Informed consent in the management of OSAS patient: form proposal

OBJECTIVES The objective of this work is to highlight need, duty and obligation by the dentist to acquire a specific informed consent from the patient affected by Obstructive sleep apnea syndrome (OSAS) and from the patient candidate for the use of the intra-oral mandibular advancement device (MAD). MATERIALS AND METHODS The patient, in order to be placed in the condition to decide and choose consciously what is the best for himself, must receive essential and exhaustive information, in relation to his own level of culture and emotion. In case of OSAS, the importance of the dialogue between doctor and patient assumes particular relevance, as it is a chronic condition with a high prevalence and a significant impact on the quality of life, whose missed diagnosis and consequent missed treatment lead to an excess in the mortality and morbidity of the affected population, with a correlated increase in the risk of road accidents and accidents at work. RESULTS For the first time, the dentist is called to deal with a pathological framework of multi and interdisciplinary pertinence with respect to which he occupies a privileged position, being able to carry out non only screening and prevention but also treatment through the application of intra-oral mandibular advancement device (MAD). This implies the potential attribution of new and greater profiles of professional responsibility, as incorrect management of the OSAS patient exposes him to risk of life. So, it becomes imperative to undertake an articulated and complete communication process, at the end of which the signing of a suitably created informed consent form acquires the value of becoming aware of the individual choice in full respect of the inviolable personal freedom and the right to health, and constitutes a basis of protection for the professional in case of a dispute. CONCLUSIONS The author - starting from the analysis of the most recent documents which refer to the principle of informed consent, Code of Medical Deontology, Law n. 219/17 and relevant jurisprudence - highlights the essential contents to adequately inform the patient of the risks related to OSAS. Specific modules are therefore proposed that are able to retrace the substantial points of the communication process, prepared for the dental management of both the patient potentially affected by OSAS and the OSAS patient treated with MAD. CLINICAL SIGNIFICANCE The presented forms are an indispensable tool for complying with the deontological and legal obligations of information and acquisition of consent in OSAS management, a chronic condition that impacts not only on the quality of life, but even on the chances of patient survival.