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Monday, October 17, 2016

Successful Sleep Dentistry Article #3 - Five Steps For A Successful Relationship With A Sleep Physician

For a successful sleep practice, it is vital for dentists to have strong professional relationships with one or more sleep physicians. Building this relationship requires determination, patience and  knowledge of the reasons why oral appliance therapy (OAT) can be an effective treatment for obstructive sleep apnea (OSA).

This article will provide five steps that dentists can follow to build a relationship with sleep physicians for a more successful dental sleep practice through collaborative patient care.

 

1. Clear up sleep physicians’ concerns about Oral Appliance Therapy

Sleep physicians are experts in sleep medicine but they may not be familiar with oral appliances for OSA. Therefore it falls on the dentist to educate sleep physicians on OAT.

Below are some common concerns and questions from sleep physicians :

- Is OAT really effective for OSA?
- What are compliance rates for OAT and how does this compare to CPAP?
- Expected side effects?

Dentists can utilize the list of educational resources below and equip themselves to clear concerns sleep physicians may have. When educating sleep physicians, dentists should present themselves as knowledgeable about OAT to avoid sounding condescending.


List of Educational Resources

Dentists can also show their credentials to demonstrate technical skills and knowledge of dental sleep medicine, including course attendances or belongings to associations.

 

2. Inform physicians about medical insurance for OSA treatment

OAT can be covered by medical insurance, not by dental insurance.

Since OSA is a medical condition, the treating physician must make the diagnosis and prescribe oral appliance therapy before the dentist can initiate therapy.[1] Dentists need to be prepared to discuss if they work with medical insurance or private pay.

When doing so, it is best for the dentist to be honest, clear and transparent with the sleep physician on whether their dental practice accepts medical insurance or is private pay. If the dental practice is private pay, the dentist should explain to the physician why they should still refer patients to their practice. These conversations offer dentists the opportunity to discuss the quality of care they deliver patients through a custom fitting oral appliance.

 

3. Update the physician on the patient’s treatment progress regularly

After OAT is prescribed by the sleep physician, dentists should effectively communicate the progress of a patient’s treatment with the physician. Clear and regular communication is the most important item of concern for the physician to ensure the patient is receiving proper treatment.

Dentists can send the sleep physician two letters after the referral, including the following:

Physician Letter 1:Thank you letter for the referral
- To inform the physician that the patient was seen for a consultation and is proceeding with OAT

Physician Letter 2:Insertion report
- To inform the physician that the patient was seen for the insertion appointment and will be sent back to their office for follow-up

 

4. Send patients back to the physician for follow-up sleep tests

Once the patient has been using OAT and experienced a relief in symptoms, the dentist should refer them back to the sleep physician for a follow-up sleep test. This will help build a strong bilateral relationship between the sleep physician and dentist.

Normally it takes a minimum of six to eight weeks, sometimes a few weeks longer, for the patient to experience relief of their symptoms including elimination of snoring, reduced daytime sleepiness and apneas, or other improvements of the patients’ initial complaints. 

Dentist can send a letter to the sleep physician to inform them that the patient is ready for a follow-up sleep test and asking them to contact to the patient:

Physician Letter 3:Case report
- To inform the physician that the patient was successfully titrated and is referred back to their office for follow-up and possible sleep study.

 

5. Share patients' experiences and feedback with OAT

As patients successfully treat their sleep apnea with OAT, they often experience an impact to their lives and partner relationships. Communicate the patients feedback from treatment with the sleep physician. This will clear the physician’s concerns and further validate OAT as an effective treatment.

In addition, keep the physician updated with the latest information regarding the products FDA-clearance, efficacy, compliance, etc. to validate the use of oral appliance further.

 

The Result: Sleep Dentists become trusted partners of sleep physicians 

By following these five key steps, dentists will have positioned themselves as a partner for the sleep physician. Sleep physicians should think of the dentist as an effective solution to treating those patients that are CPAP noncompliant, not that they are simply looking for more referrals. 

To maintain a successful relationship, dentists must keep lines of communication open with sleep physicians and continue to exhibit knowledge of protocol of role and responsibility between the physician and dentist.

To continue a successful sleep dentistry practice, dentists can conduct outreach to multiple sleep physicians in the area of their practice. Every sleep lab has a medical director, dentists can contact the sleep lab for the name of the sleep physician, often times they are an ENT or pulmonologists. Dentists can also hire a part time representative to represent the dentist as they visit physicians’ offices.

Dentists can also take a direct and proactive approach in treating a patient for OSA. For example, if a dentist identifies potential OSA symptoms while screening for sleep apnea, they can call the patients’ physician directly to open the door and begin the relationship, creating an open dialogue. The dentist needs to present themselves as knowledgeable, and caring about the patient’s health.

Below is advice from Dr. Barry Chase, an expert sleep dentist with over 10 years’ experience in the field. Dr. Chase gives his insight for starting a conversation with sleep physicians about oral appliance. Use his experience and start applying these lessons today!

“When having initial conversations with physicians about oral appliance therapy, it is important for dentists to have confidence and not see it as an intimidating process. Dentists should recognize that they are offering physicians a solution, and are a key component in the collaborative care model.   

When meeting with physicians, the topic of oral appliance side effects will likely come up. It is important for dentists to explain how using a custom fitting appliance mitigates side effects such as TMJ, tooth and jaw pain and change in bite.

It is helpful if dentists bring oral appliance product samples and demonstration models to show physicians during these meetings. This allows physicians to see firsthand the size, weight, wear and durability of the custom fitting appliance dentists will be using to treat OSA patients.

Another option for dentists is to hold a lunch and learn for physicians to see live demonstrations of the product and become educated on oral appliance therapy. This allows physicians to familiarize themselves with the product and understand the benefits of oral appliance therapy.”

 

Your Next Step

To support your successful sleep practice, Whole You provides a series of quality oral appliances together with practice, marketing and educational resources at https://www.wholeyou.com/patient-care/sleep-apnea-solutions.  If you are interested in learning more, you can either call Whole You's toll free number at 844-548-3385 or submit contact form here.

 

Further Reading

Successful Sleep Dentistry Article Series

#1 :Identifying Sleep Apnea in Your Dental Patient

#2 :The Do’s & Don'ts During Your Patients’ First Sleep Apnea Consultation

#4 :Check Points to Select the Oral Appliance That’s Right for Your Patient

#5 :A Sleep Dentist’s Guide to Begin Medical Insurance Billing

 

Other Sleep Apnea related articles

 


[1]http://www.jdsm.org/ViewArticle.aspx?pid=30229