Next Steps in Navigating the World of Dental Sleep Medicine
by Dr. Erin E. Elliott
Whoa! This is a life changing and career changing paradigm shift in my indoctrination. Some of my favorite quotes from the leaders in Dental Sleep Medicine include: “Open casket? Or open bite?” and “Teeth shift, get over it.” I say, “Oxygen trumps bite every time.” When I realized that not only could I help my patients smile confidently by providing life changing dentistry but that I could also help save their life by providing an oral appliance, I immediately pursued learning more about Dental Sleep Medicine. Besides I don’t know anyone who loves to sleep more than me.
Is two days really enough? Yes and no. It is enough to learn the basics of sleep medicine, the medical part. It is enough to learn dental signs and symptoms. It is enough to learn which appliance to use in which situation. Should you use just one appliance? No! So make sure you learn from a course that teaches more than just the appliance that is sponsoring the course. And 2 days is enough to learn the basics of medical billing. But 2 days is not enough to learn about the changing landscape of DSM and the in-depth medical side. There are 3 and 4 day intro courses as well provided by such groups as Pankey, Dawson and Spear, the leaders in teaching the occlusion that was my comfort zone. LVI has a great series on DSM as they believe that airway is king when treating restorative cases.
What I did after my first 2 day course was come back to the office, try to share the excitement with my team, and start treating family and friends. I found the most important lesson during that time was learning what I didn’t know and pursuing more education.
There are mini-residencies available at both Tufts and UCLA. The American Academy of Dental Sleep Medicine has a three-day conference every year tied in with the medical branch of the American Academy of Sleep Medicine. They also have courses available throughout the year. The American Sleep and Breathing Academy – Dental Division has an annual conference in Scottsdale that is multi-disciplinary. I think these conferences are a great way to learn from the medical side and learn the dental side in a very unbiased fashion. Learning to work side by side with sleep physicians and seeing how to navigate the medical world is imperative to treating sleep apnea in your practice. I like to say, “It is time to put the handpiece down and put the stethoscope on.” We, as dentists, are providing a dental solution to a medical problem. There is no class available teaching you how to interact with your medical community but it can begin as a simple lunch-n-learn or an observation at a sleep lab. My entire goal is to figure out the best referral pathway for my patient. If I have a patient with signs and symptoms of sleep apnea I don’t want an uphill climb to consult, test, diagnosis, treat, and confirm effectiveness. What is the best way for my typical patient to get help? To find out, I hit the pavement. I talked to any MD and sleep physician I could, to let them know the facts and the motivation behind my ‘madness.’
There are various other academies that have advanced learning tracks in treating pain and TMJ patients such as the AACP (American Academy of Craniofacial Pain) and the American Academy of Orofacial Pain. Great teachers like Drs. Jeffery Rouse, Steven Olmos and Dr. William Hang, who is an orthodontist, also have courses for basic and advanced learning.
I get notifications everyday for webinars and I am more than happy to NOT mark them as SPAM. These have been great learning tools for me to learn from very wise dentists and MD’s in the comfort of my home; Post Falls, Idaho, isn’t, shall we say, a metropolis that these speakers come to very often.
I am a member of several forums. The Wasted Day and Sleepless Nights, Dental Nexus and Sleep Better Northwest forums have made me a better sleep apnea dentist. This is where I think the real-world, case by case learning occurs. I feel blessed to be a part of a community that provides a continuous opportunity to learn and to be better clinicians and to navigate the ever-changing landscape of DSM.
The most difficult part of learning anything is incorporating it into the practice. All the head knowledge in the world will not help you if you aren’t treating cases. The best advice I can give you is to implement systems and protocols into your practice by training every single member of your team. I’ve made many mistakes over the 6 years I’ve been doing this and mistake #1 was not having everybody from front to back helping in the screening, treating and billing. The chain is only as strong as its weakest link. There are sleep dentists and other types of trainers who will come to your office to train your team. One resource I’ve just learned about is OSA University – they have online training for teams, so you don’t even have to go on an expensive trip to get your people up to speed.
Let me leave you with this… get trained and get trained now. Continue to learn so that you can have an impact not only with your patients but your team and your community. We are saving lives! When you actually put the training to use each and every day is when you have the most impact. At a recent course I taught, I had each of the 30 team members focus their energy to put out a candle lit in the middle of the circle. We sat there uncomfortably, waiting for their positive thoughts to do something, for a full minute before I finally got up and blew the candle out. The moral of the story? All of the education and positive thoughts in the world will do NOTHING if you don’t get off of your derrière and take action!
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