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Dr. John Flucke is in private practice in Lee’s Summit, Mo. He also serves as technology editor for Dental Products Report magazine and keeps an active blog filled with thoughts and tidbits on the world of technology at blog.denticle.com.
Most dentists know about the dangers of sleep apnea, but how many are actually doing something about it?
For those of you who were around in the late ‘90s and tinkering with computers, you can probably remember the rush you felt when Intel or AMD came out with a new processor.
Suddenly the sound of the platters on your hard drive spinning away vanished as the processor used its billions of on-board transistors to calculate and render processes that used to require RAM and ROM processes of limited quantity.
Things happened faster - sometimes blazingly faster. Then the folks who wrote the programs quickly figured out how to take advantage of all of that extra computing power and created better, more detailed graphics and better programs. Your computer hummed along like never before, and then the programs evolved to take advantage of all that new powerful processing power. The system began to slow down until your machine began to grind along again and then the process repeated itself over and over and over.
Dentistry is evolving at the same rapid pace as practically everything else in our society. We’re no longer seeing perhaps one discipline such as bonded restorations making a sudden jump in materials or technique. Instead, we’re seeing evolution across the board. This requires us to keep a constant vigilant eye on almost everything we do as well as the techniques we use to do them. It becomes a process of not only being knowledgeable about your career in a big picture sense but also to stay knowledgeable about your career in a micromanaging technique by technique basis.
Every once in a while, I sit back and ponder the rapid market penetration of technology and how that market penetration has pushed dentistry to the remarkable state it’s in currently.
Of course, advances in our profession aren’t always about bells and whistles. Sometimes it’s about a disease process that science helps us realize we could have a major impact in diagnosing and treating.
In the short span of the last five years or so, the profession has seen a tremendous evolution in lots of topics and processes; one of them has been Obstructive Sleep Apnea Syndrome (OSAS).
Gasping for life
Many of us in the practice of dentistry are familiar with the symptoms and ways to diagnose OSAS, but many doctors aren’t treating it for a number of reasons. Let me give you some things to ponder and consider about OSAS that you might not be aware of.
Did you know that the National Sleep Foundation states that more than 18 million American adults have sleep apnea? That doesn’t even count the number of children who suffer. That’s mainly because there’s no surefire way to diagnose the disease in children. Roughly, those statistics mean that upwards of 20 percent of American adults (that’s one in five) are potentially suffering with OSAS. And those numbers only reflect patients who have been diagnosed with a sleep test or other type of rigorous criteria.
I’ll admit to being a person who is driven by statistics. Maybe it’s just the science lover in me, but whenever I hear statistics cited, my ears perk up. So, when I see or hear something that states scientifically a disease process is affecting one in five of my patients, I take notice. The latest statistic that I’ve seen on the number of dentists in the U.S. is roughly 195,000. That means that if every patient experiencing OSAS asked his or her dentist for help, that would be about 100 patients per practice. That number is going to become more important later on.
Most of us in the profession think of OSAS as snoring and the potential lack of oxygen that it brings. However, there are a lot of other disease processes that can be driven and/or exacerbated by OSAS.
Continue to page two to read about the disease procseses.
Research by the Centers for Disease Control and Prevention demonstrates a big overlap between depression and sleep apnea. There have also been links found between anxiety and sleep apnea. The National Institute of Mental Health estimates that approximately 40 million adults between the ages of 18 to 54 suffer from some type of anxiety disorder.
When the body, and more importantly the brain, are denied proper rest cycles, bad things can happen. Some studies postulate that 46 percent of people with OSAS have depressive symptoms. When one considers the number of prescriptions for antidepressant medications and the potential for loss in the quality of life category, this can be a major reason to battle for more treatment of OSAS.
2. High blood pressure
As we all know, the risk of hypertension increases as we age. This combined with the fact that our patients are now living longer puts a greater incentive on controlling hypertension. OSAS has been shown to be a definite contributing factor.
3. Heart disease
Most of us in dentistry know about the fact that OSAS can be a major contributing factor to myocardial infarction. This has to do with the very simple fact that OSAS is a serious disruptive component of properly oxygenated blood. When the circulatory system has a hard time delivering oxygen to the body, organs such as the brain and the heart can be severely affected in a negative manner. Many sports fans remember that pro football player Reggie White, “The Minister of Defense,” died in his sleep from a heart attack contributed to by OSAS.
However, many don’t know that OSAS can also be linked to atrial fibrillation and strokes. Both of these problems can seriously affect quality of life.
4. Type 2 diabetes
This is another incredibly common disease, especially in our older patient demographic. Yet most people don’t realize that around 80 percent of patients dealing with Type 2 diabetes are also dealing with OSAS.
Interestingly, OSAS is associated with both insulin resistance and glucose intolerance. When you consider the debilitating effect that diabetes can have on quality of life, it’s essential for us to do all we can to help them manage this disease. The dental ramifications are serious enough, but there are very few diseases that we as dentists can help manage that could potentially head off something as serious as amputations.
5. Acid reflux
While there’s currently no data that shows OSAS causes GERD, many sleep specialists report that treating OSAS helps reduce the symptoms.
6. Motor vehicle accidents (MVA)
Patients who don’t get restful sleep have a very dangerous tendency to fall asleep at quiet times. For many individuals, this “quiet time” could well be when they’re sitting behind the wheel.
A study done by the Sleep Research Society and polished by the NLM and NIH showed the total number of MVAs in OSAS patients was between 2.3 to 2.6 times higher compared with the control population.
The study states: “This large-scale retrospective cohort study using national traffic accident statistics provides strong evidence for a link between sleep apnea and traffic safety. Patients with OSAS had more frequent MVAs, and injury following the accidents was more common when compared with the control population. Effectively used, CPAP therapy was associated with a reduction of MVA frequency. Severe daytime sleepiness, but not severity of sleep apnea, was identified as a risk factor for MVA in patients with OSAS.
The current study found a 2.5-fold increased MVA risk in patients with OSAS, which is in line with previous findings.”
Next: So, what's the solution?
I’m a sufferer of OSAS and as such, it’s one of my passions to educate the profession and motivate people to help find solutions to this disease. I’ve got stories of getting a “full night’s sleep” and then falling asleep at breakfast, waking up behind the wheel as someone behind me honks at a traffic light, and many more.
As I talk to colleagues about the importance of diagnosing and treating this disease, I frequently hear arguments on why they don’t treat this disease. Far and away, the most common reason is that “it’s too complicated.” Proper diagnosis requires a sleep study and a sleep physician to interpret it. Dental insurance rarely covers the treatment and billing medical insurance is a minefield of problems and procedural snafus. In short, it’s just too complicated and too stressful to legally treat and to bill for OSAS. I agree with them on that, except for one little part. That part is that it used to be difficult, but it isn’t anymore!
What if I told you that there’s now a way to treat OSAS and all you have to do is the dental part of the treatment? That’s right - there’s now a complete, professional, turnkey way to learn, diagnose, order appliances, bill and receive support for the treatment of OSAS.
That turnkey solution is SleepArchiTx and it’s available right now. The idea behind SleepArchiTx is a fairly simple one. They agree that treating OSAS can be complicated and time-consuming and the business aspect can be difficult. With all of that in mind, the company developed systems to make the treatment as easy on the dentist and staff as possible. Their basic four-point program is: screen, receive diagnosis, treat and get paid - it’s as simple as that.
A patient is screened in your office. If the doctor feels that the patient may have OSAS and could benefit from treatment, then the patient is given information about SleepArchiTx and the patient contacts the company. Their team then gets to work basically holding the patient’s hand through the process to ensure an easy experience. SleepArchiTx will also document all of the necessary information for diagnosis, therapy, prescription and medical billing.
Basically, the company has located all of the “pain points” that an office would encounter in treating sleep. I had a discussion with CEO Alice Limkakeng, and here’s what she feels makes SleepArchiTx unique:
“Founded and managed by thought leaders in the industry, the solution is as much a service offering as it is a treatment philosophy that aims to identify the vast number of people that suffer from breathing disorders and align them with the most appropriate treatment option for that individual patient.
“SleepArchiTx is a medical healthcare company that provides a comprehensive solution to help dental practices effectively identify, treat and manage patients with sleep disorders,” she adds. “Its services include an education program that trains the entire practice (clinicians, front and back office staff members), program implementation with a systematic patient workflow and a powerful treatment planning service that identifies the best treatment options for patients to yield the most ideal treatment outcomes. All of these services are concurrently handled by a medical-billing solution that performs verification of benefits, claim submissions and - what is considered the most difficult aspect of billing - denial management.”
We owe it to our patients to provide the very best treatment that we can deliver. Treating OSAS is just one more thing that the profession can do to improve the quality of life for many. Thanks to SleepArchiTx, there really is no reason to put this off any longer. From learning about the disease to treatment and billing, the entire process has been streamlined. Reach out to them at 888-777-3198 or firstname.lastname@example.org.