Archives for posts with tag: Mentoring

We know that men are more at risk of developing obstructive sleep apnea. But for women who suffer from OSA the 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 a large 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.

How Sleep Apnea Influences Cancer

The 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.

Sleep apnea leads to neurochemical imbalances. When poor sleep is the result of any untreated sleep disorder, the neurochemical balance that a whole-body process like sleep requires is disrupted.

 Two of the key hormones that fall out of balance—cortisol and melatonin—are critical for maintaining a healthy immune system (cortisol) and for regulating the body’s circadian system (melatonin). In addition, this neurochemical balance can lead to body-wide (systemic) inflammation.

 

How does this relate to cancer?

  • Without a healthy immune system, the body can struggle to fight off the aggressive cellular behaviors that can lead to tumors.
  • With an imbalance in circadian rhythms as the result of decreased melatonin, the body produces higher amounts of other substances that are risk factors for cancer (for women, higher estrogen can lead to breast cancer, and for men, higher estrogen can lead to prostate, bowel, lung, and bladder cancer).
  • Systemic inflammation causes oxidative stress to the organs. Oxidation is a breakdown of tissues that is the consequence of long-term inflammation; oxidative stress refers to the damage that results from unchecked systemic inflammation, which makes it easier for cancer—an opportunistic disease—to establish itself wherever the body is most vulnerable.

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. 

Conclusion

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

 

 More case studies

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

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.

  

Researchers have also suggested a correlation between sleep apnea and increased cancer risk of any kind.   Risk of some cancers may increase. One Cancer study of 1,240 participants who underwent colonoscopies found that those who slept fewer than six hours a night had a 50 percent spike in risk of colorectal adenomas, which can turn malignant over time.
 
Sources: 

American Sleep Apnea Association
Centers for Disease Control
Mayo Clinic
National Institutes of Health
National Sleep Foundation
The New York Times
Wisconsin Cohort Study
World Health Organization

As a women in dentistry I am sure you wondered how your gender compares in statistics like age, income, hours worked, and more. Here are some interesting data followed by fascinating facts

How many dentists are there in the U.S. ?

As of 2019, there are 200,419 dentists working in dentistry (dentists using their dental degree in some fashion) in the U.S. 

Source: Supply of Dentists in the U.S.: 2001-2019

What is the dentist-to-population ratio in the United States?

As of 2019, there are 61.1 dentists working in dentistry per 100,000 U.S. population. Ratios vary by state.

Source: Supply of Dentists in the U.S.: 2001-2019 . 

How many dentists are female?

Among the 200,419 dentists working in dentistry as of 2019, 33.4% are female.

Source: Supply of Dentists in the U.S.: 2001-2019 (Tables in Excel). 

What percentage of dentists are specialists?

As of 2019, about one in five professionally active dentists (21.0%) reported that their practice, research, or administration area is an ADA-recognized specialty.

Source: Supply of Dentists in the U.S.: 2001-2019

Female dentists in the United States are younger than their male colleagues. According to the latest data available, 80 percent are age 44 or under, while more than 60 percent of male dentists are age 45 or older. Compared to their male colleagues, women are less likely to be in solo practices and more likely to be employees or independent contractors. Fifty-three percent of female dentists are solo practitioners compared to 75 percent of male dentists, and 29 percent of women are employees or independent contractors compared to 8 percent of men.4 While this discrepancy is in part a function of age differences, women tend to move more slowly into solo practice arrangements than men.

 Women are somewhat more likely than men to work part-time: 28 percent vs. 15 percent, and are less likely to work overtime: 16 percent vs. 30 percent. A recent study indicated that marital status does not appear to have an impact on work hours among female dentists. However, having children reduces women’s work hours by nearly one workday per week, on average.

Gender differences in income are frequent topics of discussion. According to an ADA survey, nearly two-thirds of female dentists believe that they earn less than their male counterparts, while nearly two-thirds of male dentists believe that there is no gender difference in dentists’ income levels. The existing data, however, indicates that the perceptions of female dentists are more accurate than those of their male colleagues.

A comparison of the average income of all female dentists with the average income of all male dentists is not a useful indicator of income inequality, because, as we have indicated, there are substantial gender differences in practice arrangements and experience among U.S. dentists. Still, when comparing the average net annual income of full-time male and female practitioners who have been out of dental school less than 10 years, women earned only 64 percent of what men earn. Additionally, among dentists in all age groups, women who were partners or who were in solo practice only earned 58 percent and 73 percent, respectively, of what men earned in the same practice arrangements. Women as employees only earned 47 percent of what men earn as dental practice employees. 

THE TREND

Women in the pipeline

The number of women in the pipeline for a career in dentistry has grown dramatically over the last 30 years. Enrollment of women in U.S. dental schools stands at 48 percent;  in 1970, only 1 percent of dental students were women. 

in an analysis of the first-year data, we found that students’ motives for attending dental school appeared to be organized into four distinct areas.   The first cluster focused on money issues, and reflected the importance of financial and job security aspects of a dental career to students.  The second cluster was a set of people-related motives. Students who gave high ratings to these motives thought that caring for and helping other people were important reasons for attending dental school.The third cluster centered on the notion of flexibility, and suggested that the freedom and flexibility that dentists have in scheduling their work relative to other professions, both health-care-related and otherwise, is important to dental students. The fourth cluster focused on business-related motives for becoming a dentist, and the degree to which students stressed self-employment and being one’s own boss as important reasons for pursuing a dental career.

Our data showed that both women and men found the financial aspects of a dental career equally important as a motive for attending dental school. The perceived flexibility of a dental career was also equally important to both men and women. On the other hand, male students rated business-related motives as being more important in their decision to pursue dental school than did female students. Conversely, female students rated caring or helping motives as more important than did their male counterparts.

When asked about their aspirations following dental school, significant gender differences among first-year students emerged. Despite the fact that first-year students are not likely to have a great deal of in-depth knowledge about dental specialties, with the exception of pediatric dentistry, women were less likely to aspire to postgraduate dental education than men. In fact, the most significant predictor of postgraduate educational aspirations among first-year students was gender. Furthermore, compared to men, women were less likely to see themselves in a solo practice following graduation and more likely to see themselves as an employee or associate in a dental practice.

 CONCLUSION

The trends show an ever improving picture in all categories for women in dentistry.

Are you ready to cut those strings that have tied you to the dental chair for all those years? You have had a long productive career of interacting with people in need and improving their quality of life. Now, after years of intense dedication to detail you are looking for alternatives. You want to hang up the loupes but are wondering what to do first and what will you do when you start to miss the patient interaction.   Here’s what one astute dentist did:

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

She 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 comfortably support her and her mounting medical bills.

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

Sidney contacted me and we came up with a solution for her.  We implemented a new program that added another three hundred thousand dollars in value to her sale price.

Within two months of making her decision she was treating two patients, on average, each day for sleep apnea. Her 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 her practice for 2.5 times more than that original market value and she 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?

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

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.

Are you ready to cut those strings that have tied you to the dental chair for all those years? You have had a long productive career of interacting with people in need and improving their quality of life. Now, after years of intense dedication to detail you are looking for alternatives. You want to hang up the loupes but are wondering what to do first and what will you do when you start to miss the patient interaction.   Here’s what one astute dentist did:

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 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 me and we came up with a solution for him.  We implemented a new program that added another three hundred thousand dollars in value to his sale price.

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?

You may contact me cskdoc@aol.com to discuss solutions to your own personal situation .

By Charles Kravitz, DDS
 
Every dentist wants to develop a strong presence in the exciting and profitable world of Dental Sleep Medicine. We have all heard the stories of phenomenal success some dentists have in treating patients for Obstructive Sleep Apnea.
 
This article will provide you with the solutions to your questions and get you excited about incorporating Dental Sleep Medicine (DSM).into your Dental Practice.
 
 “How Will Benefit by DSM in my Dental Practice?”
     This is a huge winner for your practice, for you, for your team, and for your patients.
 
    A.  The Benefits for you and your Dental Practice
              1.  Acquire New Patients- lots of them.
 
You will be sought for your unique professional dental service. 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 their brains and to other organs. Strokes. Heart attacks. Diabetes. Dementia. People are recognizing that they have the symptoms and are asking their Dentists about it. 
 
When people learn that you are “The Sleep Dentist” or “The Snore Clinic”, and you can help them, they will call you. “Build a field and they will come.”( from Field of Dreams.)Your New Patient flow will increase.
 
            2.  Greatly Increased Income
 
With the new patients come new needed services. People who are health conscious and are concerned about their sleep disorder will be equally concerned about their oral health. You will enjoy new opportunities to help your new patients.
 
We know that this dental practice “niche” has quickly evolved into a full time “specialty” for energetic, dedicated dentists. The revenues generated from sleep services are impressive.
 
            3. A Unique Life-saving Service
 
I’m sure you understand that now, more than ever, you need to stand out and be able to offer not only EXCELLENCE, but also DIFFERENCE.  In this sluggish economy, where there is a perception of “financial doom”, (I personally don’t believe in that.), dental consumers have a tight hold on their wallets, and reports of dental service acceptance show a concerning drop. With DSM you will offer a unique dental/medical service.
What are YOU doing now to offer a unique service? Your First Class Service and Patient Engagement are expected as basic “givens”.  But what is your niche ? Are YOU the dental practice they must go to? 
 
            4. Serve an Underserved Need
 
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). 
 
            5. Significance
 
One of the basic human needs is to feel significant. It is a personal reward we can give ourselves. We dentists enjoy a lifetime of helping our patients. Caring for people is one of the driving forces that made us choose this career. It makes us feel good to know we are helping people to avoid pain, eat healthier, and feel more confident about their appearance. That is all great. But how does it compare to the feeling of saving a patient’s life? When you know you have taken patients who spend half their night’s sleep without oxygen going through their airway and to their brain- and you have corrected their life threatening disease, how does that make you feel? Significant! You will be seen as a hero.
 
    B.  The Benefits to Your Dental Team
 
Every member of your team plays an important role in the Dental Sleep Medicine service and they will enjoy the following benefits: 
 
            1. Professional Pride, Prestige 
 
All team members will know, as you know, that they are steps above the dental community in truly providing comprehensive health care. 
 
 
            2. Providing a Needed Service
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 and of those that are new patients, are there for you to help them.
Your team members will be perfectly positioned to help their family, neighbors, and new friends.
According to a Harvard health report there are 18.9 million undiagnosed cases of obstructive sleep apnea. 
            3.  Rewards  
On top of the emotional rewards that your team members receive, they are contributing to the financial success of your practice. DSM is over 80 percent staff driven and you may feel they deserve to share rewards with you. 
            4.  Job Security  
DSM in a practice can build quickly and strong.Your employees make valuable contributions to its success and have the good feeling of being needed. By the same token, you will know that they are critical to your success and would not want to lose them. 
            5.  Feeling of Significance 
Like you, your employees enjoy the feeling of “making a difference”. Everyone needs to feel significant. It is a personal reward we can give ourselves. Caring for people is one of the driving forces that made your staff want to be a dental professional.  When they know they have taken patients who spend half their night’s sleep without oxygen going through their airway and to their brain- and they have contributed to correcting their life threatening disease, how does that make them feel? Significant! They will be seen as heros.
    C.  Benefits for Your Patients
              1. Your patients will now have a convenient and caring source (you) that can discover and treat that serious disease- Obstructive Sleep Apnea- that wakes them up all through the night and diminishes their quality of living.
            2.  They will understand that trained dental professionals are the best source for discovery of  Obstructive Sleep Apnea. They will spread the word – referrals.
            3. They will know their dentist will be able to offer them the most comfortable and popular treatment for OSA- the Oral Appliance Therapy. (OAT). 
              4. They will be delighted that Medicare and their private insurance, in most cases, will pay for the OAT. 
              5. Your patients will sleep better, feel better, be healthier and live longer. 
 
Contact me to learn more: cskdoc@aol.com

You are in an excellent position to screen for sleep apnea and to help identify your undiagnosed (and therefore, untreated) OSA patients.

How can you miss these clinical signs?

You…..

• have direct observational access to the physiological structures of your patients’ upper airways

• are already screening chair side for other health conditions that can be easily spotted during a dental visit

• may see these patients more frequently than primary care physicians will, with nearly one quarter more likely to see a dentist than a physician over any given time period. 

Your field of operations is right next to the opening of the airway.

Clinical signs of Obstructive Sleep Apnea:
~constricted airway – measured by a Mallampati score *
~ large neck circumference

          Over 15 inches in women
          Over 16 inches in men
  
~ oversized and/or inflamed uvula
~ extra large tongue
~ scalloped tongue edges-caused by tongue forced against the teeth, gasping for breath.
~ enlarged tonsils     
~ a droopy soft palate
 ~ retrognathic mandibular jaw.
~ obesity
~ heavy or struggled breathing
~ bruxism
~ obvious lack of energy
~ lack of focus in children causing ADHD -in 20% of ADHD victims.
~ sleepiness during dental appointment.
                                                                                                   *MALLAMPATI CLASSIFICATION

   Want more information, email me cskdoc@aol.com.

Retired? Or just tired?

 Looking for something more exciting to top off your dental career?
A dentist who is selling a practice and those who are worn out from years of intense dedication to detail are looking for alternatives. They want to hang up the loupes but are wondering what to do next.

After a long productive career of interacting with people in need, it is difficult to go “cold turkey”, even if golf is a passion.

There is a great solution awaiting you.

The laborious, long, stressful day in the operatory can be replaced with a very productive, rewarding, stress-free patient service.   You can choose how many days you want to work, where you want to provide the service and what kind of patients you want to see. And your rewards, both financial and emotional, will be greater than ever.

Dental Sleep Medicine!

 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.

Here are some of the benefits (not in any order of importance):

  1. Acquire New Patients- lots of them.

People are recognizing that they have sleep breathing symptoms and are searching for Dentists who can help them.

  1. Serve an Underserved Need

    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.

  1. Increased Income

You have heard the reports about the huge successes with DSM. With the new DSM patients come other needed services.

  1. Professional Pride, Prestige and
  2. The feeling of significance

One of the basic human needs is to feel significant. It is a personal reward we can give ourselves. We dental professionals enjoy a lifetime of helping our patients. Caring for people is one of the driving forces that made us choose this career. It makes us feel good to know we are helping people to avoid pain, eat healthier, and feel more confident about their appearance. That is all great. But how does it compare to the feeling of saving a patient’s life? When you know you have taken patients who spend half their night’s sleep without oxygen going through their airway and to their brain- and you have corrected their life-threatening disease, how does that make you feel? Significant! You will feel like a hero.

How do you get started?

If you are interested enough to have read this far, you have already started. To succeed in DSM you must have passion to continuing 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 introduction for 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.

Send your questions to me at cskdoc@aol.com.

We know we have received great benefits from our dental and hygiene careers. We built social, emotional and economic strength for ourselves through our hard and smart work. Now we can “pay it forward” Share your tips, ideas, advice with the dental community on the LinkedIn DENTAL MENTORS network.  https://www.linkedin.com/groups/4746892  
Every one of us is an expert in some area(s) that can help others. Join this non-promotional group and have that good feeling about mentoring others.