The Sleep Magazine- 1st {Premier} Issue

WWW.DENTALSLEEPMAGAZINE.COM

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

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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


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


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


Awards

-

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Dr. Brian Allman


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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Dr. Brock Rondeau


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



©

“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.


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?

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Dr. Hansen


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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Ortho and OSA

Achieving a healthier start for our young patients


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



18

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Why you should be involved!There is a surplus of patients who badly need the help of dentists treating sleep disorders


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?


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!


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


Chicago, IL


Phoenix, AZ


Chicago, IL


San Diego, CA


Miami, FL


Las Vegas, NV


Chicago, IL


Phoenix, AZ


San Diego, CA


Miami, FL


Chicago, IL


Phoenix, AZ


SEMINAR SCHEDULE

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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.

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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




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


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.”


Preliminary ANALYSIS:

DIAGNOSIS:

TREATMENT OPTIONS:

Collaboration of Dental and Medical Sleep Specialists

FOLLOW-UP:


“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


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”.

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INITIAL TMD COMPLAINTS


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

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dsp

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™

Continued on Page 47


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 +


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.


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.”


Introducing: SGS 3D Airway Softwareap

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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


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


D

The O2 OASYS Oral/Nasal Airway System® - a Must With Nasal Resistance - a Should Without Nasal Resistance



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.


case

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to

Manufactured By:

Dental Sleep Medicine in Review



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.

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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!


Women Dentists Treating Sleep Apnea


dentist needs to have a

cooperative relationship with the medical

profession


Mandibular Advancement Device (MAD): A Practical Technique for the Youthful, Impaired, and/or Cost-Conscious Patient.

®

®

®

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-

When Additional Mandibular

Continued from Page 31


D

OAT Bite Registration.

Multidisciplinary Study Club.

Ambulatory Sleep Studies & Instrumentation.



SLEEP GROUP SOLUTIONS

Documents

The Sleep Magazine- 1st {Premier} Issue