Archives for posts with tag: SLEEP
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)

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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

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 (aside from 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 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

-What  are the deductibles?

-An easy way to help your entire team eliminate any problems with Medical Billing

 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’.”

Beginning with the seminar training, the dentist must be 1000% committed to success. (Anything we endeavor will be more likely to be achieved when we are positive that we will win.) The seminar training is only the beginning of the learning process. We must retain what we have learned, continue to study, to research all new ideas and to practice our treatment plan presentations with our teams. Everyone on the team must be skilled and committed.

Sleep Apnea training, although essential, is not the end of the education. It is, as Winston Churchill said in 1942 during WWII,  “…this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”

This Dental Sleep Training course may be the most valuable CE Seminar you have taken. *

Here’s one example of a very useful test that anyone can do to determine the likelihood of Obstructive Sleep Apnea.
The  Mallampati Score is a very simple exam and is an effective indicator of a compromised airway.   The subject can be sitting or standing with a vertical axis of their body and head.  As long as the tongue is protruding we are able to see the airway. The variables are, above, the soft palate and uvula, laterally, the walls of the fauces (or the tonsils and adenoids), and below, the base of the tongue.
The tongue is the most common offender for obstructive sleep apnea. Macroglossia can be effectively dealt with by oral appliance therapy- a mandibular advancement device (MAD).
Imagine trying to breathe with an obstructed airway… and a nasal obstruction!
Your Sleep Coordinator or Hygienist can do this exam as part of routine screening on every patient. Class III and IV must be treated.

About the SGS Course Instructor: Dr. Jeff Horowitz

Dr. Jeff Horowitz, a native of Old Bridge, New Jersey, completed his undergraduate studies at the University of Pittsburgh , receiving early admission to dental school after his junior year. In 1991 he earned his Doctorate of Dental Medicine degree from the Medical University of South Carolina. Dr Horowitz has dedicated himself to continuing education, earning him the fellowship award from the Academy of General Dentistry.  Dr. Horowitz is also a member of the American Association of Dental Sleep Medicine.

* You will receive 16 CE credits and a training in the most exciting and rewarding dental service.

Read the course outline and register here with Promo Code TN500 to get a 50% tuition saving:    

http://join.sleepgroupsolutions.com/seminars/nashville-tn-4/

Read the rest of this entry »

Lack of sleep is causally connected to many physical problems.

We know that from numerous reliable studies.

Obstructive Sleep Apnea (OSA) is a major cause of sleep loss and one of the common symptoms of (OSA) is being overweight. Sleeping less than six hours, or more than nine hours, a night appears to increase the likelihood of weight gain. So then, how does OSA effect weight gain?
 FAT GUY SLEEPING
There are three hormones that factor in the equation of lack of sleep contributing to weight gain.  

1. Ghrelin: the Hunger Hormone

Lack of sleep increases ghrelin, and decreases leptin, both effects producing increased hunger and obesity. Ghrelin is produced in the gastrointestinal tract and functions as a neurotransmitter. When the circadian rhythm is interrupted by exposure to light at night, gherlin is released.

 2.  Leptin: the Anti-hunger Hormone. 

Leptin is the satiety hormone that has opposite effects from ghrelin.  The receptor for leptin is found on the same cells in the brain as the receptor for ghrelin.

3.  Melatonin:

Melatonin maintains the body’s circadian rhythm by regulating the other hormones. The circadian rhythm is an internal 24-hour “clock” that plays a critical role in when we fall asleep and when we wake up. When it is dark, your body produces more melatonin. When it is light, the production of melatonin drops. Being exposed to bright lights in the evening, or too little light during the day, can disrupt the body’s normal melatonin cycles. For example, jet lag, shift work, and poor vision can disrupt melatonin cycles.

Melatonin supplements can be helpful for those who are sleep disadvantaged but adherence to directions is recommended.

melatonin 5-6-15

The Process

An inverse relationship between the hours of sleep and blood concentrations of ghrelin exists: as the hours of sleep increase, ghrelin levels trend lower and obesity is less likely.  Short sleep duration is associated with high levels of ghrelin and obesity.

When the stomach is empty, ghrelin is secreted. When we eat something the stomach is stretched and ghrelin secretion stops. Ghrelin acts to increase hunger and to increase gastric acid secretion and gastrointestinal motility to prepare the body for food intake.

What else does Ghrelin do to effect weight gain?
Beyond regulating hunger, ghrelin also plays a significant role in other systemic functions. Ghrelin influences body composition, it stimulates the release of growth hormone and regulates the distribution and rate of use of energy.

Conclusion

This is just another convincing reason to get adequate healthy sleep…. at the right time. Light is the circadian rhythm disrupter. Avoid light disturbances during sleep: have no lights in the bed room, pull the shades down to block any outside light, wear an eye mask.

https://adental.files.wordpress.com/2015/06/counting-sheep-a.jpg

Resources
WebMD
Wikipedia
Zarouna SWozniak, G, Papachristou, Stalo Zarouna,
Psychology Department, University of Cyprus, Nicosia 1678, Cyprus.
  • Department of Cell Biology, Physiology and Immunology, University of Cordoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), and CIBER Fisiopatología de la Obesidad y Nutrición, 14004 Córdoba, Spain.

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.

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 realtor 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’s astute transition Broker came up with an idea. If he could implement a dental sleep medicine program he 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 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 income for each case was $3500. This amounted $21,000 a week for three easy, relaxed, rewarding half days a week. This projected to revenues of an incr
 edible $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?
If you are interested in getting into this exciting, rewarding, life-saving Dental Sleep Medicine field you may contact me at cskdoc (aol) for more information.