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Transcript of The Sleep Magazine- 1st {Premier} Issue
DENTAL SLEEP MEDICINE
W
“Starting
Your Dental Sleep Practice Within Your
Practice, TODAY!”
1) positive airway pressure2) surgery3) oral appliance therapy4) topical nasal treatment.
We must embrace,
nurture and successfully cultivate the
multidisciplinary model
Dental Sleep Medicine Inaugural IssueLet’s answer the call to action and start Saving Lives!
Dr. J.Brian Allman,
WWW.DENTALSLEEPMAGAZINE.COM 1
Airway Pathology and Sleep Disorders ............................................................................. 2
Any news? Market Opportunity ........................................................................................ 4
“Why should I attend your seminars? What makes them better than others out there?” ........................................................... 4
FEATURED SPEAKERSDr. Brian Allman ................................................................................................................ 5Dr. Rondeau ....................................................................................................................... 7Dr. Dan Taché .................................................................................................................. 31
Dentists Can Save Lives .................................................................................................... 6
Starting a Dental Sleep Medicine Practice Within Your Practice, TODAY! ...................... 8
NOW is the time to integrate Sleep Disorders Dentistry into your practice ................. 10
Snoring and Bruxism in Children: It is not All Just Noise! ............................................. 12
Ortho and Osa ................................................................................................................. 16
Women Dentists Treating Sleep Apnea .......................................................................... 17
Why You Should Be Involved .......................................................................................... 18
The Million-Dollar Question ........................................................................................... 19
Medical Insurance Billing for Oral Appliance Therapy ................................................ 20
SGS Sleep Seminar Schedule ......................................................................................... 21
Educating Dentists in the Recognition & Treatment of Sleep Disorders ..................... 22
The Future of Sleep Disorder Breathing Testing .......................................................... 26
Collaboration of Dental and Medical Sleep Specialists ............................................... 28
Your Friendly Neighborhood Sleep Lab ........................................................................ 29
“Raising Awareness - Finding Sleep patients in your practice” ................................. 32
The Pharyngometer An Excellent Treatment Tool - The Greatest Sales Tool .............. 34
Introducing: SGS 3D Airway Software .......................................................................... 36
The O2 OASYS Oral/Nasal Airway System® - a Must With Nasal Resistance - a Should Without Nasal Resistance ...................... 39
The ABCs of CPAP Therapy & Compliance ................................................................... 40
Dental Sleep Medicine in Review ................................................................................. 42
Sleep Disorder Patient: Jim .......................................................................................... 44
Mandibular Advancement Device (MAD): A Practical Technique for the Youthful, Impaired, and/or Cost-Conscious Patient .... 46
DSM Magazine’s Clinical Pearls ................................................................................... 44
table
ofco
nte
nts
by educating more dentists about the
life saving treatments they should
be offering.”
DISCLAIMER
DENTAL SLEEP MEDICINE2
CE Seminars and customized in office training programs
Noninvasive upper airway acoustic diagnostic imaging
Home sleep apnea screeningNEW - Online Videos2009 SGS Sleep Seminars
Dr. Brian Allman
Dr. Dan Tache
Dr. Brock Rondeau
SEE OUR FULL SEMINAR CALENDAR FOR DATES AND LOCATIONS “Which appliance should I use”
Airway Pathology and Sleep DisordersIt is estimated that up to 90 million people in North America suffer from a sleep disorder
WWW.DENTALSLEEPMAGAZINE.COM 3
REM Sleep
How much sleep do I need?
Why do I wake up feeling tired?
Is snoring harmful?
Do you snore? Are you exhausted all day? Do you want to sleep better? Have you been diagnosed with Sleep Apnea?
HeadachesSnoringExcessive daytime
tiredness
Heart attackStroke
DENTAL SLEEP MEDICINE4
Any news?Market Opportunity
“Why should I attend your seminars? What makes them better than others out there?”Our instructors are practicing this every day. Sleep represents a huge part of their practices
DENTAL SLEEP MEDICINE6
surgical interventionCPAP device
oral appliances
Dentists Can Save Lives!
be nasal oropharyngealhypopharyngeal
1. Nasal obstruction
2. Oropharyngeal obstruction
3. Hypopharyngeal obstruction
Serious cardiovascular complications, high blood pressure, heart attacks and strokes are linked to OSA
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DENTAL SLEEP MEDICINE8
The quickest and most effective way to incorporate dental sleep medicine into a general dental practice is to educate your staff as to the systemic co-morbidity and mortality of sleep disordered breathing.
A second key
Finally, discuss an agreed upon communication protocol with
Starting a Dental Sleep Medicine Practice Within Your Practice, TODAY!Few people unaffected by snoring or obstructive sleep apnea
Continued on page 45
DENTAL SLEEP MEDICINE10
©
“Traditionally,
it takes 6 to 12 months for economic
trends to affect dental practices. The
full impact of the down turn may be yet
to come.”
WHAT IS SLEEP DISORDERS DENTISTRY?
WHY PROVIDE SLEEP DISORDERS DENTISTRY?
A dentist can help save lives!
An opportunity to contribute by reducing
the national debt!
There is an abundance of patients!
Patient feedback is positive!
Offering this service sets a practice
NOW is the time to integrate Sleep Disorders Dentistry into your practice
Offering improved patient help and additional income stream.
WWW.DENTALSLEEPMAGAZINE.COM 11
apart from others in the area!
Sleep Disorders Dentistry
is another stream of income
for a practice!
HOW DO I GET INVOLVED WITH SLEEP DISORDERS DENTISTRY?
-
-
D
feat
ure
dsp
eake
r
Dr. Hansen
DENTAL SLEEP MEDICINE12
Snoring and Bruxism in Children: It is not All Just Noise!
Does your child/patient have any of the following symptoms?
Continuous loud snoring Episodes of not breathing at night (apnea) Failure to thrive (weight loss or poor weight gain) Chronic Mouth breathing Enlarged tonsils and adenoids (with frequent sore throat infections) Problems sleeping, bed wetting and restless sleep (including sleep
walking) Excessive daytime sleepiness Frequent headaches Daytime cognitive and behavior problems, including problems paying
attention, aggressive behavior and hyperactivity, which can lead to problems at school.
Pediatric Obstructive
Sleep Apnea Screening
Quiz
Nighttime arousals, disrupted sleep, daytime sleepiness, bed wetting and behavioral problems
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E
proper testing equipment is imperative
dentist treating OSA should
have a thorough knowledge of the
temporomandibular joint and be able to
treat it as well
Women Dentists Treating Sleep ApneaMany women are more comfortable with a female practitioner, revealing a more accurate medical history
Continued on page 45
DENTAL SLEEP MEDICINE
18
O
Why you should be involved!There is a surplus of patients who badly need the help of dentists treating sleep disorders
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1. Limitations
2. Range of motion:
3. Comfort:
4. Adjustability:
5. Durability:
Keep an open mind. New appliances
arrive on the scene weekly.
The Million-Dollar Question.
“Obtaining a correct diagnosis, using all of the diagnostic aids available, is much more important than a specific appliance.”
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Diagnosis Before Appliance
D
Michael P. Pecenka & John T. Herald, D.D.S.
Which appliance should I use?
DENTAL SLEEP MEDICINE20
N
(These tools are for priviate carriers. In billing Medicare, there are other requirements you’ll want to know about unless you choose to opt out of Medicare)
Do I send the claim to dental insurance first?
Can our practice verify medical benefits in advance?
What if the patient wants to get a preauthorization in writing?
Can I handwrite my claims?
Does insurance pay for snoring?
What are the most common codes given by physicians or on a sleep study that we can then use?
1.
2.
3.
4.
Medical Insurance Billing for Oral Appliance TherapyOnce you have the right tools, getting paid is easier than you think!
WWW.DENTALSLEEPMAGAZINE.COM 21
What is the most commom CPT code for oral appliance therapy? E0486
E0486
Do I need a DME license to bill a durable medical equipment code?
I got paid in the past for DME code: E1399. Can I still use this code?
What other procedures can be billed for the patient with obstructive sleep apnea?
What one piece of advice can you give me to make billing easier?
Philadelphia, PA
Dentists Role in Snoring and Sleep Apnea
San Diego, CA
SGS - Dental Sleep Medicine Seminar
Anaheim, CA
Dentists Role in Snoring and Sleep Apnea
Las Vegas, NV
SGS - Dental Sleep Medicine Seminar
Chicago, IL
SGS - Dental Sleep Medicine Seminar
Phoenix, AZ
SGS - Dental Sleep Medicine Seminar
Chicago, IL
SGS - Dental Sleep Medicine Seminar
San Diego, CA
SGS - Dental Sleep Medicine Seminar
Miami, FL
SGS - Dental Sleep Medicine Seminar
Las Vegas, NV
SGS - Dental Sleep Medicine Seminar
Chicago, IL
SGS - Dental Sleep Medicine Seminar
Phoenix, AZ
SGS - Dental Sleep Medicine Seminar
San Diego, CA
SGS - Dental Sleep Medicine Seminar
Miami, FL
SGS - Dental Sleep Medicine Seminar
Chicago, IL
SGS - Dental Sleep Medicine Seminar
Phoenix, AZ
SGS - Dental Sleep Medicine Seminar
SEMINAR SCHEDULE
conti
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ucat
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DENTAL SLEEP MEDICINE22
Educating Dentists in the Recognition & Treatment
of Sleep Disorders
15-30%
of the population is suffering from
COURSE AQUAINTSDENTISTS WITH:
with various physicians
dental sleep practice.
conti
nuin
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ucat
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WWW.DENTALSLEEPMAGAZINE.COM 23
AMERICAN ACADEMY
OF CRANIOFACIAL PAIN
Learn from the Experts at AACP!Course Dates:May 15-‐16, 2009
May 19, 2009
Location:
To register, contact:
Suite 920
Tuition:
*Join AACP and save! To request your mem-bership application, call the AACP Central
ACT NOW: LIMITED ENROLLMENT!Information for making reservations at the American Airlines Training & Conference Center will be sent to you as soon as your
ORAL APPLIANCES FORSLEEP-DISORDERED BREATHING:
A HANDS-ON COURSEIn this 2-day, participation-based course, you will fit a total of 6 sleep appliances for yourself
including the Silent Sleep temporary appliance, the NORAD “boil and bite” appliance, plus 4
custom appliances you will select from the following list:
That’s a $1,500 value in appliances alone! Additionally, Drs. Jamison R. Spencer and
Robert L. Talley will share straightforward methods of screening, diagnosis and treatment
planning plus bite registration techniques and principles of appliance titration used in the
treatment of patients who suffer from sleep-disordered breathing. Strategies for working
within your medical and dental communities to help the many, many patients who are CPAP
intolerant, as well as those who are struggling with snoring, will also be presented.
Upon conclusion, you should know how to: treat sleep patients using different types of
oral appliances; develop a treatment plan for follow-up with a sleep-disordered breathing
patient; work within your medical, dental and sleep communities; market your practice in a
professional manner and work with insurance companies.
MEET THE INSTRUCTORS:
TAP3® Triple Laminate
TAP3® Thermacryl
EMA®
Moses
Silencer®
SomnoDent MAS™
Full Breath
OASYS Oral/Nasal Airway System™
Jamison R. Spencer, DMD, MSDiplomate, American Board of Dental Sleep Medicine
Diplomate, American Board of Craniofacial PainFellow, American Academy of Craniofacial Pain
Robert L. Talley, DDSDiplomate, American Board of Dental Sleep Medicine
Diplomate, American Board of Craniofacial PainFellow, American Academy of Craniofacial Pain
FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. June 1, 2007 to May 31, 2011
AACP is an ADA CERP recognized provider. January 1993 to December 2009
Visit www.aacfp.org for complete program details!
AACP INSTITUTE
of the American Academy of Craniofacial PainPhone: 800.322.8651 OR 847.885.1272
fax: 847.885.8393 | www.aacfp.org
DENTAL SLEEP MEDICINE26
The Future of Sleep Disorder Breathing Testing
Background
Home Testing
self application of the device by the
patient
Standard Sleep Measures
New Technology
The negative impact on health and the financial burden sleep disorders create - is growing globally
WWW.DENTALSLEEPMAGAZINE.COM 27
CPC
technology represents
a breakthrough
in how sleep can
be visualized
“The CPC technology is not a sleep-stage or
respiratory event detector but [it] does provide a dynamic measure of sleep state-modulated cardio-pulmonary interactions,”
“As the technique is automated, inter-scorer reliability is eliminated as a problem. The technique can track dynamic sleep physiology, and provide a unique ambulatory measure of sleep quality.”
-
-
“60% of all Americans
over 40Snore.”
DENTAL SLEEP MEDICINE28
Preliminary ANALYSIS:
DIAGNOSIS:
TREATMENT OPTIONS:
Collaboration of Dental and Medical Sleep Specialists
FOLLOW-UP:
WWW.DENTALSLEEPMAGAZINE.COM
“I have been fortunate to work with sleep labs in Nashville Tennessee for 16
weekly sleep conferences held at the lab, and this blossomed into a genuine interest on my part to learn more about sleep and how dentists could work with the sleep labs in treating patients. I have taken many sleep related courses and now network with many dentists across the country to improve patient care. When I have a patient that I think may have sleep disordered breathing, I often send them home with an portable sleep monitor (pulseoximetry or screener).
disordered breathing I encourage these patients to make an appointment with the sleep lab and have a consultation and/or polysomnography. If the sleep physician thinks the patient is a candidate for an oral appliance, he is referred back to me with all of the necessary documentation to get insurance coverage for the treatment If another patient is CPAP intolerant or otherwise deemed a good candidate for oral appliance therapy, the sleep lab will often refer
this patient to me for treatment. I think we have a great hand in glove working relationship to achieve maximum
us the care of their health. The important part of this relationship is that we speak the same language and have the same goals for our patients.”
“At Dental Sleep Solutions we have been involved with the treatment of sleep apnea with oral appliances for over 7 years. During this time we have utilized many different methods to build our practice but none have been as rewarding as our efforts with building relationships with our local sleep labs. The majority of our patients come from sleep lab and physician referrals. Working with your local physicians can be very educational and rewarding. I have learned a great deal from these practitioners and I have developed close
are just getting started in the dental sleep
your initial efforts are directed toward establishing these relationships. Time spent in this area will quickly increase your practice as well as your knowledge of sleep medicine.”
Your Friendly Neighborhood Sleep Lab
29
DENTAL SLEEP MEDICINE30
CASE STUDY: VERTICAL
MODIFICATION OF A MAD
FOR IMPROVED AIRWAY
STABILZATION
CASE SUMMARY:
PICTORAL REVIEW
When Additional Mandibular Advancement
to Find the “3-D Sweet Spot”.
pat
ientc
ase
INITIAL TMD COMPLAINTS
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We will be offering our Advanced Dental Sleep Medi-cine In-Office Continuum on the following dates: June: 19;; 20 (with Thursday evening, Meet and Greet and dispensing of Portable Monitors) September: 25;; 26 (with Thursday evening, Meet and Greet and dispensing of Portable Monitors)
fe
ature
dsp
eake
rDr. Dan Taché
™
Continued on Page 47
DENTAL SLEEP MEDICINE32
START IN YOUR OWN PRACTICE!
“Raising Awareness - Finding Sleep patients in your practice”
0 = No chance of dozing1 = Slight chance of dozing2 = Moderate chance of dozing3 = High chance of dozing
SITUATION/CHANCE OF DOZING
0 - 9
10 - 15
16 +
WWW.DENTALSLEEPMAGAZINE.COM 33
Class 1:
Class II:
Class III:
Class IV:
*If Mallampati and/or tonsil classifications are unclear, more information can be found at www.sleepgroupsolutions.com.
DENTAL SLEEP MEDICINE34
The Pharyngometer An Excellent Treatment Tool - The Greatest Sales Tool.
FIG 1
FIG 2
FIG 3
FIG 4
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FIG 5
FIG 6
FIG 7
FIG 8
FIG 9
“In a lifetime spent in the dental
industry I’ve worked closely with
many dental clinics and vendors. My
experience with Sleep Group Solutions
has been very positive. The SGS team
is an asset to the dental sleep medicine
help further this industry. Frequently
dentists will ask my opinion of certain
products and services available from
other companies - I
have no reservations
about referring my
clients to SGS.”
WWW.DENTALSLEEPMAGAZINE.COM 37
IDEAL FOR USE AS A TEMPORARY APPLIANCE
immediately without waiting for lab fabrication. This makes it an ideal temporary appliance to use when patients
need to undergo dental work or if they've lost or damaged their existing appliance. The strong fabrication of the
NORAD will last your patients for months, which makes this appliance the most versatile temporary appliance on
the market.
SLEEP GROUP SOLUTIONS PRESENTS
CHAIR SIDE
FABRICATION
AS EASY AS
1-2-3!
THE NORADBOIL AND BITE APPLIANCE
5MM 7MM
DENTAL SLEEP MEDICINE38
Visit our website at www.sleepgroupsolutions.com
NO
RA
DBOIL AND BITE
APPLIANCE
IDEAL FOR USE AS A TEMPORARY APPLIANCE
“Every office should keep at least one of these on hand at all times.” -Dr. Brian Allman
The NORAD is an FDA approved oral appliance for
the treatment of snoring and
sleep apnea. It is a "boil & bite" appliance which means
a patient immediately without
waiting for lab fabrication.
This makes it an ideal temporary appliance to use
when patients need to undergo dental work or if
they've lost or damaged their
existing appliance. The strong construction of the
NORAD will hold up to many months and even years of
use making this boil & bite
appliance even more versatile.
Many of the features found on the NORAD have never been available in a
boil & bite appliance before and some are not even available on much more expensive lab fabricated appliances.
5mm and 7mm
WWW.DENTALSLEEPMAGAZINE.COM 39
D
The O2 OASYS Oral/Nasal Airway System® - a Must With Nasal Resistance - a Should Without Nasal Resistance
Continued on page 41
DENTAL SLEEP MEDICINE40
C: Compliance
The ABCs of CPAP Therapy & ComplianceBy Greg Anderson, owner, Suncare Medical Inc.
A: Apnea
B: Breathing
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The O2 OASYS Oral/Nasal Air-way System®
Continued from page 39
Sleep Group Solutions supports the American Sleep Apnea Association
and is working in collaboration with there AWAKE program.
SGS Clients if you would like to be a speaker in the
A.W.A.K.E program in your area please contact us at [email protected]
and will put you in contact with your local AWAKE Group.
DENTAL SLEEP MEDICINE44
ORHINOMETER - Evaluation of Nasal Airway
PHARYNGOMETER - Evaluation of Pharyngeal Airway
cm
SUMMARY OFPHARYNGOMETER TESTS
Sleep Disorder Patient: Jimfrequent heavy snoring, significant daytime drowsiness, nocturnal tooth grinding and feels unrefreshed when he awakens in the morning.
pat
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ase
WWW.DENTALSLEEPMAGAZINE.COM 45
Initial Exam 1.44 cm2
Wax Bite 6 mm. open, edgeto edge 2.23 cm2
Insert Oral Appliance 2.47cm2
Pre-TreatmentSleep Clinic Sleep Study AHI 26 (Moderate OSA)
With Oral ApplianceHome Sleep Study AHI 5.2 (Normal)
your referring physicians.
Starting a Dental Sleep Medicine Practice Within Your Practice, TODAY!
Continued from page 8
Women Dentists Treating Sleep Apnea
Continued from page 17
dentist needs to have a
cooperative relationship with the medical
profession
DENTAL SLEEP MEDICINE46
Mandibular Advancement Device (MAD): A Practical Technique for the Youthful, Impaired, and/or Cost-Conscious Patient.
®
®
®
pat
ientc
ase
DENTAL SLEEP MEDICINE48
D
OAT Bite Registration.
Multidisciplinary Study Club.
Ambulatory Sleep Studies & Instrumentation.