THE TRUTH ABOUT SLEEP APNEA SEMINAR TRAINING

Dental Sleep Medicine: the hottest button in dentistry today.
Awareness of sleep apnea in America is at an all-time peak. People who recognize that they have the symptoms are asking their doctors about it. Every dentist would like to be “The Sleep Dentist”.

Seminars and courses are now available every week, in different cities, throughout the United States. More and more dentists are getting trained to discover the more than 40 million estimated victims of sleep apnea, and to treat them with the most appropriate modalities. 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. Dentists, we like to say, 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.

Keys to Success
Success in treatment acceptance and end point attainment varies with, and depends upon, each individual dentist’s determination and his/her patient’s cooperation.  The training programs will present the tools, the screening and diagnostic equipment, the techniques, the verbal skills, etc., but as in other health-care therapies, a partnership between the professional provider and the patient is the key to success. The patient’s cooperation is essential. Take periodontal disease therapy (STM or CPT), for example. The dentist and hygienist will remove the disease, teach the patient how to maintain periodontal health, and then monitor the patient’s progress for the patient’s lifetime. Sleep apnea can be considered an episodic disease like periodontal disease, diabetes and cardiac disease. For these there is no cure; only a lifetime of care to keep these diseases under control.  Failure of patients to comply will result in an episodic return of the symptoms in any of these cases. Compliance will keep them under control. So that explains the patient’s role in the “partnership for success”.

Why do some dentists take the course, go back to their Practices, “try it” and become discouraged?
And now the dentist’s responsibilities.
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.

11-26-13 DOS EQUOSWe must be able to answer these questions:
How do I keep my team motivated and constantly alert to help these patients?

How do find and connect with a certified medical sleep physician?
How do I “sell” my patient on the need for these services?
How do I bill patients and third party benefit payers for my DSM services?

This article did not promise the details of a “How to ….” for a DSM practice. Those answers are available for anyone to find, just as we found the answers to mastering.Perio Hygiene, composites and Smile Enhancements. The point of this article is that the 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.”  And THAT is “the truth about sleep apnea training”.

2-26-14 CHURCHILL.VICTORY

Did George Washington’s dentures contribute to his death?

HAPPY BIRTHDAY,  President Washington! 

282 years old   February 22, 1732-2014

Dentistry has come a long way since Dr. John Greenwood gave you those dentures in 1789 made from >>>>>>>>

2-18-12 GW

There must be dozens of portraits of George Washington. I have never seen any with him smiling. Those darn Hippo dentures with the spring openers must have been painful.

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Light from a red laser scans a resin reproduction of the 1789 lower denture originally carved from Hippopatamus ivory for George Washington.

Was the throat infection that took George Washington’s life caused by colonies of bacteria that grew in his world famous dentures?   What material were they made from?

By the time he became President, in 1789, at age 57, he had only one tooth remaining,   At his inauguration, Washington was wearing a full set of dentures which were attached to his final tooth. Washington had frequent dental problems during his tenure as commanding general of the Continental Army. A famous painting of Washington in 1779 shows a scar on his left cheek, believed to be the result of a badly abscessed tooth.

One cannot help but wonder if his teeth might have been the source of the chronic infections he suffered. His dental and health problems were intertwined.

Washington was treated by no fewer than eight prominent dentists who practiced in colonial America, but his favorite was Dr. John Greenwood.  Dr. Greenwood’s dentures had a base of hippopotamus ivory carved to fit the gums. The upper denture had ivory teeth and the lower plate consisted of eight human teeth fastened by gold pivots that screwed into the base. The set was secured in his mouth by spiral springs. The upper and lower gold plates were connected by springs which pushed the upper and lower plates against the upper and lower ridges of his mouth to hold them in place. Washington actually had to actively close his jaws tightly to make his teeth bite together.

His final dentures were made in 1798, the year before he died. This set had a swaged gold plate with individual backing for each tooth and was fastened together by rivets. Today, the lower denture is on display in the National Museum of Dentistry in Baltimore, and another the set was donated to the University of Maryland Dental School in Baltimore, the oldest dental college in the world.

Source: Research by Michelle Keib

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WHAT IS MISSING IN YOUR COMPREHENSIVE DENTAL EXAM?

A truly professional comprehensive dental exam examination (D0150 or D0180) should include much more than what the CDT codes delineate.
What is essential?
Beyond the obvious FMX, charting of existing and needed dental and periodontal conditions, and an oral cancer screening,there are many other evaluations which are directly related to our services and are within our range of authority and responsibility. 
The Comprehensive Exam should also include measurement of vitals such as blood pressure, etc., sleep dysfunction screening such as the Epworth Sleepiness Scale, and a careful discussion of any notable items (alerts) in the patient’s med history. These things don’t need to be spelled out in the CDT code. They come with our desire to do what we know is right. If I were still practicing today I would certainly perform these and a nutritional analysis.

11-27-11 APPLE A DAY

  TMJ exam, facial muscle palpation,Mallampati classification  (correlates tongue size to pharyngeal size) and
an oxygen saturation test will provide critical information.  Any dentist/hygienist/team will chose how extensive they wish their dental exams to be and what should be included.
Would we be “spending too much time” in a dental exam visit?

Not if we care about our patient’s total well being, our conscience, and our dental license.

And is this “nearly always accepted by patients with huge value and appreciation”? YES, it is, where the dental team shows their patients how much passion, care and skill they have. I see it in many dental offices. The really successful ones.5-20-12 HUMAN PYR

Do you want to do more?
Here’s your opportunity to increase your service to your community, to create your “niche”, and  to stand out in your community as a complete care-giver.
It is reported that 34% of the population has SA symptoms.
One of the next three patients that walk thru your doors is a Sleep Apnea victim. Are you able to help them?
Does your New Patient Exam include a screening for Sleep Apnea?
1-21-13 LOGO DENTAL PROS SHARING

Interested? Then check this out: http://sleepgroupsolutions.com/2.0/

WHAT ARE YOU MISSING IN YOUR NEW PATIENT EXAM THAT CAN HURT YOU?

Dentists are in the first line of discovery and defense of many systemic diseases. 
We are often the first ones to discover diabetes, sleep apnea and oral cancer.

The three serious conditions listed above are all too frequently under-diagnosed. 
New tools and techniques are now available for dental professionals to be able 
to do far more as comprehensive caregivers for their patients.
An interdisciplinary approach, enabling conferencing and sharing of information 
between patients' full medical teams will provide the most reliable diagnosis 
and optimal treatment.

Oral Cancer Screening
-Oral cancer is the most prevalent form of cancer. 
-It can form in any part of the mouth or throat.
-Most oral cancers begin in the tongue and in the floor of the mouth. 
-Anyone can get oral cancer, but the risk is higher if you are male, over age 40, 
use tobacco or alcohol or have a history of head or neck cancer. 
-The methods in use for oral cancer screening have been cumbersome and costly. 
-Dentists now have an easy to use and economical system for oral cancer 
screening and are calling this a "game changer".
   - "Oral ID" has an impressive record of evidence-based testing, is sought after 
because of its non invasive ease of usage, and its very affordable cost.
Sleep Apnea Screening
-Patients are realizing how a blockage of oxygen to the brain, caused by 
nocturnal apnoeic events, can influence systemic damage. 
-Sleep Apnea is connected to strokes, cardiac arrest, diabetes and dementia. 
-The public asks their dentists for help- most dentists are unprepared. 
-Less than 1% of practicing dentists are trained and qualified to screen and treat 
the over 40 million victims of Sleep Apnea.
-One of the next three patients that walk thru your doors is a Sleep Apnea victim. 
      -Are you prepared to help them? 
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Diabetes Mellitus 
The oral manifestations of diabetes include:  
-Periodontal Disease, Xerostomia, tenderness, pain and burning sensation 
of tongue, secondary enlargement of parotid glands with sialosis. 
-Increased caries prevalence in adults. 
-Increased risk of infection- reasons unknown, but macrophage metabolism 
altered with inhibition of phagocytosis. 
-Peripheral neuropathy and poor peripheral circulation, 
-Oral mucosal diseases including Candidal infections, lichen planus and 
recurrent aphthous stomatitis. 
-Delayed healing of wounds due to microangiopathy and ultilization of protein 
for energy may retard the repair of tissues. 
-Increased prevalence of dry sockets. 
-Immunological deficiency: -A high sugar medium decreases 
production of antibodies.
10-25-11Sugar COKE Blood pressure and other "vitals" 
Imagine administering a mandibular block, having your patient go into 
cardiac arrest, and realizing that no one in your office has taken that patient's 
blood pressure today.
 Enough said about that!

1-21-13 LOGO DENTAL PROS SHARINGAre you providing a Comprehensive Exam?

Laser diode-driven lab-on-a-chip detects periodontitis pathogens.

A new mobile diagnostic platform driven by a laser diode can identify the 11 most relevant periodontitis pathogens in less than 30 minutes rather than in four to six hours. Scientists at the Fraunhofer Institute for Cell Therapy and Immunology (IZI; Leipzig, Germany) have collaborated with two companies, BECIT GmbH (Wolfen Germany) and ERT-Optik (Ludwigshafen, Germany), to develop a lab-on-a-chip module called ParoChip. In the future, this will allow dentists, hygienists, and medical labs to prepare samples quickly and then analyze the bacteria. All steps in the process–the duplication of DNA sequences and their detection–take place directly on the platform, which consists of a disk-shaped microfluidic card that measures around six centimeters in diameter.
Dentists use sterile paper points to remove bacteria from the tooth. (Image courtesy of Fraunhofer IZI)
Dentists use sterile paper points to remove bacteria from the tooth. (Image courtesy of Fraunhofer IZI)

The analysis is conducted in a contactless and fully automated manner. Samples are taken using sterile, toothpick-shaped paper points, after which the bacteria are removed from the point and their isolated DNA injected into reaction chambers containing dried reagents. There are 11 such chambers on each card, each featuring the reagent for one of the 11 periodontal pathogens. The total number of bacteria is determined in an additional chamber via polymerase chain reaction (PCR), which allows millions of copies of even tiny numbers of pathogen DNA sequences to be made. In order to generate the extremely quick changes in temperature that are required for PCR, the disk-shaped plastic chip is attached to a metal heating block with three temperature zones and mechanically turned so it passes over these zones. This causes a fluorescent signal to be generated that is measured by a connected optical measuring device featuring a fluorescence probe, a photodetector, and a laser diode. The key benefit is that the signal makes it possible not only to quantify each type of bacterium and thus determine the severity of the inflammation, but also to establish the total number of all the bacteria combined. This enables doctors to fine-tune an antibiotic treatment accordingly.

“As the connected optical measuring system allows us to quantify bacteria, ParoChip is also suited to the identification of other bacterial causes of infection, such as food-borne pathogens or those that lead to sepsis,” says Dirk Kuhlmeier, a scientist at the IZI. “Using ParoChip does away with many of the manual steps that are a necessary part of current bacteria tests. The synthetic disks can be produced cheaply and disposed of after use in the same way as disposable gloves.”

Already available as a prototype, ParoChip is initially intended for use in clinical laboratories; however, it could also be used by dentists, and hygienists to carry out in-house analysis of patient samples in their own practice.