Opportunity knocks: CPAP failures and sleep solutions

Jan. 1, 2011
New year. New challenges. New opportunities for practice growth and exploration. Time to talk seriously about what is considered the new frontier in dentistry.

Rob Veis, DDS

For more on this topic, go to www.dentaleconomics.com and search using the following key words: CPAP failures, sleep solutions, OPAP, medical/dental connection, Dr. Rob Veis.

New year. New challenges. New opportunities for practice growth and exploration. Time to talk seriously about what is considered the new frontier in dentistry. Now more than ever, dental practitioners have a significant role in the successful recognition and treatment of snoring and mild-to-moderate obstructive sleep apnea (OSA).

Statistics tell us that more than 12 million Americans suffer from OSA, and that 50% to 80% of sleep patients are rejecting CPAP – the accepted gold standard of care in the treatment of sleep disorders.

What’s more, the American Academy of Sleep Medicine has affirmed that oral appliances, and dentists, can often be the first line of OSA defense. Opportunity knocks. So why are only a small percentage of dentists choosing to integrate sleep therapy into their practice offerings?

The problem

  • The perceived learning curve for use of dental sleep appliances appears too daunting, time-consuming, or costly (or all three).
  • Snoring and sleep apnea are still perceived by many dentists and physicians to be a "medical" problem. Consequently, the threat of a "turf war" rears its head.
  • Because OSA is still billed through insurance as a medical problem, dentists assume they lack the orientation or information necessary to ensure proper billing and administration for sleep therapy appliances.

The new OPAP

We have the means to provide comfortable, compatible, effective oral delivery of CPAP via the newest, dramatically improved version of an existing appliance technology.

The custom-fitted OPAP® (Oral Pressure Appliance) attaches directly to a CPAP/BiPAP unit. It fits into the mouth and is held in place by the upper and lower teeth. No face mask. No headgear. No straps. Flow, temperature, and humidity can be titrated and controlled.

Now, rather than being faced with having to provide the patient with a costly $300 appliance, which may not actually work in the long run, the dentist can manufacture an inexpensive boil-and-bite OPAP for use with the existing CPAP as a true test appliance.

Next, the patient takes it to the sleep lab where a split test (one-half without appliance, one-half with) is performed, and the lab can titrate flow and comfort levels.

The patient then goes home and uses the appliance. If it works, a permanent appliance can be made. The dentist takes alginate impressions, makes models, and uses the test appliance to determine ideal bite relationship.

The medical/dental connection

The new OPAP makes it easy to integrate with the medical field – no conflict, no "turf" battles – because CPAP has already been prescribed by a physician. The physician is more likely to write a prescription for the orthotic with the dentist as provider. The result? A mutually cooperative effort for the patient’s benefit.

For those patients who come directly to you, you can provide an inexpensive appliance that allows them to go to a sleep physician, get tested, and do a split study.

The win-win transformation

Patients do not want to buy a laboratory-made appliance unless they know it is going to work. The boil-and-bite OPAP appliance prescreens and pretests for CPAP appropriateness and acceptance. The appliance is set to ensure compatibility and comfort.

If all indications are that a patient has truly exhausted CPAP as a viable treatment, the dentist can provide the patient with clear alternatives – avenues of appliance therapy, surgery, or both.

To sum up, the patient has a sleep-treatment solution that is just that. Dollars spent on the permanent, treatment-sure, cost-effective appliance can be justified.

The physician has been effectively included in the mix, either as a prescriptive source or sleep test referral. Medical insurance is paying for appliances that are provided by dentists at a rate that allows you to successfully integrate this modality into your practice.

You have the patient, the platform, and the profit margin. You are the go-to resource who can easily provide patients with answers to their sleep problems. As a result, your practice will benefit and grow. That is a win-win situation and an opportunity worth pursuing.

Note: For a more detailed look at the new OPAP and other alternatives in sleep appliance therapy, visit www.OPAPHealthcare.com.

Dr. Rob Veis is CEO of the Appliance Therapy Group® (ATG). Reach him through www.appliancetherapy.com or by calling (800) 423-3270.

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