The Future of Sleep Medicine

by Deepit Anand, Brett Brocki, & Patrick Kircher

For too long, Dental Sleep Medicine (DSM) has been a fragmented patchwork of solutions; difficult to navigate and stitch together. And, because obstructive sleep apnea (OSA) is a medical condition that can be treated by a dentist, a group of interdisciplinary providers must work in conjunction with one another. Unfortunately, lack of training, disjointed electronic medical record systems, and fractured insurance payer systems have made it confusing and difficult for patients to access affordable, life-saving treatment.

The story of Nexus Dental Systems is about a group of innovative companies joining forces to save more lives. Partnerships were formed with a vision of a comprehensive solution that simplified the delivery of life-saving treatment to millions of patients with OSA. Together we are reshaping the future of dental sleep medicine.

These solutions include credentialing, whole team training, patient outreach and education, and an innovative medical billing solution that is integrated into the whole process.

Our Vision

Over the years we have seen every passing fad, every miracle solution, and heard every excuse in Dental Sleep Medicine. We have seen many dentists give up on sleep medicine because they could not overcome several common hurdles, the most frequent complaint being problems with medical insurance billing. While medical billing is a huge obstacle, it does not exist in a vacuum. The truth is that many of these issues are interconnected. To build a sustainable solution for the future of sleep medicine, we need to construct a true ecosystem that is adaptive and resilient to the constant evolution of the industry.

Nexus Dental Systems was created to unite several key solutions for medically necessary dental treatments into one fully integrated system. These solutions include credentialing (ACSDD), whole team training (N3Sleep), patient outreach and education (DreamSleep, DentalPlay, Dentool App), and an innovative medical billing solution that is integrated into the whole process. We united these capabilities to address the main challenges dentists face when treating sleep.

Recognized Education

There are many options out there for education in Dental Sleep Medicine. From weekend events, online courses, seminars, and webinars to multi-week programs and mini-residencies, there are a lot of options for DSM education. For most of these programs, passing is determined by the completion of a required number of hours and a score on an exam. With one exception that we are aware of, none require that a board review dentist’s cases. Dentists are becoming “Diplomates’’ without ever having treated a case and this is harming the entire field of dental sleep medicine.

Physicians go through intensive training, and even after they have graduated, they must complete a residency, where all their cases are reviewed by a senior physician with years of experience, because results in the real world are different from results on an exam. Physicians want to refer to someone they trust with the life and care of their patient. A practitioner who will provide medically appropriate treatment, verified with efficacy testing, who has a proven record of successfully treating OSA with oral appliance therapy. Therefore, board certification without case review is harming the reputation of DSM. In fact, we believe this so much that we found the only group that requires case review in DSM: The Academy of Clinical Sleep Disorder Disciplines. The ACSDD is a not-for-profit organization that offers a rigorous 13 CE online course program, which qualifies a dentist to submit cases for board review. A multidisciplinary board reviews twenty cases, including five in detailed narratives to evaluate the appropriateness, quality, and efficacy of treatment. There is no other program like it. No other program that puts patient care first. No other program proves a dentist knows what they are doing and didn’t just get a certificate for sitting through a weekend course.

Team Training

Teams need help for many reasons, but the common issues we have seen are poor understanding of the importance of dental sleep medicine, resistance to change, and lack of a clearly defined protocol supported by the dentist. The truth is that most dentists are extremely busy. No matter how many weekend courses, seminars, and online courses you have taken, it is unrealistic to think you can translate that into an actionable protocol for your office, and then train and mentor your whole team on it while maintaining a full dental patient load. There are too many processes, systems and details that need to be ironed out, and the team is already busy with their existing workload. There is no quick fix.

So, what can be done? The solution is whole team training that includes custom protocol development and ongoing coaching. Someone who knows the systems and can create step-by-step guides for each team member based on the reality in your practice. This is exactly what N3Sleep was founded to do: fix these problems so dentists can help people and save lives. The N3Sleep team has experience with all the software, systems, and tools you may have already bought. They can identify who on your team should be doing each step and build a fool-proof system to make sure nothing falls through the cracks. Our system is not a separate process added onto your existing workload, it is integrated directly into current protocols. When we are onsite, we want live patients in for their scheduled appointments so we can directly integrate our process into your protocol. This reduces resistance from the team and fosters a sustainable process moving forward.

Patient Outreach and Education

To succeed in DSM, dentists need to reach the patients who need help. Your first sleep patients will come from your existing dental patients. They are already in your office; they just need screening and a referral for testing. Since 2016, DreamSleep has been creating informative and effective patient outreach materials for the dental office, social media channels and innovative screening events. DentalPlay (Dentoolapp.com) is the perfect complement: a vast library of informative and medically accurate 3D animations of sleep, oral surgery, cosmetic, implant, orthodontic and periodontic procedures. These are available for streaming to a tablet chairside or added to your office video system and customizable with your logo. On-demand access to these videos make your team be more effective when explaining procedures to patients.

Medical Billing

It’s the elephant in the room. It is the number one reason dentists give up. Even in the best-case scenario, it takes forever to get paid and is wildly inconsistent. Insurance companies are not in the business of paying out money. Solving this problem has been the biggest challenge we have faced. Through several acquisitions we’ve made, Nexus Dental Systems can offer a full suite of medical billing capabilities that will bring consistency to reimbursement. Whether In-Network or Out-Of-Network, this billing solution provides every one of our clients with a customized protocol and a clear pathway to optimal, consistent reimbursement. Our system includes comprehensive training for your team, proprietary and integrated billing software, and access to our billing network.

Why We Do This

These four tenets are the foundation of our fully integrated Sleep Medicine ecosystem. Over the years we have built this program to address the biggest challenges dentists face. Our goal has always been to create a sustainable and resilient system able to adapt to the constant drumbeat of change in this industry. An estimated 67 million Americans, about 1 in 5, have AHI >5, and they need our help. Their health is suffering, and their condition will get worse without treatment. In 2017 the ADA tasked every dentist with screening for Obstructive Sleep Apnea and providing treatment when prescribed by a physician. We are here to help you deliver on that mission.

Deepit Anand, Brett Brocki, and Patrick Kircher are the founders of Nexus Dental Systems. To learn more about obstructive sleep apnea (OSA) and what we are building and each of our brands, visit our website nexusdentalsystems.com.