ABDSM flashcards
ABDSM · Build recall with a focused review session.
32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Apnea definition
- Cessation of airflow for at least 10 seconds, scored as obstructive when respiratory effort continues and central when effort is absent.
- Hypopnea definition
- Airflow reduction of 30% or more for at least 10 seconds with a 3% or greater oxygen desaturation or an associated arousal.
- AHI severity thresholds
- Apnea-hypopnea index 5-15 is mild, 15-30 is moderate, and greater than 30 events per hour is severe OSA.
- STOP-BANG interpretation
- Scores of 3 or more indicate high OSA risk; scores of 5 or more indicate high perioperative risk and warrant heightened monitoring.
- Epworth Sleepiness Scale
- Eight-item self-report of daytime sleepiness scored 0-24; 11 or more suggests excessive sleepiness warranting further evaluation.
- Berlin Questionnaire
- Three-category screen covering snoring/apnea, daytime sleepiness, and hypertension/BMI; two or more positive categories indicate high risk.
- OSA diagnostic criteria
- Diagnosis requires AHI 5 or greater with symptoms or comorbidity, or AHI 15 or greater regardless of symptoms.
- Home sleep apnea test
- Unattended testing valid for suspected moderate-to-severe OSA in adults without major cardiopulmonary disease; negative results may need in-lab study.
- RERA definition
- Respiratory effort-related arousal: escalating effort leading to arousal without meeting apnea or hypopnea criteria; contributes to upper airway resistance syndrome.
- Mandibular advancement device
- Oral appliance that protrudes the mandible to enlarge the pharyngeal airway; first-line for mild-moderate OSA and CPAP-intolerant patients.
- Tongue-retaining device
- Appliance that holds the tongue anteriorly using suction or a bulb, used when mandibular advancement is not tolerated or indicated.
- Bite registration purpose
- Records maximum protrusion and vertical dimension so the appliance can be fabricated at a defined therapeutic mandibular position.
- George Gauge use
- Instrument that records maximum mandibular protrusion and incisal separation, providing reference for appliance design and titration.
- Vertical opening effect
- Excessive vertical opening rotates the mandible posteriorly and can narrow the airway; minimizing it improves advancement effectiveness.
- Titratable versus fixed device
- Titratable appliances allow incremental mandibular advancement after delivery; custom titratable devices generally show better efficacy and adherence.
- Titration increment
- Mandibular advancement is increased in small steps, typically 0.25-0.5 mm, over weeks until symptoms improve or efficacy is confirmed.
- Efficacy confirmation
- Follow-up sleep testing after titration documents AHI reduction, commonly to less than 5 or a 50% or greater decrease from baseline.
- Initial follow-up timing
- First post-delivery visit typically occurs within 1-4 weeks to assess comfort, retention, tissue response, and early side effects.
- Common MAD side effects
- Salivation, dry mouth, tooth discomfort, and morning jaw soreness are common early effects that usually resolve within weeks.
- Occlusal change risk
- Long-term mandibular advancement can reduce overjet and overbite and cause mesial drift; baseline records and periodic review document change.
- Informed consent content
- Documents risks of occlusal change, tooth movement, TMJ symptoms, and the need for ongoing monitoring and possible retreatment.
- Dental baseline records
- Periodontal charting, caries assessment, occlusion, TMJ evaluation, photographs, and scans establish a reference before appliance therapy.
- Xerostomia impact
- Reduced salivary flow increases caries risk and can impair appliance tolerance and retention; address before and during therapy.
- Bruxism and appliances
- Parafunctional grinding increases appliance wear and fracture risk; a night guard is not a substitute for an advancement device.
- Appliance hygiene
- Daily cleaning and periodic professional evaluation reduce microbial load, tissue irritation, and appliance odor during long-term wear.
- Physician diagnosis requirement
- Dentists screen and treat OSA but diagnosis requires physician evaluation and sleep testing; treatment follows a confirmed diagnosis.
- Collaboration workflow
- Physician diagnoses and orders testing, dentist fabricates and titrates the appliance, and the physician reviews follow-up efficacy results.
- Reimbursement documentation
- Claims often require physician diagnosis, documented AHI, and evidence of CPAP intolerance or patient preference for oral appliance therapy.
- Scope of practice check
- Regulations for dental sleep medicine vary by jurisdiction; confirm local rules before providing appliance therapy.
- Positional OSA
- AHI is markedly higher in supine sleep; positional therapy or combination with an appliance may be needed for control.
- Retention requirements
- Adequate abutment teeth, typically 6-8 per arch with healthy periodontium, are needed for appliance retention and force distribution.
- TMJ screening
- Baseline evaluation of joint noise, pain, and opening range identifies patients needing modified advancement or referral before therapy.