Saliva is produced by three paired “major” salivary glands in the head and neck – Parotid, Submandibular, and Sublingual as well as ~400 “minor” salivary glands throughout your oral cavity and oropharynx. Saliva is usually plentiful (your mouth makes between one pint and one liter per day) and is important in the enzymatic digestion of food, providing an immunologic barrier for dental protection, and to foster ideal oral mucosal health. Salivary glands may be affected by several different disorders that disrupt their important normal function:
Obstructive Sleep Apnea (OSA) is a common problem affecting nearly one-third of the adult population. The long-term health effects of untreated OSA are beginning to become established and are frightening: increased risk of cardiovascular disease, stroke, dementia, pulmonary hypertension.
It’s been more than twenty years since the 1997 revisions to Evaluation and Management guidelines, which focus mainly on physical examination. The 2019 proposed changes provide practitioners a choice in the basis of documenting E/M visits; alleviate the burdens, and focus attention on alternatives that better reflect the current practice of medicine. The implementation of electronic medical records has allowed providers to document more information, yet repetitive templates, cloning, and other workflows have pushed the envelope on compliance in documenting the traditional elements of the visit.
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