Archives for posts with tag: Continuing Ed

Learn at home to treat Snoring and Sleep Apnea during the social isolation and travel ban.  Here is your solution to counter decreased income and cancellations of appointments. We can train you by telephone, email and webinars. By the time the Coronavirus is over you will be set to welcome the large number of DSM candidates who are searching for your help. Contact me for more information:  cskdoc@aol.com

Studies show that people suffering from sleep-disordered breathing have an increased risk of developing cancer and are up to five times more likely to die from the disease.   Once again the culprit is HYPOXIA. The lack of oxygen (hypoxia) caused by untreated Obstructive Sleep Apnea (OSA) can be a catalyst for a process called neovascularization (the creation of new blood vessels), giving a blood supply that can encourage tumor growth.  Snoring may be a warning that you may have OSA.

Cancer cells thrive in a low oxygen environment. Hospitals will put a patient on oxygen if their O2 levels drop below 92. Untreated OSA can cause oxygen levels to drop anywhere from the 90’s, 80’s and even in the 50’s.

Sleep apnea causes sustained low blood oxygen.

One of the biggest problems with sleep apnea is the way in which it deprives the body of necessary oxygen. Frequent apneas (pauses in breathing that last at least 10 seconds, but often last much longer) lead to nocturnal intermittent hypoxia.

Dentists perform exams of  patient’s mouth, neck, and airway on a regular basis while screening for oral cancer. These health screenings are important, lifesaving moments in a patient’s health journey– we can do that with a similarly deadly condition like untreated sleep apnea.

Detecting OSA and leading the way for treatment can add YEARS to a  patient’s lifespan while significantly improving quality of life. Both cancer and OSA have symptoms that can be easily recognized in the chair during a regular checkup. While checking the mouth for masses and swelling, you can also check on the Mallampati score  and be alert to possible concerns you may have.

 

MALLAMPATI EXAM

Symptoms of both oral cancer and sleep apnea should be screened for everyone, especially for heavy drinkers and tobacco users. The irritation from cigarettes and other forms of tobacco may cause inflammation that’s disruptive to the airway. Smoking, of course, is known for its carcinogenic properties, but perhaps more surprising is that around 70% people diagnosed with oral cancer turn out to be heavy drinkers. Alcohol use is also known to cause apneic events by relaxing muscles in the airway (this is particularly dangerous when people use alcohol to help get to sleep due to an already existing issue with sleep apnea).

WOMEN WITH SLEEP APNEA HAVE INCREASED RISK OF CANCER 

We know that men are more at risk of developing sleep apnea. But if you happen to be a woman and you suffer from OSA your risk of developing cancer is more than your male counterparts, says a recent research published in the European Respiratory Journal. During the study the scientists collected data of 20,000 patients with OSA. It was found that around 2 per cent of these patients were later diagnosed with cancer.

Researchers analysed data based on age, gender, alcohol consumption, body mass index and smoking. Again, there was a strong association between sleep apnea and higher cancer prevalence. Additionally, the link was stronger in women than men.

A 2012 study identified a link between sleep and aggressive breast cancers. Ref: American Cancer Society

MORE CASE STUDIES

In 2013, Spanish researchers reported that people with severe sleep apnea had a 65 percent increased risk for cancer. They suggested the risk is associated with increased hypoxia, a condition where the body is deprived of oxygen.

Another study from the University of Wisconsin found people with sleep-disordered breathing are five times more likely to die from cancer than people without sleep apnea. Researchers from the American study admit the study is limited in that there are no studies to compare it with that look at cancer survival in people with sleep apnea.

One recent study reported in the Journal of Sleep Medicine shows moderate and severe cases of sleep apnea are associated with increased cancer risk. That study also showed an increased risk for all “all-cause mortality” and cancer mortality due to cancer. The 20-year study showed that people with moderate to severe cases of sleep apnea are two and a half times more likely to develop cancer and three times more likely to die from cancer. The authors noted these findings confirmed previous research conducted by American and Spanish researchers.

Animal studies have also confirmed previous findings. One 2014 study  reported in the journal Cancer Research linked sleep apnea with aggressive cancer growth in mouse models. Mice with tumors were placed in low oxygen environments that mimic the effects of sleep apnea and tumor growth in the mice progressed rapidly.

 

With a convincing condemnation of Sleep Apnea as a cause of cancer we need to be more serious about screening patients for cancer and OSA.

 If you have any concern about your risk, ask us about it.  We’re here to help.

A dentist asked me, “ How do I find sleep apnea patients that I can treat?“

Here’s how I answered him, “They will find you.“
If you saw the award winning movie “Field of Dreams” you will remember Ray Kinsella (Kevin Costner) being told, “Build a field and they will come.”   He did build a baseball field in a Kansas corn field and sure enough the great legends of the game came to play there.
After you have been trained and become confident in your screening and treatment skills you’ll be pleasantly surprised at the vast number of sleep apnea patient resources.  Build your field and they will come.
These are just a few of the sources available to you:
  • word gets around that you are the sleep doctor and new patients will seek you out
  • your patient base will produce enough candidates to keep your schedule filled  
  • you will be developing a network of healthcare professionals that will send you patients
  • patients you have treated will be referring their family and friends
Success in Dental Sleep Medicine, unlike in other ventures, does not have to be long and drawn out. If you focus on all the “little things“ and stay dedicated you will reach your objective in a few months.
Studies reveal OSA is prevalent. 
-A 2015 study in Switzerland reported 50% of men and 23% of women had at least moderate OSA.1
-In 2002, the Sleep Heart Health study found that 24% of men and 9% of women have at least mild OSA.2

-In the Wisconsin Sleep Study Cohort, it was reported that 10% of men and 3% of women age 30 to 49 have at least moderate OSA, while 17% of men and 9% of women age 50 to 70 have at least moderate OSA.

-Over 50% of children diagnosed with ADHD suffer from sleep apnea
-According to a Harvard health report there are 18.9 million undiagnosed cases of obstructive sleep apnea and 40% (1.3 million) of CPAP users are non-compliant. So that alone conservatively projects 20.2 million victims of obstructive sleep apnea who may be helped by a dentist trained in Oral Appliance Therapy (OAT). 
-OSA is highly underrecognized, and it is estimated that 82% of men and 93% of women in the United States with OSA are undiagnosed.4
Is there any better opportunity today in dentistry?
Are you ready to build your field of dreams?
Write me with any questions at cskdoc@aol.com.
References
  1. Heinzer R, Vat S, Marques-Vidal P, et al. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2015;3(4):310-318.
  2. Young T, Shahar E, Nieto FJ, et al; for the Sleep Heart Health Study Research Group. Predictors of sleep-disordered breathing in community-dwelling adults. Arch Intern Med. 2002;162(8):893-900.
  3. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177(9):1006-1014.
  4. Young T, Evans L, Finn L, Palta M. Estimation of clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep. 1997;20(9):705-706.

                                                                                     

                                                                                          ‘it’s THE START that STOPS most People’

We know you are interested in developing a strong presence in the exciting and profitable world of Dental Sleep Medicine.    Here are answers to the most frequently asked questions.
  1. “Are there enough patients who need my DSM Service?”

If  you did not get one new patient coming to your office because of your new magnet (DSM) you could keep a schedule filled with your existing patients. Studies show that 34 percent of the American public have symptoms of sleep disorder. That means that one of every three people that you currently treat (IN ADDITION TO those new patients that hear about you), are there for you to help.

According to a Harvard health report there are 18.9 million undiagnosed cases of obstructive sleep apnea and 40% (1.3 million) of CPAP users are non-compliant. So that alone conservatively projects 20.2 million victims of obstructive sleep apnea who may be helped by a dentist trained in Oral Appliance Therapy (OAT). Is there any better opportunity today in dentistry?

  1. “Why is THIS the best time for me to learn DSM?

Dental Sleep Medicine is the hottest button in dentistry today.
Awareness of sleep apnea in America is at an all-time peak. The fires of awareness are being stoked by the public media and by social media. Patients are understanding and becoming increasingly more concerned about the blockage of oxygen to the brain and to other organs. Strokes. Heart attacks. Diabetes. Dementia. People are recognizing that they have the symptoms and are asking their Dentists about it. Some Dentists have the solutions. Every Dentist would like to be “The Sleep Dentist.

  1. “How would I get paid? Do Insurances cover the Services?”

With training in Dental Sleep Medicine you will learn the answers to these often asked questions about reimbursement:

-What is the difference between dental and medical codes?
-What is Durable Medical Equipment and how does that apply to us, as dentists?
-How some dentists leave thousands of dollars of medical reimbursement on the table and lose case acceptance in the process    -What  are the deductibles?
-What documents do I need for successful medical insurance processing?
-What do I need to know about Medicare?

-The number one medical billing error you should not make

 4.  “How do I get Started?”

If you are interested enough to have read this far, you have already started. To succeed in DSM you must have passion for helping people and excitement for being at the forefront of a new medical/dental science. With only 4% of dental practices qualified to offer these services, you can be proud to be a medical/dental pioneer.

The first step in your education is to attend a DSM training seminar. There you will learn all the basics. Sleep Group Solutions presents two-day seminars every weekend in two different cities. The “Introduction to Dental Sleep Medicine” covers all aspects “from A to Pay”. You will learn the mysteries of the science of sleep, a functional protocol for screening and treating patients, how to find patients who need your services, the various intra-oral appliances and how to monitor their efficacy. and billing benefits with medical codes.

Oral appliance therapy (OAT) is the most convenient and preferred therapy for the mild and moderate cases and for those patients who cannot tolerate the CPAP device. Fortunately, this is where The Dentist rides in on a white horse to the rescue. We dentists like to say we are on the front line of the battle against sleep apnea. Dentists are in the optimum position to see the signs and symptoms and can offer the most preferred solutions to the problem..
In the words of the Great Master Yoda, in the classic Star Wars movies, “There is no ‘try’; there is only ‘do’ or ‘do not’.”

                                                                                                                                                                                     “It’s the Start that Stops Most People”

MALLAMPATI EXAM

Are you concerned about Obstructive Sleep Apnea?  You should be because it is estimated that 22 million Americans suffer from sleep apnea, with 80 percent of the cases of moderate and severe obstructive sleep apnea undiagnosed.
 

Here is a simple yet accurate diagnostic test you can use to see the opening of your airway.

Stand in front of a mirror and protrude your tongue. Aim a light toward the back of your mouth.
Is your airway open like the diagram on the left? You are safe.
SIZE DOES MATTER
If your airway is obstructed by the base of your tongue, or a droopy soft palate, or from side to side by the pillars or tonsils, then this should concern you.
WHAT IS OBSTRUCTIVE SLEEP APNEA?
Obstructive Sleep Apnea (apnea=without breath) occurs while you are at sleep and not even aware of it. (Your bed partner may be well aware of your symptoms.)  During an apnea event you will not be able to inhale for 10 seconds and even up to a full minute until your body forces an autonomic response: your tongue will push forward in an attempt to open the airway, your teeth will gnash and grind.  When you are awake you may be able to see these signs in your mouth but you are unaware while asleep.
This dangerous cycle may repeat throughout your night and it may average 30 such episodes per hour. A severe case of obstructive sleep apnea (OSA) could produce 240 episodes during an eight hour sleep. This is not uncommon.
Imagine how much life-supporting oxygen is being transported to your heart, your brain, and other organs. Well-known mental effects of OSA are chronic daytime fatigue, irritability, confusion, inability to concentrate, dementia, and Alzheimer’s disease.
High blood pressure, strokes, heart attacks are also connected to OSA.
FOR DENTISTS:
If you want to learn about the treatment protocol, case planning, insurance coverage, and the rewards, I strongly recommend this 2 day, 16 CEU course for dentists and hygienists. Dates and cities here:        http://join.sleepgroupsolutions.com/seminars/
By registering with this promo code CK200 you will save $200 off the cost of the tuition and bring a hygienist tuition-free,  In this website you’ll see the cities and dates for this training course.

WHAT IS MISSING IN YOUR COMPREHENSIVE DENTAL EXAM?

A truly professional comprehensive dental exam examination (D0150 or D0180) should include much more than what the CDT codes delineate.
What is essential?
Beyond the obvious FMX, charting of existing and needed dental and periodontal conditions, and an oral cancer screening, there are many other evaluations which are directly related to our services and are within our authority and responsibility.
The Comprehensive Exam should also include measurement of vitals such as blood pressure, etc. and a sleep dysfunction screening with a sleep questionnaire and a careful discussion of any notable items (alerts) in the patient’s med and sleep history. These things don’t need to be spelled out in the CDT code. They come with our desire to do what we know is right.

MALLAMPATI EXAM

TMJ exam, facial muscle palpation, Mallampati classification  (correlates tongue size to pharyngeal size) and an oxygen saturation test will provide critical information.  Any dentist/hygienist/team will chose how extensive they wish their dental exams to be and what should be included.

Would we be “spending too much time” in a dental exam visit?

Not if we care about our patient’s total well being, our conscience, and our dental license.

And is this “nearly always accepted by patients with huge value and appreciation”? YES, it is when the dental team shows their patients how much passion, care and skill they have. I see it in many dental offices. The really successful ones.

5-20-12 HUMAN PYR

Do you want to do more?
Here’s your opportunity to increase your service to your community, to create your “niche”, and  to stand out in your community as a complete care-giver. Your rewards will be enormous!
It is reported that 34% of the population has sleep breathing symptoms. One of the next three patients that walk thru your doors is your candidate.

Are you able to help them?

Does your New Patient Exam include a screening for Sleep Apnea?1-21-13 LOGO DENTAL PROS SHARING

 

Interested? Then check this out: http://sleepgroupsolutions.com

or ask me:  cskdoc@aol.com

We are pleased to offer you an updated current Dental Sleep Medicine presentation at your next Study Club or Dental Society meeting.
Dentists are excited to learn how to help their patients who are afflicted with Sleep Apnea. Here’s how we can help them.
Our presentation “Successfully Treating Snoring and Sleep Apnea in the Dental Office” can be tailored to your organization’s schedule- from one hour up to a half or full day.
One third of the adult population have symptoms of a sleep breathing disorder and Oral Appliance Therapy (OAT) can only be offered by dentists. OAT also has overwhelming benefits for those who cannot or won’t use the CPAP.
Our program includes screening procedure, how to motivate the Dental team to engage their patient on the subject, the morphology of the airway, co-morbidities to look out for, the effects to other systemic diseases, use of airway imaging equipment, treatment modalities and medical billing for dentists. If allowed enough time we can have a hands-on interactive testing of the attendees.
This is an AGD/PACE CE accredited course.
Sleep Group Solutions is the largest and most comprehensive company in Dental Sleep Medicine education and we have been acclaimed for our presentations by many dental associations across the country.  (Please see the list below.)
(You can private message me  at cskdoc@aol.com)
Here are some of the Dental Associations and Study Clubs we presented to:
Connecticut State Dental Association Annual Meeting (3 times)
World Clinical Laser Institute (WCLI)
Georgia Regents University (Last Chance CE’s)
Arkansas State Dental Association (ASDA)
University of California Fresno State (UCFS)
Dental Practice Builders
Dental Assets, Dental Marketing, International
KOIS Study Club
Doctors’ Choice Companies, Jupiter, Florida (3 times)
Dr. Allison Lee, Carson Dental Group, California
First Choice Practice Sales, Newport Beach, California
Coachella Valley Dental Society
L A Dental Meeting
Fort Lee, NJ Study Club
South Orange Dental Study Group
North West Arkansas Study Club
Queen’s County Dental Society (3 times)
Redwood Empire Dental Association (2 times)
Comprehensive Care Study Session
Barry D. Hammond, DMD Georgia Regents University
Raleigh Wake County Dental Association
Bronx County Dental Association
Southern California Academy of General Dentistry
New Mexico Dental Association (2 times)
New Orleans Dental Association
Yosemite Dental Society
Hunterdon Dental Study Club
Virginia Dental Association
Greater Houston Dental Society
Issaqueena South Carolina Study Club
Maine Dental Association
2016 World’s Fair of Dentistry
National Dental Association
New Hampshire Dental Association
Fialkoff Dental Study Club (NY  State)
Broward County Dental Association (Florida) (2 times)
Philadelphia County Dental Association
Arizona Dental Association
Michigan State Dental Association
New Haven CT Dental Society
Houston Asian American Dental Society (HADS)
New Jersey Academy of General Dentistry (NJAGD)
So. Broward Dental Society (Florida)
Maryland Academy of General Dentistry
New Mexico Dental Society
Dental Divas Study Club (Philadelphia)

(You can private message me  at cskdoc@aol.com with your questions or for scheduling a speaker)

It is estimated that 22 million Americans suffer from sleep apnea, with 80 percent of the cases of moderate and severe obstructive sleep apnea undiagnosed. 

If we accept the reports that a minimum of 80% of Sleep Apnea is undiagnosed, then only 20% is actually addressed in any fashion.

  And we don’t know how many of those who have been diagnosed have been effectively treated. These figures suggest an epidemic health issue that is screaming for attention. The first step is universal screening and diagnosis but why are so many sleep apnea afflicted people undiagnosed?

The undiagnosed may fit into these categories:

1. Patients have no idea that such a thing as Sleep Apnea exists.

        Hard to believe it but there are such people.
2. They know about, but have no idea that they suffer from, Sleep Apnea .
        “Isn’t snoring normal?”  “Doesn’t everyone wake up 4-6 times a night?”
3. They know they have the symptoms of Sleep Apnea but are in denial.
        I know a smart lawyer who insists sleep apnea does not exist. He tells me that I am “just as bad as [his] wife” who listens to him snore and gasp for breath every night.
4. They know they have problems but refuse to do anything about it.
       Some have heard horror stories about CPAP machines and simply do not want to take action. They need to learn about the oral appliance therapy (OAT).
5. Misdiagnosed Sleep Apnea.
        There is a lack of knowledge of sleep apnea among many health professionals. Physicians are alerted only to the stereotypes but Sleep Apnea is a non-discriminating attacker- it effects people of all genders and ages.It is often misdiagnosed as ADHD.

It is sometimes very difficult to get these people to want to be screened and diagnosed by just telling them their symptoms are evidence of a serious disease.    It is necessary for them to “see” it for themselves and for them to adopt a top down approach – of their own volition.

The best way to do this is to educate them in the most simple, effective, non intimidating and cost effective way – we can show them films of OSA victims having sleep breathing events.  We must find a way to get them screened and filmed and then show them their results. This is an massive education deficit issue.

Sources

American Sleep Apnea Association  http://www.sleepapnea.org/i-am-a-health-care-professional.html

Indy Star,Lauran Neergaard, http:/ /www.indystar.com/ articles/ 9/ 186972-5719-052.html

Detroit Free Press, Bill Dow,http:/ / www.freep.com/ news/ health/ sleep2e_20041102.htm

It is estimated that 22 million Americans suffer from sleep apnea, with 80 percent of the cases of moderate and severe obstructive sleep apnea undiagnosed.

If we accept the reports that a minimum of 80% of Sleep Apnea is undiagnosed, then only 20% is actually addressed in any fashion.

The undiagnosed may fit into these categories:

1. Patients have no idea that such a thing as Sleep Apnea exists.

        Hard to believe it but there are such people.
2. They know about, but have no idea that they suffer from, Sleep Apnea .
        “Isn’t snoring normal?”  “Doesn’t everyone wake up 4-6 times a night?”
3. They know they have the symptoms of Sleep Apnea but are in denial.
        A “smart lawyer” who insists sleep apnea does not exist. He tells me that I am “just as bad as [his] wife” who listens to him snore and gasp for breath every night.
4. They know they have problems but refuse to do anything about it.
       Some have heard horror stories about CPAP machines and simply do not want to take action. They need to learn about the oral appliance therapy (OAT).
5. Misdiagnosed Sleep Apnea.
        There is a lack of knowledge of sleep apnea among many health professionals. Physicians are alerted only to the stereotypes but Sleep Apnea is a non-discriminating attacker- it effects people of all genders and ages.It is often misdiagnosed as ADHD.
It is sometimes very difficult to get these people to want to be screened and diagnosed by just telling them their symptoms are evidence of a serious disease.    It is necessary for them to “see” it for themselves and for them to adopt a top down approach – of their own volition.The best way to do this is to educate them in the most simple, effective, non intimidating and cost effective way – we can show them films of OSA victims having sleep breathing events.  We must find a way to get them screened and filmed and then show them their results. This is an massive education deficit issue.  Learn how to help them: SleepGS.com

Sources

American Sleep Apnea Association  http://www.sleepapnea.org/i-am-a-health-care-professional.html

Indy Star, Lauran Neergaard, http://www.indystar.com/articles/9/186972-5719-052.html

Detroit Free Press, Bill Dow, http://www.freep.com/news/health/sleep2e_20041102.htm

Dr. Sidney Shaw was an old-fashioned type dentist. He had a conservative treatment approach to the practice of dentistry, he exuded an obvious passion for helping his patients, and everyone loved him. He had an admired and successful general dental practice.  At the ripe young age of 66 he was diagnosed with atrial fibrillation and his doctor told him he had to slow down. That’s when he made the painful decision to hang up his loupes, put his practice up for sale and reap the rewards from the 38 years of hard work invested into building his practice. He felt he could retire comfortably on his proceeds from the sale.

He contacted a dental transition broker who conducted a very comprehensive practice valuation. To Sidney’s dismay the valuation reported a market value of 310,000. This was more than disappointing to Sidney; it was devastating. It was not enough to support him and his wife and their medical bills.

“Disappointment is a temporary obstacle on the road to success.”

Sidney contacted Kenny Jones of Doctors’ Choice and this astute transition Broker came up with an idea. He could implement a dental sleep medicine program that could add another two to three hundred thousand dollars in value to his sale price.
With his health scare Sidney made some major business decisions. He hired an associate, he cut back to three half days a week, he took a dental sleep medicine training course, got some private coaching and concentrated on screening and treating his patients for sleep apnea.
Within two months of making his decision he was treating two patients, on average, each day for sleep apnea. His average fee for each case was $3500. This amounted to $21,000 a week for three easy, relaxed, rewarding half days a week. This projected to revenues of an incredible $1,050,000. for a 50 week year. This may sound like “pie in the sky” but when you check around you will find examples like this being quietly conducted all throughout the nation.
The happy ending:
Sidney sold his practice for 2.5 times more than that original market value and he stayed on 3 half days a week as a ” sleep specialist” for the new owner. How is that for a ROI of two months’ training?

Treating patients for sleep breathing disorders is an excellent way to continue your public service and receive even greater income in shorter hours than practicing general dentistry. Practicing DSM can be the apex of your public service career. Nothing in dentistry can compare to the ROI you will receive.

You may contact me cskdoc@aol.com for further information.