Dr. Jason Hui says that after incorporating myTAP® into his practice, he can start treatment on the first visit and have patients self-adjust for several weeks for better therapeutic positioning for their custom appliance. Read more about what it can do in this article.
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by Jason Hui, DDS, MAGD, D.ABDSM
The myTAP appliance has significantly impacted my dental sleep medicine practice. When properly fitted, I view this appliance as a “semi-custom” alternative that performs just as effectively as a fully custom oral appliance. In fact, I frequently designate myTAP as the definitive appliance for some of my severe obstructive sleep apnea (OSA) patients, but I’ll save that story for another occasion.
Before integrating myTAP, our treatment workflow resembled that of most dentists: assess the patient’s need for treatment, take impressions and a protrusive bite record, await medical insurance approval, await for the dental laboratory to fabricate the oral appliance, deliver the appliance to the patient, and conduct a few office visits for adjustments and follow-ups to evaluate the oral appliance effectiveness and patient’s compliance. When factoring additional delays and patient scheduling conflicts, it wasn’t uncommon for patients to receive their oral appliance 2-3 months after their initial visit with me.
This treatment delay consistently posed issues. For instance, consider a pilot, truck driver, or school bus operator struggling to stay alert due to excessive daytime sleepiness during work hours because of poor sleep quality and untreated obstructive sleep apnea. Imagine spouses constantly irritated at each other due to poor sleep from epically loud snoring; these couples usually are already sleeping in separate bedrooms, which negatively affects their relationship and intimacy. Many of my patients also want to get treatment sooner due to an upcoming trip with friends or family where it doesn’t make sense financially to get separate rooms. Lots of people have delayed treatment for many years until the symptoms were no longer tolerable or could be dismissed as somehow “normal.” Frequently, I will see a new patient struggling with a disease or symptom, and testing/treating for sleep apnea was the last consideration. These patients have seen several doctors, managing certain conditions unsuccessfully such as drug resistant hypertension, cardiac arrhythmias, chronic fatigue, depression, anxiety, insomnia, etc. Wouldn’t you prefer to address all their needs sooner? I certainly would, and myTAP enables me to do just that. myTAP often also serves as a diagnostic appliance, to see if it helps these patients, before moving forward. Many of us treating sleep disordered breathing with oral appliances have seen the improvement in quality of life for our patients. Treating their problems as soon as possible is often a priority for the patients I see. I have never encountered a patient that struggled with a problem who was excited to wait for treatment.
Most dentists I talk to about myTAP usually ask me how it is billed. I bill it to the patient. The myTAP can be billed under CPT code E0485 which is for all prefabricated oral appliances used for the treatment of OSA. However, if E0485 is billed, the insurance carrier usually will not cover the custom fabricated oral appliance HCPCS code E0486. My treatment coordinator presents financials to the patient as a total treatment fee. The amount includes the myTAP and the estimated out of pocket cost for the custom oral appliance, after insurance support.
Since incorporating myTAP into my dental practice, for diagnosed patients I can begin treatment at the initial visit. Upon the patient’s return for the second visit for fitting the custom oral appliance, we can evaluate the efficacy and compliance of oral appliance therapy for their OSA, given that the patient has worn a myTAP for several weeks. Typically, the patient has been self-adjusting the myTAP and has determined the therapeutic position. We replicate this position in the custom oral appliance fabricated by the lab. Subsequently, we return the patient to their sleep physician for a post-treatment sleep apnea test to verify the appliance’s effectiveness. The initial myTAP now becomes a backup oral appliance should anything happen to the custom-made one. Using myTAP at the initial visit translates to fewer follow-up visits, resulting in cost savings for patients in copays and chair time overhead for my practice. Moreover, fewer follow-up visits open more appointment times on my schedule for productive appointments and expedite new patient intake.
Most cases, the treatment process involves just those two visits, with treatment beginning from the patient’s initial encounter. Patients and spouses are happy, and referring physicians are typically SHOCKED at how quickly the sleep apnea is resolved.
I strongly encourage all dental sleep medicine practitioners to incorporate myTAP appliances into their workflow. The inclusion of myTAP has brought the following benefits to my practice:
- Enhanced patient care and satisfac
- Reduced number of office visits to complete treatment, leading to quicker patient referrals back to referring
- Increased word-of-mouth referrals.
- Provision of a backup oral appliance once the patient obtains the custom oral appliance.
- A more affordable treatment option compared to a custom oral appliance. This is particularly beneficial for patients who lack insurance coverage or those wanting to assess its effectiveness prior to committing to the custom oral appliance.
The best way to get started with myTAP is to call Airway Management, Inc. Their in-house lab, Airway Labs, provides every new dentist with a complimentary myTAP when sending in the first case. Learn how to create an effective myTAP for yourself, your family, or your team members, and witness how myTAP can enhance the workflow in your dental sleep medicine practice!