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Sleep Apnea Screening and Treatment
Getting educated on sleep disorders can involve time, money and brain power.
Dentaltown.com > Message Boards > TMD & Occlusion, Sleep Apnea/Snoring and Appliance Therapy
Nathan Saydyk
Member Since: 04/07/04
Post: 1 of 75
You learn something new every day. I had a patient ask me to make them an anti-snoring
device because they can't stand their CPAP. I told him that I would look into it and get back to
him (I was mainly thinking cost and what to charge). Well ... a week later I know more (and
less) about sleep medicine than I would have ever thought. I don't have the time or money for a
course in sleep medicine but that is now on my CE list.
Using Dental XP course by John Nadeau and other resources (Dentaltown being the main
one) I believe I have a better handle on my place in providing this to patients. I have contacted
a sleep center that is very close to my office and will also be meeting with an
tomorrow to
attempt to build a team for treatment of sleep apnea and snoring.
My biggest concern is in children-my main resource for this is my orthodontist. It seems
that as far as dental appliances for children you are limited to a Frankell or Herbst appliance. I
would love more info on what others are doing. So here is my protocol rough draft.
. Identification of patients at risk for sleep apnea
A. Positive questions on health history, triggering follow-up questions regarding:
Breathing or sleep problems (i.e. snoring, sinus)
igestive disorders i.e. gastric re u
Emotional problems
Psychiatric treatment
ften feel e hausted or fatigued
Subject to frequent headaches
Often feel unhappy or depressed
B. Utilization of initial patient sleep screening form to evaluate need for intervention.
. onsult in dental office to e plain
risks
. eferral to sleep center or irtu
for home sleep test
4. With diagnosis of OSA review with patient recommendation of sleep center. If a CPAP
is recommended then a follow-up in our office will include asking if the device is being
used at dental re-care visits. ecare catagory for
in entri .
5. If sleep center recommends dental device or if patient displays history of non-compliance
with CPAP then move forward with production of dental device.
. itration of device either in sleep center or in office here is where it is a little shady for
me I have never titrated one of these and I am not sure how you would do it in the office .
. erification of device with an at-home sleep study.
. ollow-up in dental office by asking patient at dental re-care visits if they are wearing it and
home sleep studies every si to months. ecare atagory in entri for
evice
and home sleep study).
Well, there it is in rough draft. Let me know what you think. I am a rubber-hits-the-road
clinician and have to make things easy for me and my team to make clinical decisions and
follow-up.
he ne t part has to do with billing medical. I have never done this. I understand that the
sleep center and the home sleep study place will bill themselves. As for my part I would bill for
the consult and the device. Not sure if I can bill for follow-up on the device or just build that
into the cost of the device. ■
MAY 17 2012
continued on page 22
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