is also lacking., (© 2023 John Wiley & Sons Ltd.)