Want to make a difference in your patients’ lives but are tired of doing the same old thing? Are you stuck in the hamster wheel of dentistry? Fillings, crowns, bridges, extractions, endo, removable prosthetics, etc. Rinse and repeat? Looking for a new treatment to add? Maybe something that isn’t back-breaking work like the #15-DO composite I did the other day. Well, boost your practice, career, and back by adding sleep and airway. Forget about just saving teeth; save some lives as well.
What is sleep apnea anyway? During sleep, the repetitive collapse of the upper airway (back of the throat) causes episodes of partial airway collapse for at least 10 seconds that can result in a significant blood oxygen level drop, a brain awakening, or both. None of that is good. How prevalent is sleep apnea? I have heard that up to 10-30% of your patients may have suffered from some level of sleep apnea or an airway issue. So, if you think about practicing with 1000 active patients, then there may be at least 100 that have some level of sleep apnea. What are the most significant issues with untreated Sleep Apnea? Untreated sleep apnea has been associated with more risk of a stroke, arrhythmias, heart attack, weight gain, type 2 diabetes, GERD, Alzheimer’s, etc.
Some patients may not even know they have sleep apnea. Some patients aren’t even asked while at their PCP and only inquire about it because their spouse gave them an ultimatum due to the snoring, they had a scare while driving, or they feel so fatigued throughout the day.
Hesitations and barriers
What keeps you from successfully adding sleep apnea and airways to your practice? For me, some of the most significant barriers were the thought of trying to navigate medical insurance coding and reimbursement, the fear of the treatment not helping the patient, or not knowing where I could go for guidance if I needed help. Plus, we had no training in dental school, and a lot of this may also be new for the staff. Patients may also have been coming to you for a while, and I don’t remember you asking them. Sleep and airway seemed like a treatment that was too difficult for me to add to my practice. So, to get started, we must educate ourselves, the staff, and our patients.
Use 3rd party companies to remove some of these barriers
As mentioned, I learned 0.0% of sleep apnea and airway in dental school. However, there are a lot of companies out there that can help you with training, screening, sleep studies, medical diagnosis, treatment, and follow-up care. For example, sleep studies used to be done in a clinic or sleep lab, but a lot of this can now be done remotely with home sleep studies and online consultations. In addition, some services will help with the medical insurance coding and options to engage with peer support groups.
Sleep apnea treatments in the dental office
The mouth is the gateway to the body. So, let’s put our doctor pants on and save some lives. Continuous Positive Airway Pressure, or CPAP, is considered the gold standard for treatment. However, CPAP can have low compliance, maintenance, or recall issues. If the patient isn’t using it or keeping it clean, it’s not helping. Another option is where the dentist comes into play with a dental mouthpiece for mild to moderate sleep apnea. These dental devices tend to have a higher compliance rate, and the cleaning and maintenance are much easier. A mandibular advancement device brings the tongue forward indirectly. Primary lip closure at rest to prevent mouth breathing is also crucial.
Training, training, training, and more training. Like most new modalities you are adding, you need to be adequately trained before treating your patients. So don’t jump in without being thoroughly educated. More importantly, know your limitations. Start with your staff and their family, or even yourself. Have everyone fill out the proper questionnaires and sleep studies; you may be surprised at how many of them, or even yourself, suffer from some sleep apnea. I did, and low and behold, guess who had mild sleep apnea? This guy. This isn’t just an adult issue, either. Some children may also suffer from a lack of air during sleep.
Feel the energy
After treating a few patients with successful outcomes, you may feel the positive energy seeping into the rest of the office culture. Please don’t make it a secret that you are changing people’s lives. Tell the staff and share in the successes. Patients may tell you how they feel better, have more energy, are back in bed with their partner, and feel healthier.
We, as dentists, see patients at least twice a year and have the ability to be involved with early sleep apnea signs or symptoms. Getting assessed early could be one of the best things someone can do for their health. And, hey, one of those patients could be you. So ask me how I know. ENJOY GOING TO WORK EVERY DAY! Life is too short to dread going to work every day. However, taking things slowly, not straying out of my comfort zone, and adding new treatment modalities such as sleep and airway to my practice have decreased those Sunday night blues.
Although I am just getting started with sleep and airway treatment, I see it as one of the least stressful, most enjoyable, and financially rewarding treatments I provide weekly.
Being able to control my stress levels by making choices and positively impacting patients has relieved my burnout in dentistry. If you can feel yourself losing joy in dentistry and wishing to change your past, there’s hope. Find some tools that make you happy and expand your practice and your options. Being in the dental profession can be a great life once you find your groove, but getting there can take a while. However, with new treatment modalities and keeping up with the latest technology, you can start loving your job again.
About the Author
Dr. Eric Block DMD, CAGS, FICOI, FICD, FAADS
Dr. Eric Block is a full-time practicing dentist in Acton, Massachusetts, husband, and father of two kids. He is known as The Stress-Free Dentist and hosts the Stress-Free Dentist Podcast.