Not Necessarily a Silent Killer

Ever since returning to provide dental care back in June, I’ve experienced kind of a nagging jab in the ribs right between my ears (and yeah, I minored in mixed metaphors during undergrad at Cal State, LA.) It was reminiscent of the voice I used to hear before I learned not to be so over-confident or assume. The voice used to whisper, “2.13, 2.13…” my first quarter GPA at Cal State, LA (again.)

There are three ways to grow a business, in this case, a dental practice: Increase the number of patients, help the existing patients secure additional care to improve their health and quality of life; and lastly, add additional services that add value to patient care and long-term health.

I’ve taken on Sleep Dentistry training multiple times. If you’ve ever visited us, you’ve been screened for Obstructive Sleep Apnea (OSA.) We’ve treated patients for OSA; we’ve made appliances for patients and therefore, saved some lives. But we haven’t committed to Sleep care the way we have Invisalign Orthodontics or laser-assisted Periodontal care. We’ve lacked a system. We haven’t taken on the “Quarterback” accountability or created the relationship with Physicians we have with Oral Surgeons or Endodontists (root canal specialists.)

I just looked up our very first experience providing a sleep appliance for a patient; it happened in 2004. In 2002, we began providing Invisalign; we’ve treated hundreds, going on a thousand patients. By comparison, we’ve provided maybe thirty sleep appliances.

And I remember our first appliance experience clearly; my patient of record’s concern was snoring. The patient’s colleague had had great success disappearing her snoring after being fitted with an appliance. My patient left me a name and a phone number and for me, it wasn’t jump; it was how high?

I called Dr. Mark Abramson, the doc who developed the OASYS appliance; he spent 30-minutes with me on the phone and sent me a CD explaining the appliance and its benefits. I made the appliance, delivered it, held my breath, and after Night One, heard my patient report her first full night’s sleep in over 20-years.

I’ve always believed retaining an element of child-like curiosity as well as a stubborn dose of immaturity creates the magic for staying young…although I hope my growing desperation isn’t that obvious.

And I’m disappointed that it’s taken a pandemic and some messages from the Universe to finally get me off my ass to make sleep a key component of our complete oral health care; especially because my grievance with OSA is personal.

90,000,000 Americans suffer from Obstructive Sleep Apnea (OSA); only 10% receive care. Only 3% manage the disease…that can steal away 15-years of life. Turns out, dentists have an opportunity to be gatekeepers and play an important part in an evolving team of care providers managing a deadly insidious disease.

OSA is a condition where the airway is restricted; a blockage behind the tongue and soft palate effectively stops or inhibits breathing during sleep. And the signs and symptoms as well as the toxic effects can begin to show up early.

Folks with OSA are prone to heart disease, diabetes, hypertension, and acid reflux. 75% of stroke victims also have OSA. People with unmanaged OSA are 23-times more likely to suffer a heart attack. Drivers suffering from OSA are seven times more likely to have automobile accidents.

Signs and symptoms include snoring, daytime drowsiness, morning headaches, jaw and facial pain, teeth clenching and grinding, and other subtle oral indicators that can be screened by dentists.

After the screening, dentists can refer patients to sleep clinics for testing, evaluation, and diagnosis by a sleep physician. Dentists can also provide home sleep tests that are reviewed and evaluated by sleep physicians. Light and moderate OSA can be treated with oral appliances and sleep hygiene; the treatment for severe OSA is Continuous Positive Airway Pressure (CPAP) therapy, or an oral appliance for those who can’t tolerate CPAP.

This week, March 6 will mark 45-years to the day I saw my dad die of a heart attack in our living room on an early Saturday evening I’ll never forget.

Dad was a type II diabetic, had an 18” neck, was prone to falling asleep in front of the TV while snoring like nobody’s business. After his diabetes diagnosis at age 50, Dad ate right, stopped drinking (cold turkey), and dropped about 40lbs; he was only 66 years old the night he died.

So, what used to just be accepted as some virtual nocturnal call of the wild is more likely the sound of someone desperately trying to breathe…while sounding a noisy 911 alarm. A simple screening could lead to a much longer, more beautiful life.

About a week ago, I was on the phone with a consultant regarding a strategy for my doing less clinically while my talented associate Doc took on more responsibility on the path of assuming ownership. Sleep dentistry came up during the conversation; the consultant’s life “had been saved” by an OSA screening and CPAP therapy.

Three days ago, a patient I’ve seen as a friend for 16-years reported the worst night of sleep he’d ever experienced (during a sleep study.) Then, he thanked me for saving his life. The same day, I signed on for an approach to implementing a system that saves lives.

Ask us about OSA.