by Glennine Varga, AAS, RDA, CTA
The good news is sleep disordered breathing is starting to become more of a focus in our profession. The bad news is…well, there is no bad news. The increase in awareness may create a competitive environment with patients and your referral sources, but competition is good. Dental teams have expressed frustration that patients want to see in-network providers or only do what the insurance allows. How do we work with these types of patients and what’s the best thing to say? Now is the time to ask: Is there anything else we can do to increase the value of our services in an up and coming competitive market?
Dental Sleep Medicine can be a wide range of various services including combination therapy with Positive Airway Pressure (PAP) or surgical intervention. No matter the options offered to patients, it’s important that everyone delivers the same message. In the spirit of team – call a team meeting and determine what information will be provided and if there are any other therapies/remedies that may help your patients’ therapy succeed. Make sure to get properly trained and determine what communication will be said about each offering. Remember, if your patients are successful with their therapy, you will be part of that success and that is something invaluable. Establish a way to communicate with patients, preferably in an interactive style. Invite them to share complaints and concerns and offer ways to address them. Be clear with expectations regarding finances and insurance. Here are the most common adjunctive therapies and communication pointers for patients.
Sleep hygiene awareness is one of the most important added value services you can provide. Communication should start with your first introduction to the patient online or over the phone. Before patients pick up the phone to call you regarding your dental sleep therapy services they must first know you provide them. Educate patients on your website about signs and symptoms; give them interactive questionnaires and videos to watch. Once you have them on the phone, make sure you know how to schedule a sleep specific patient or introduce sleep within your general dental new patient comprehensive exam. Learn how to help them connect the dots between medical, family and social history and sleep related breathing disorders. Guide them to discover proper sleep breathing is essential to overall health and wellness. If possible give your patients resources like apps, articles, videos or give them a list of your favorite sleep books. Patients will remember you when you take the time to educate them on their own sleep and give them pointers that can make a huge difference.
Nasal guidance is my favorite adjunctive therapy! Help your patients breathe through their noses. We have two ways to breathe. Our oral appliances are designed to reposition the mandible to hold the tongue and soft tissue out of the way. However, nasal airway is paramount and your upper airway resistance syndrome (UARS) patients will love you for guiding them toward optimal nasal support. My favorite regime is Max Air Nose Cones and a humidifier or an essential oil diffuser. Some patients may need a little more help like lip tape or chip straps. When communicating with patients, promote how comforting the air will be flowing through the nose and how relaxing it is to just let go and fall asleep knowing the airway will be supported. Learn how to use the products you are promoting and if possible try out the products yourself. The best way to explain something is to experience it firsthand. Everyone on the team should know your referral preferences, providers and products, and have your referral information readily available. Patients will pay closest attention to the person they’ve connected with the best in the office; any referrals should come from the ‘most trusted’ person in the office.
Pediatric guided growth of the maxilla and mandible is way to intervene with a non-optimal airway. Communication surrounding this type of therapy should be focused on developing better sleep and breathing patterns. Children with growth deficiencies may need extra guidance to achieve symmetry and balance, which will also provide more room for all the teeth and more sagittal space which is very favorable for the airway. In all communication it’s important never to promise any outcomes. We can be supportive and positive with our comments as we help our patients reach maximum medical improvement (MMI). It’s fun to celebrate your patient’s progress with enthusiasm and genuine interest.
Ancillary sleep products to improve the quality of your patients’ sleep can be a great way to add value to your services. White noise machines, blue screen blockers, sleep masks, cooling mattress pads and fans are items you can carry in your practice for patients to purchase or you can provide an item list they can purchase online. You can educate your patients about sleep hygiene let them know research shows blocking the blue light from electronics and sleeping cool improves sleep. Having products patients can try that same night is exciting. Don’t forget positional therapy products like pillows, apps or items to use to keep your patients off their backs.
Supplements and sleep aids may be a focus in your practice. Create fun ways for your patients to participate with compliance. You can give them printed materials, charts or calendars and remember: the more natural the supplement, the better. Melatonin is a natural hormone that helps to relegate the sleep and wake cycle. Magnesium is one of the most common minerals on earth and can aid patients with insomnia. It is essential for human health and can help the body and brain relax. By quieting the nervous system, magnesium can help prepare the body and mind for sleep. Calcium for relaxation as it helps the cells in the brain to use tryptophan to create melatonin. Research shows it works best to take both calcium and magnesium together. Theanine is an amino acid that is found in tea leaves, preferably black tea, a lower-caffeine alternative to coffee. It can also be taken in supplement form and helps with relaxation, focus and sleep. Essential herbs or oils such as bergamot, lavender, sandalwood, frankincense and mandarin are all great and when combined can be very useful sleep – inducing blend. Passion flower tablets or liquid extract have proven benefits improving sleep quality and effective treatment for insomnia. The Encyclopedia of Natural Healing for Children and Infants is considered by many an authoritative reference on natural pediatric medicine. Invite a local nutritionist or natural medicine practitioner to a team meeting to learn more.
Patients will pay closest attention to the person they’ve connected with the best in the office – their ’most trusted’ person.
Think outside your walls reach out to local mattress companies, chiropractors, naturopathic and holistic communities see if you can co-sponsor each other by offering patients extra cost savings on new mattresses, services or products. Maybe you can offer a fun sleep awareness event to showcase products and services. Dental sleep medicine is patient specific – let your patients tell their stories and look for ways to help them resolve complaints. The more remedies you know about the better your chances of success.
Editor’s Note: This Sleep Team Column will be dedicated to the team and provide practical tips and resourceful information. Let us know your specific issues by email to: SteveC@MedMarkMedia.com, while we can’t respond to every individual. Your feedback will help us create the most useful Sleep Team Column we can!