How I Transitioned to a Dental Sleep Medicine Practice

by Mayoor Patel, DDS, MS
After graduating dental school in 1994, I was ready to begin my career and to improve people’s oral health. Two years later, I had opened two successful dental practices and was a drilling and filling machine. I enjoyed seeing and helping my patients, but the challenge and excitement was diminishing and I knew I could do more for them. I was a young and curious dentist with a lot of questions. When I started seeing correlations between patients’ responses to my questions and headaches, pain, problems sleeping and serious health issues, I realized I needed to do something more, but it took me almost a year to figure out what.
In 1997, I heard Dr. Henry Gremillion and the late Dr. Parker Mahan discuss TMD treatment at the University of Florida. I still remember the excitement running through my head on that drive back from Gainesville. I finally had the answer and committed to treat patients with craniofacial pain and TMJ disorder. I knew it would be a process, but I also knew my patients well enough to understand just how many lives I could change.
I had two major questions:
How can I avoid the “trial by error” approach to helping the more challenging patient cases?
How do I get paid for the value of my services, without limiting the patients I can help?
I embarked on a journey to learn as much as I could, beginning with courses on pain and dental sleep medicine from Drs. Gelb, Okeson, Pertes, and Stack, to name a few and studied at annual meetings by the American Academy of Craniofacial Pain (AACP), American Academy of Orofacial Pain (AAOP) and the American Academy of Dental Sleep Medicine (AADSM).
Exhausting the resources of many gurus in the field, I had the clinical knowledge but lacked the internal systems to run a limited practice. Fortunately, at my first AACP annual meeting in mid-2002, I met Rose Nierman. Everything fell into place. A dedicated system for tracking craniofacial pain and sleep therapy was my missing piece. As soon as we implemented DentalWriter software for medical billing, and data capturing and obtained the support, the practice grew.
In late 2002, my team was on board and we were screening and treating our patients, but that wasn’t enough to make these services the primary focus of my practice. Other dentists weren’t referring because I performed dental procedures. We changed the name to reflect a craniofacial and sleep focus and stopped accepting new dentistry patients – a huge risk – but one we felt was necessary to achieve the goal.
We grew each year, and by 2007, after oral appliances were recognized by the AASM, dentistry patients represented less than 25% of my practice revenue. That was 8 years ago and a lot has changed to expedite this process, but it’s still a process that must be well thought out. It took ten years, but by 2012, we were 100% focused on pain and sleep.
Along with board credentials, communicating got us recognized, respected and referred to. Referrals from medical and dental practices increased the most from the letters we send to patients’ physicians and dentists following consultation, treatment and discharge.
Those sleepless nights, tossing and turning about limiting my practice to pain and sleep paid off. We see patients three days a week and enjoy the rewards of changing lives every minute. I often get asked, “Can I limit my practice?” My answer is, “Yes. If you believe you can, you will.” Set goals, commit to the process, find experts to educate, train and support you and your team and don’t be afraid to ask for help along the way.