Episode #236: Jen Kirkham – Helping Dentists Get Started With Sleep Apnea

Dr. Eric Block: Welcome to the Stress-Free Dentist Podcast. I’m your host, Dr. Eric Block. As always, I want to inspire, entertain, and educate you on the best tools and technologies out there. My goal is to help make your practice and career more profitable, efficient, and most importantly, more enjoyable. And check out all of my nonfiction and children’s books on Amazon and check out thestressfreedentist.com  for any upcoming events. And if you’re feeling you’re a dental professional that’s burnt out, or you just feel stuck or want to get to that next level, visit the International Academy of Dental Life Coaches or iadlc.com , and we’ll get you matched up with a life coach that understands dentistry.

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Dr. Eric Block: Hey everyone. Welcome back to the next episode. Uh, I just wanted to trick Jen there. I have Jen Kirkham, she’s the COO of airVata , and I had her cool, uh, sleep appliance in there, and I just, I was gonna try to go the whole interview with it in, but, um, I think, uh, I would’ve just made a fool outta myself. Um, but, uh, Jen, um, uh, so much to get into. Uh, first, uh, I wanna hear about your journey into dentistry, and then I wanna hear all about sleep apnea treatment, airVata. Um, you’ve got a cool thing called the Net Zero Lab Bill Program. Um, let’s dive in. Um, Jen Kirkham, let’s, let’s hear your story about how you even got into dentistry.

Jen Kirkham: Uh, great, thanks, Eric. I’m so happy to be here. And anytime that I get to share my story, I get really excited because it’s something that relates to a lot of dental professionals out there. Um, I train dentists across the nation on dental sleep and the psychology of case acceptance. And I’m a hygienist. I have over 22 years of experience, and I maintain my, I can still do dental hygiene. Um, I stay current on all the latest and greatest. And I realized early on in my dental hygiene career that scaling teeth and seeing how quickly I could remove debris was not, like, my joy. So I was always looking for ways to reinvent myself and dive deeper. I started with oral systemic connections and, you know, functional medicine, and that led me into airway and sleep, especially when I saw that my own family was having sleep issues and breathing issues with my kids at a young age.

Jen Kirkham: So it was a really exciting thing for me to look into because I could do something about that to help my family. And then once I learned all of the things that were staring at me in the face, the dental signs and symptoms of sleep disorders, I naturally saw that, wow, this can really change lives. So, um, I was in an education, uh, education director role, and I got an opportunity to interview the top sleep professionals that we all know. Um, I got to know Michael Gelb. I got to know Steve, um, all the sleep programs related to Spear and Dawson and Coy, and also met Lane Martin. So here I was learning from the elite and then staying tuned in to the day-to-day of a dental practice. And I saw a huge disconnect. So ever since then, I’ve been plugged in and have a passion, an obsession for helping dental professionals that were just like me years ago integrate this important program into an existing restorative dental practice.

Jen Kirkham: So, and fast forward to today, that still stays true. Um, I keep in touch with all my dental professional friends and I feel like all I can talk about is sleep, because it relates to so much of what we do from the day to day. Um, and you’ll notice I’m talking with a lisp and have a little different smile. It’s because I am walking the walk and talking the talk—literally—because I’m also improving my own sleep health and have utilized everything that I talk about and train. So I have personal experience and then have—I’ve trained over tens of thousands of dental team members  on this very thing. And it lights me up inside. So yeah, that’s how—

Dr. Eric Block: Yeah. You mentioned a family member. Um, was that how you first got involved with sleep, or did you go to a course, or did you learn about this in hygiene school?

Jen Kirkham: Oh, man, there’s so much of what I do now that is not taught in hygiene school and is not taught in dental school. So there’s a huge disconnect for young graduating dentists and seasoned dentists to have a lack of understanding, um, and a disconnect from what the leading science is to actual clinical workflow. And I learned this because my 9-year-old at the time wasn’t sleeping, and it was affecting my professional performance. I was exhausted, because if she wasn’t sleeping, I wasn’t sleeping. And lo and behold, it was because she had a sleep disorder. Pediatricians couldn’t figure it out, and the only way that I figured it out was because I was interviewing Michael Gelb on airway and sleep education, and he taught me the clinical signs and symptoms in children and adults. And right then and there we did a Zoom screening, and I got connected with the leaders in airway and sleep who could then talk to a local provider. And she was actually the first case in Idaho to be treated 10, 12 years ago. And now she’s a thriving college student, graduated with honors, and on a different life trajectory because of that. And I feel so blessed, and my story is just like so many others that I hear time after time again.

Dr. Eric Block: And, uh, if you feel comfortable, uh, what kind of symptoms was your daughter having? Was—did, did she have, uh, was she snoring, not sleeping well? Were there, uh, did she have a narrow arch or crowded teeth?

Jen Kirkham: You know, I look at pictures back then, and she had basically, uh, an X-bite, you know, where all the molars were lingually inclined, her Perva Wilson was all collapsed, and she wasn’t snoring, but I could hear her breathing. So it didn’t meet the traditional criteria. She had exercise-induced asthma, and it was getting worse and worse and worse. So the stress from constricted breathing and a small airway box—her teeth—it was just causing this cascade of results that was subtle and wasn’t sick enough until, um, her asthma medication was no longer effective. So imagine a 9-year-old going and doing exercise at recess and having an asthma attack that we struggled to get under control. And that became an emergency where it—it was a very stressful time. And the cascading result of that is she had low reading scores because her brain was exhausted. She had low confidence and struggled making friends because she struggled to communicate, ’cause her brain was in fight and flight during the night, every single night, night after night. So those were the little subtle symptoms that only a tuned-in mother could really define.

Dr. Eric Block: Yeah, there’s, there’s nothing like helping out, uh, you know, whether it’s a staff member or family, um, the staff’s family. Um, I think that’s such a great way to get started is, you know, I was actually my own first patient because I knew something wasn’t right. I was, um, I was waking up and snoring more heavily, and my wife was telling me that I was gasping for air. And that’s when I—yeah, that’s when I got my first, uh, sleep study and first appliance. And, um, it was, you know, a game changer. And my sleep study came back, and I had mild sleep apnea. And who better to start, you know, than with yourself? And I know dentists are probably wondering, like, how to get started. Um, get yourself a sleep study, or someone in your family or your staff. Um, what—what are your recommendations there, Jen, for—for dentists to get started with sleep?

Jen Kirkham: That’s a great question. Um, I’ll tell you that what a lot of dentists do, um, is go to a CE course. I’m not sleeping. I need to learn about sleep. Hey, I should do sleep in my practice. I’m gonna go to a CE course. I’m going to say something totally, like, controversial and against the grain. And, you know, as a hygienist, this might come from out of Timbuktu, but just get yourself a device. Prove it to yourself. Um, and we create an easy way to do that. So all dentists can make a sleep appliance, and all dentists are improving or inhibiting sleep, whether they realize it or not.

You know, the biggest aha for dentists in themselves or their patients is clenching and grinding. And what do we do, Eric? Patients clenching and grinding—what do we give them?

Dr. Eric Block: Yeah, I mean, I bet 95% of dentists give them an upper night guard.

Jen Kirkham: Yeah. And there’s a lot of research around the upper night guard. Maybe we should have another deep dive discussion on that. Um, I’m taking a stand that I will never, uh, like, love to see an upper flat plane night guard in another patient’s mouth—never again. Um, and I will have a long discussion with any dentist that wants to have that conversation.

So my number one recommendation for a dentist who wants to prove it to themself and just do a little experiment that’s risk-free, non-invasive, and completely easy to do—go to airVata.com.  You can set up an inquiry to set up a lab account and just take intraoral scans of yourself and get yourself a device. So we’ll get a notification saying, "Hey, I want to get a lab account." And the reason why that’s my recommended first step is because you and I are both passionate about science, we’re passionate about research and clinical things—like, I love studying the inflammatory process and all the little things that make a difference. But when it comes to a successful sleep program, the opposite approach is what works. Where if you focus on doing the thing and then find out all the little details and ways to optimize it, it’s the reverse process.

Jen Kirkham: That’s what I recommend.

Dr. Eric Block: And when you do, do you take the scans full upper, full lower? Uh, what kind of bite do you recommend? Do you recommend, um, like an edge-to-edge bite, uh, or more, a little bit more protrusive?

Jen Kirkham: Oh, that’s a great question. That’s actually another area where there’s a lot of new research coming out. Uh, so much so that we brought on an RPSGT to the airVata team. Like, are you familiar with what an RPSGT is and does?

Dr. Eric Block: No.

Jen Kirkham: A lot of people don’t know this, which is—I’m so glad that I met him. Um, an RPSGT is a technician that works at a sleep lab, and their sole job is to watch someone sleep, look at the metrics, and adjust an oral sleep appliance if they have one—or put one in and adjust it—to the best place that a patient can sleep the best. So we have over 2,000 sleep study, PSG, polysomnogram—data points. That was the basis for the design of the airVata.

A lot of oral appliance companies start from a dental perspective to try and reduce bite changes and, you know, TMJ and all of that. Yes, that’s important. But remember, the ultimate goal is, if you’re putting in a sleep appliance, what are you trying to accomplish? What are we trying to accomplish?

Dr. Eric Block: We’re trying to get the patient to sleep better and have fewer apneic events and have a better quality of life.

Jen Kirkham: Yeah. So what’s interesting about that is, going back to your question of what kind of bite do we utilize, we have a bite jig that’s universal that gives the technicians enough room to have the material made. And the airVata does what’s called a biomechanical titration.

So this RPSGT—the technician who watched over 2,000 patients sleep with an appliance just like the airVata is now today—saw, oh, there are certain things that need to take place. And the design of the airVata allows for that, which means it allows them to go to their habitual bite, it allows the patient to move their jaw side to side, and it showed us—it debunked the degree of protrusion principle and the locked-in principle.

So, you know, some people are really successful with dorsal fin appliances or like a Herbst-style appliance. Sometimes patients are successful, but sometimes they’re not. And so a good-for-most solution really is the airVata. And I can’t wait to share more data as it comes out. We’re constantly reviewing that.

So a bite for the airVata is using our universal bite jig and letting the patient go into that habitual place, and then let the airVata do its job of working with the patient’s muscular movement during the night that needs to happen—while protecting the airway and not letting the jaw go into a retro position.

Dr. Eric Block: So I typically, with some of the appliances that you mentioned, would titrate the patient. I’d have them come back in weekly, and I’d ask them a series of questions and I would titrate them forward a millimeter or half millimeter and then see ’em again the next week. Uh, you mentioned—did you say biomechanical titration? Is that—did I say that right?

Jen Kirkham: Yeah, yeah.

Dr. Eric Block: Can you explain that again? How the—the airVata and the patient—it actually kind of titrates itself?

Jen Kirkham: Sure. The airVata can titrate to four positions with one band. And that’s really important because some patients do need more protrusion, ’cause they’ve got a smaller sleep box—an airway box—you know, they’ve got a larger tongue and a large uvula. Maybe their airway on a CT scan shows it’s only 60, right? So they need more protrusion. So you can adjust ’em to the next point.

And then the band is made of a material that’s just flexible enough that allows that muscular movement—that biomechanical movement—that naturally needs to happen in sleep. And then it protrudes them when relaxed to a more protruded position. The device doesn’t let you go further than what the muscles and the joint capsule will allow. And that’s a really, really important point—that the only time that you’ll get jaw soreness is if there’s a cant. And in our trainings, we teach you how to accommodate for that.

Does that answer your question?

Dr. Eric Block: Yeah. And I’m actually gonna hold up the device here and—can you see that okay?

Jen Kirkham: Yeah, yeah. I can.

Dr. Eric Block: If we have a lower portion that is more protruded than the upper portion, um, can you actually explain—you know, I usually tell patients—I try to speak in lay terms and talk to patients like I’m talking to my 10-year-old. And yeah, I’ll show ’em a video and I’ll tell them that, you know, what we’re trying to do is move your jaw forward, which moves your tongue forward, which prevents your tongue from falling back. And that’s the most common reason why we have obstructive sleep apnea, is the tongue falls back and closes off the airway. And these mandibular advancement devices keep the jaw forward, which keeps the tongue forward, which keeps the airway open.

Am I saying that right? Is that—would you agree?

Jen Kirkham: Yeah, a hundred percent. Yeah.

Dr. Eric Block: And the airVata pretty much does that as well. It’s—the lower jaw’s more forward, it has the band, um, it’s very light. Um, and yes, you can, like you mentioned, can go—you know, when you have it in, you can—you can go left and right.

Mm-hmm.

Because I have had some patients that didn’t like the dorsal, for example, ’cause they felt like they were too locked in, and they wanted that freedom of movement. Uh, and I’ve had some patients break the Herbst. Um, they just broke ’em. Um, or the metal portion started to get some discoloration, like a rust color, and they didn’t like that.

How does the airVata differ from other appliances regarding its material and everything that goes into it?

Jen Kirkham: Yeah, great question. There’s—you know, I always tell patients there’s, um, 150 different options, and, um, we’re going to go to the Bentley solution that’s gonna be the most comfortable, the easiest to clean, and also effective. And that’s all patients really care about: is it gonna work, is it comfortable, and is it gonna hold up?

So the material that we chose—and we’ve tested all different kinds of materials, and we probably always will—but the one that performs the best right now is surgical nylon. And one of the downsides of surgical nylon in the past—there’s a great company out there, and you’ll see different nylon versions of appliances because it’s really a great material—but the downside of nylon is that it’s not usually retentive. Like, a patient will put it in their mouth and it just pops right out. And that can be a challenge, especially if you want it to stay in a place that’s gonna stay on during the night.

Who knows, you know, all bets are off what happens during people’s sleep sometimes. So what we did is we worked with a 3D engineer to the point where we have the inside definition dialed in to where we have an internal ball clasp system that’s not putting pressure enough where it’s going to, you know, cause open spaces—putting too much pressure on the embrasure spaces—but it’s the sole point of adjustment in retention where you get that lock-in, but it’s comfortable and not impinging on tissue and wrapping around the teeth just enough to stay on.

It’s the only device in the market that has this retention system built in with nylon. And anyone who knows—that’s tried another nylon device on a patient who has a short clinical crown—that’s a recipe for no device working. But the airVata will.

Dr. Eric Block: And it—uh, are these 3D printed?

Jen Kirkham: They are. They’re 3D printed—but not only that, they’re domestically 3D printed. We only work with U.S. manufacturers and designers and printers and engineers from the very get-go. Um, one of our founders, Dr. Lane Martin, he’s a veteran. He served in the Navy, had a distinguished career there. So we really have a passion for keeping things in the U.S., and that’s allowed us to not face some of the headaches that we see with the modern economics.

And in fact, we saw posts from some other really great manufacturers of sleep appliances make an announcement that, you know, "We’re gonna have to raise our prices and almost double our turnaround time," because, you know, it’s been a tradition for outsourcing. So these are domestically 3D printed, and we’ve had a lot of really great feedback.

Dr. Eric Block: And what about the—the blue attachment here? Is that—is that nylon?

Jen Kirkham: Um, it’s actually a material called TPU. So it’s been tested for biocompatibility. It’s a different material than the EMA. Okay? We looked at all the designs of all the appliances, and it’s what we call a hinge connector. So it has just enough give for our body’s muscles to work and move, and just enough support to hold the airway open. So we have a certain durometer strength and a certain material that works with the appliance and works with our bodies.

Dr. Eric Block: Mm-hmm.

Jen Kirkham: I haven’t seen one break yet, which is pretty amazing.

Dr. Eric Block: Yeah. That was, like I said, an issue with some of the other appliances I was using in the past—would come back in and they’re, you know, just broken. And, uh, it’s, um, you know, that’s not good for anyone when that happens. Yeah.

Um, and now tell me—tell me about the lab process and the Net Zero Lab Bill Program.

Jen Kirkham: Yeah. This program came out of one office I was training, and there was a really high-level executive. He owns the parent company that has nationwide tire stores. Okay? And I brought this issue up to our leadership team, and we came up with this program. We recognized that a lot of patients lead busy lives and need a backup or a second appliance. And who wants to pay for an additional appliance that’s thousands of dollars for a patient—and say something happens to it later on and it breaks, and then the office has to contact the lab and have a new one made again?

So we came up with the concept: well, what if you find the patient’s motivation and real-life need upfront, and in a way have an additional win for the practice? So here’s the math around a Net Zero Lab Bill.

Let’s do some easy math here. So let’s say—and I encourage everyone, get a pen and paper and write this out—okay? So let’s say Bob. Okay, so we’ve got Bob. Bob is a patient that needs a sleep appliance, and we present a treatment plan of a $3,000—for the sake of easy math—a $3,000 appliance.

Now your treatment coordinator is talking with Bob about the process and getting consent and creating financial agreements. And the treatment coordinator—let’s call her Nancy—Nancy’s talking to Bob. Nancy says, “Okay, Bob, so we’ll have you come back in two weeks to receive your appliance.” And Bob goes, “Yeah, I hope that this really works out. This is a lot of money. This is expensive.”

So Nancy picks up on cost and value and says, “Well, what makes you say that? Yes, it is an expensive investment. What would make it most worth your while? Are you saying it’s expensive because it’s a budget issue? Or does this really mean a lot to you?”

And Bob says, “Well, I travel a lot for work and I don’t wanna spend $3,000 on something that I might lose because I travel every week.”

So Nancy thinks, “Oh, would a second appliance or a backup protection plan work well for you? Why don’t we get you a second appliance in preparation for the opportunity that you might lose it? So have one in your suitcase and have one at home. So in the event that you lose it—someone throws it away in a hotel—you can have an extra one back home.”

And let’s say there’s an $800 replacement appliance. So the patient is getting a $3,000 appliance and then a second appliance—valued at $3,000—for $800. Okay? So $3,800 is the patient investment.

Now let’s talk about the lab fee for this one case—for Bob. The airVata lab fee for our providers is $399 plus shipping and handling.

Dr. Eric Block: Mm-hmm.

Jen Kirkham: So let’s say we have $399 times two. What does that come to, Eric?

Dr. Eric Block: Um, can we just call it $400, because, um, I’m not great with math. So, um, that times two is $800.

Jen Kirkham: Yeah. So $800 is the investment for the practice. What did that just do for your profitability?

Dr. Eric Block: Yeah, I mean, that’s—and it covers if the patient loses it and, you know, needs another one. It’s all taken care of.

Jen Kirkham: Yeah. So you just—so, if—I don’t wanna complicate things, but I did this math before when I was helping an office, and there’s an average of, every case, it’s a 32% increase in productive chair time. ‘Cause that’s what really helps have a sustainable program for a dental office.

Let’s be honest. You know, we’re helping change people’s lives—it’s great for Bob—but if the practice can’t do better economically, then it’s not going to be sustainable. So we have to take that into consideration.

So the patient paid a replacement fee that paid for both lab fees. And here’s the real kicker. Now I’m really gonna change up some math.

Now here’s a real math pro issue thing. So, you would think—our lab fee is $400 for an appliance. Now, I will tell you on the back end, it doesn’t cost airVata as much to do a second appliance if we’re doing two appliances in one shot. Guess what? Our overhead actually reduces. So we pass that savings on.

And so I want you to cross out one of the $400 and replace it with $129.

Dr. Eric Block: Mm-hmm.

Jen Kirkham: That’s not only a net zero lab bill—you’re actually in more positive. So because our overhead went down when we did that second appliance at the same time, we’re passing along the savings because we want you to have Bob be happy with the airVata.

Dr. Eric Block: And then it also just creates so much less headaches. If a patient only has one appliance and they lose it or it breaks, then there’s frantic phone calls. There’s time that they’re personally without their appliance, you know, to have a new one made. So this—this takes care of a lot of those issues.

Jen Kirkham: Eric, this relates to your point—it’s a stress-free, it’s a stress-free sleep program.

Mm-hmm.

In so many ways. I mean, you get the happy patient, and workflow-wise, deliver both appliances to Bob. Give Bob both of those appliances. Don’t store inventory "just in case." Let the patient take ownership and say, "Here’s your backup. This is your investment protection plan. Here’s your initial, and here’s your backup."

Dr. Eric Block: Yeah. I also have a lot of patients that come in and they travel, and they don’t want to travel with their CPAP. Do you recommend making an airVata for a patient that—you know, can they wear it with their CPAP? And is it a, you know, a decent alternative? Much better than them having nothing? But for patients that don’t want to travel with their CPAP?

Jen Kirkham: Oh, for sure. It’s getting harder and harder to get on an airplane with other stuff. I mean, it’s a pain in the butt, right?

Mm-hmm.

Yeah, that was actually a dealbreaker as we were going through the design of the airVata. It has to work with patients that are doing combo therapy. It has to be slim, it has to be durable. And it works really great in conjunction with CPAP and effective enough that if they can’t travel with their CPAP—or they’re going camping, with a group of guys on a river trip—like, they need an appliance that works. And it can be a great resource for that.

Dr. Eric Block: Now let’s review some issues that dentists may face. Um, you know, why do you think so many dentists struggle with adding sleep medicine to their practice?

Jen Kirkham: It’s complicated. They overcomplicate either the workflow or overexplain things to the patient. I mean, you are really great at explaining things to a patient in a way that it’s not a complex thing—even though we’re working with a complex problem.

Um, yeah, just overcomplicating, and then not having the team come along with them in the integration process. So I always ask doctors: how much did you spend on CE courses about sleep? And how many successful cases have you done in the last three months?

And on average, I’m seeing dentists spend at least $35,000 in CE courses, including travel. Maybe they are bringing their team, but the biggest mistake is not matching it up with a step-by-step clinical workflow.

And so we—we have a six-week program that will bring offices through. It’s very intentional, where we focus on—like, you’ve got your CE, that’s great, and if you need more clinical education and understanding, we’ll help you. But it’s the integration. You know, do this first. We give you as close to a recipe for success as possible.

So within 90 days, doing five to ten appliances, replacing your old upper flat plane night guard—that’s a reality. Our average provider is doing between five and ten cases every month when you follow the step-by-step process. And quite frankly, it’s what’s needed. There’s a lot of people really suffering with those upper flat plane night guards.

Dr. Eric Block: Yeah. And I—I recommend start with yourself. I mean, it may turn out that you—the one listening—has a mild case of sleep apnea. Get a home sleep study and try out the appliance. And no better person than yourself. And you can explain it to patients even better, ’cause I wear a sleep appliance. And when patients come in for the consult, I tell them that I have sleep apnea. And I’m like, “Join the club. You know, I have sleep apnea too, and I wear a device every night. And it’s—it’s changed my life.”

Now, if a dentist—let’s say they have a really big office—do you recommend, you know, getting the whole office trained, or maybe starting with like one or two champions in the beginning?

Jen Kirkham: Yeah, we—you know, I love working with large and small teams. And if I had to pick one or the other, I actually love working with larger groups because there’s a fun process of peer-to-peer mentorship that naturally happens.

So when we work with offices that have large teams like you described, we have a pre-meeting powwow with the doctor and the point. And we do just that—we get the doctor an appliance, we have the point person get an appliance as well. And then we have a scheduled agenda where we introduce it to the team and we mitigate the fears ahead of time.

So, so Eric, when we spoke prior—like, you know, a while ago—what were some of the fears or apprehensions that your team faced? Just out of curiosity. Do you have a—

Dr. Eric Block: It’s—it’s anything new, you know? Especially a new treatment modality. It’s a big deal. You know, if you’re bringing in, like, a new composite or something, that’s not as big of a deal. But when you’re adding a new language, you’re adding new billing—it’s a whole thing. And verbiage that everyone needs to, you know, be educated and be on board.

And I always recommend too, when you’re adding something big like this, to start slow. You know, I gradually brought it in, and now it’s part of our everyday conversation in our practice. But I didn’t want to get pushback from the staff. I wanted them to be on board with me. Because I’ve been there—when you’re the only one excited about something and no one else is—it’s not a good feeling. So it’s—you, like you said—it’s so key to have the team on board.

Jen Kirkham: Yeah. And one of the mistakes that doctors do make in this process is they wait for their team to be on board—and then they do the thing. And the way that we work with the team is we set up that this is normal and this is very familiar. That’s why I’ve really studied the psychology of change management and sales—because that’s the key to success.

So we mitigate that on the front end rather than the back end. We don’t start with CE and learning and resistance—we start right up front, getting them excited in a way that is familiar, that it fits into the existing workflow of things, so that they can clock in, come in, and do their normal duties. And this just is part of it. And it’s not coming across as more to do or another language to speak.

We actually just swap—we swap out a few things, and it’s a huge aha for the team. So when this is successful, we see practices bringing in, on average, $18,000 to $25,000 more per month. And so that’s why we begin with a little bit of a practice baseline, and then within 90 days we’re saying, “Okay, let’s look at this number and this number,” and there’s an average of 32% growth when we approach the integration the right way, in the right order of things. It’s really fun to see.

Dr. Eric Block: And when an office does get it right—you know, the flow—like, initially, I know most dentists out there like me learned none of this in dental school, and like you said, in hygiene school as well. So there’s that fear that you’re trying something new that you didn’t have any education in.

Like you said, take the CE courses, but once you start to figure it out and you start to understand the flow, it’s really, you know, such a great thing to add to your practice. And doing sleep apnea and devices is not backbreaking work. It’s not like doing a number 15 DO on a patient that can’t open wide.

It’s such rewarding work. You’re not just saving teeth, but you’re saving lives and helping people way beyond just their teeth. I did fear initially changing someone’s bite, and I know a lot of dentists fear that. Can you talk a little bit about that?

Jen Kirkham: Yeah. In our training, we always teach how to make a great morning guide. We always use a morning aligner. And when the appliance is doing its thing, it allows the patient to go to their habitual bite—their muscles are allowed to do that—which is the biggest game changer in dentistry because it’s not in that fixed position. So we teach you the protocols to put in place to mitigate the risk of that happening.

Dr. Eric Block: Yeah, I make a morning repositioner—or a.m. aligner or whatever you want to call it—for every patient. And I tell ’em, “Bite into this, you know, for five or ten minutes in the morning, and it’ll reset your bite.” And, um, you know, it’s part of the consent form as well.

But when you think about it, if someone—and I tell ’em upfront—I’m like, “Look, you know, Judy, your bite may be off. My bite’s off. But I’m sleeping better and I have more energy, and I’m living better. You know, I still chew—look at me—I’m not skin and bones here. I still chew food fine. You know, if there’s a little bite discrepancy, sleeping better is—that’s the key. It’s living longer and sleeping better.”

Jen Kirkham: Yeah. What’s interesting is a story that Lane told me where he had a patient who had a perfect bite, a beautiful smile, but—he actually—it’s sad—but he died of heart failure related to sleep apnea. But at his funeral, when people were saying their condolences, he had a beautiful bite and a beautiful smile.

But what if he could have had better sleep and maybe, you know, not had that as the thing that was the fear that was stopping his dentist from helping him with a better treatment?

The biggest thing is, any bite changes—as minimal as they may or may not be—it’s not because teeth are moving. So in our training, we actually cover the root reasons for bite changes and the degree they may or may not be. And you’ll realize it’s usually a fraction of a millimeter off, and the reason is because of muscles.

So we can dive into that with any doctor who’s interested in learning more, because it is kind of a complex thing, but it’s something to be understood. But I do invite everyone listening to not let that be the thing that stops you from helping somebody—maybe yourself—from breathing better while you’re sleeping.

Breath above all trumps an occlusion—but it’s important. So, yeah.

Well, congratulations, Eric, for not letting that stop you and recognizing that, like, oh wait—I mean, I feel like you’re the 1%.

Dr. Eric Block: Yeah, there’s—you know, there’s always a fear when you’re trying something new. But, um, Jen, you know, you have such a great group there at airVata. Um, there’s also a community of other dentists that treat patients for sleep apnea, and I—I learned so much. And, um, like I said, I knew nothing about this, and now I feel very comfortable.

Tell us, Jen, how do we find out more about airVata? And you can leave an email, phone number—whatever you wanna leave—a website.

Jen Kirkham: Yeah, I would love anyone who’s interested in this concept—like again, if you’re thinking, “I need to go to a CE program about sleep,” I really want you to go to airVata.com , get registered as an inquirer of a lab account, and we’ll get notifications that, hey, you want to get an appliance to start the conversation—and we’ll reach back out to you.

So you’ll put in your lab info, your office information, your phone number, and we’ll reach out to you. If you want a conversation—if you want to speak with me or any one of our team members—just send an email to hello@airVata.com 

 and just tell us, mention the Stress-Free podcast, mention that you heard this information, and we’ll know kind of what your thoughts are and what you heard.

So go to airVata.com , get your lab account request in, and email hello@airVata.com 

.

Dr. Eric Block: All right, Jen Kirkham, thank you so much. Such a great episode. And we’ll be in touch.

Jen Kirkham: Yeah, thanks so much for having me.

Dr. Eric Block: Thanks again for listening to the Stress-Free Dentist Podcast. And don’t hesitate to get in touch with me at thestressfreedentist.com . And if you haven’t already, please subscribe on your favorite platform and leave us a review.

Until the next episode, I’m Dr. Eric Block, the Stress-Free Dentist.