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Today’s email insights:

• Dental Changes Curing Ménière's Disease

• Laser-aided Bone Growth During Expansion

• Leptin To The Nasal Breathing Rescue

• A Practice Hurdle No One Can Avoid

• Kids Playing Videos Games While Sleeping?

Today is a 5-minute read👇

Clinical Corner

🥼Use the clinical corner as your secret weapon to impress your colleagues and patients!

1/ Fresh Insights on Ménière's Disease: Your Dental Chair Matters! 🚨

Ménière's Disease (MD) diagnosis and treatment can be daunting. Now, a new study adds a fresh perspective. Short version? Your dental practice could be a game-changer.

🎯 Goal

This research examined whether adjusting bite force and timing (occlusal corrections) would affect MD symptoms. The results were unexpected.

🔬 Method

Eighty-six MD patients filled out questionnaires to evaluate pain and functional restrictions, using the PHQ-15 scale. They then underwent Disclusion Time Reduction (DTR) coronoplasty, a process that adjusts bite force and timing.

Their Disclusion Times (DT) and sEMG temporalis and masseter levels were measured before and after the DTR procedure.

🎲 Results

The DTR therapy led to significant improvements. MD symptoms - ear fullness, vertigo, and tinnitus - showed a marked decrease in intensity, duration, and frequency (p < 0.00001).

Post-therapy, patients' disclusion times and EMG values significantly improved (p < 0.0001). These improvements aligned with the reduction in symptoms at 1-month and 3-months post-DTR (p < 0.0001).

🚀 Takeaway

This study suggests MD could have an occlusal cause, particularly in long Disclusion Time. It reveals that DTR therapy can be effective, with all subjects reporting symptom reduction post-treatment.

As a dental sleep professional, this could be a game-changer. Consider DTR as a promising treatment option for your MD patients.

Remember: Better bites may lead to lesser MD symptoms. Let's chew on this!

2/ The Scoop on Low-Level Laser Therapy 💡

Let's talk about low-level laser therapy (LLLT) and its impact on bone growth in the midpalatal suture region during transverse maxillary expansion.

🎯 What You Need to Know:

Researchers examined whether LLLT speeds up bone growth in this area. It turns out, the answer isn't straightforward.

🔬 The Study:

The team did thorough reviews across seven key databases and three additional gray literature databases, using specific terms. They used RevMan® software for RoB summary adaptation and performed a meta-analysis. Heterogeneity (I2) and publication bias (Egger and Begg) tests, plus a sensitivity analysis was also done.

👀 Findings:

Five studies were included in the qualitative synthesis, and three made it to the meta-analysis stage. All were prospective randomized clinical trials. Bias risk was low, according to Egger (P = .1991) and Begg (P = .024) tests.

Despite high heterogeneity (I2 = 81%, P < .00001), there was no significant difference between the photobiomodulation (PBMT) group and the control group three months post-op (P = .850). No significant difference was noted among subgroups evaluated after this 3-month period either (P = 0.490).

🚀 Takeaways:

Photobiomodulation as an additional therapy in transverse maxillary expansion has limited benefits according to this study. It aids in bone healing in the midpalatal suture region, but only after three months. More research will be needed to determine optimal clinical protocols.

Considering LLLT for patients? Check the time and patient expectations first.

3/ Localizing Effects of Leptin on Upper Airway and Breathing During Sleep

This can be a complex one to follow. Thank you to our readers for the suggestion!

🎯 What You Need to Know:

Obesity often tags along with complications like obesity hypoventilation and obstructive sleep apnea. These conditions spring from defects in the neural control of the respiratory pump and upper airway structures. Did you know leptin-deficient obese mice exhibit impaired ventilatory control and inspiratory flow limitation during sleep? Today we'll look into where, in the central nervous system (CNS), leptin is pulling those strings.

🔬 The Study:

Researchers divided obese mice into two groups. One received leptin (10 μg/2 μL) in the lateral ventricle (n = 14) while the other group got theirs in the fourth ventricle (n = 11). After leptin administration, the team analyzed polysomnographic recordings to observe effects on respiratory and upper airway functions. CNS loci were identified using two markers: leptin-induced signal transducer and activator of transcription 3 (STAT3) phosphorylation, and projections of respiratory and upper airway motoneurons via a retrograde transsynaptic tracer.

👀 Findings:

Regardless of the route of leptin administration, the mice's minute ventilation during non-flow-limited breathing in sleep improved. Leptin administration via the lateral ventricle, but not the fourth, also lessened inspiratory flow limitation and obstructive hypopneas. It's also noteworthy that leptin had an effect in the dorsomedial hypothalamus, where upper airway motoneurons were synaptically connected.

🚀 Takeaways:

Leptin seems to wield a dual-power wand. It relieves upper airway obstruction in sleep apnea by tweaking the forebrain, possibly at the dorsomedial hypothalamus, while it also upregulates ventilatory control through hindbrain action sites, possibly in the nucleus of the solitary tract. This research presents a compelling case for further exploration of leptin signaling in the hypothalamus as a potential therapeutic target in sleep apnea treatment.

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Business of Sleep

📈Better businesses = more lives saved!

The Biggest Hurdle in Dental Sleep Practice? It's All About Communication

Ever wondered what the Everest of dental sleep practice is?

Bet you're thinking it's getting everyone on board with the program, or maybe it's the jaw-dropping number of times patients say "no" to treatment when their wellbeing is at stake. And let's not forget that dental and medical fields could really use a group therapy session for some much-needed collaboration.

Two years ago, we might have agreed. But after spending nearly two decades in sleep medicine, we've found a villain causing more chaos in dental sleep practices than any other: communication.

Yes, you read that right, communication. And no, we aren't just talking about our innate human struggle to effectively get our point across.

Time to Face the Facts:

Salesforce-backed research showed a whopping 70% of employees believe poor communication hampers a company's performance. Another 99.1% prefer a workplace where people are upfront and efficient in discussing issues. Not to mention, 86% blamed ineffective communication for workplace failures.

But let's flip the script - improve communication and your dental sleep practice will start to transform.

Teamwork Makes the Dream Work:

Your dental team is key, and your practice's efficiency depends on them understanding you.

So, where to start? Identify the roles in your dental practice and how they connect to those needed in a dental sleep practice. A VIP data metric survey found that a clear understanding of these roles led to a 30% rise in the conversion from screening to diagnostic testing.

Once roles are clarified, you need the right people in place, with team buy-in crucial for a well-oiled machine.

Get to know your team here with this quiz!

Accountability and Goals:

Next, hold everyone accountable and set measurable goals. And remember, the goal isn't just the number of patients you treat or treatment plans accepted. It's making a positive impact in patients' lives – don't get caught up in the dollar signs.

Donald Miller, a marketing guru, says, "When you confuse, you lose". So keep it SMART - Simple, Measurable, Attainable, Realistic, Time-based.

Workflow, Workflow, Workflow:

Ever come back from an inspirational weekend course only to have everything fall apart in your own practice? The reality is every practice is unique, with differing numbers of practitioners, team sizes, and patient volumes, amongst others.

A dental sleep practice, a living, breathing entity, relies entirely on your team. It involves simple yet complex steps like screening, scheduling, diagnostics, case presentation, and billing protocols. Each one a potential stumbling block.

The solution? Recognize these obstacles, create an action plan, and effectively communicate it to your team. As Michael Hyatt states in his book No-Fail Communication, "writing your intention produces clarity, increases trust, and enables execution."

Better communication = improved processes. So, make the leap. Your team (and your bottom line) will thank you for it.

🔥 Ready to elevate your Dental Sleep Medicine practice? Join us at the 2024 North American Dental Sleep Medicine Symposium. Unlike any other event, this gathering isn't about academia or impractical research. No commercials. No hidden agendas. It's about learning practical aspects of dental sleep medicine from top-notch professionals who are already leading the game.

Imagine: Your team, brimming with newfound insights on time management, case presentation, medical billing, and clinical techniques. Your practice, ready to reach new heights. Earn 11 hours of CE while you're at it.

Use our exclusive discount code 'MORETHANTEETH' to get a whopping 40% off on your tickets. Don't miss out on this incredible opportunity! See you there.

Something Sweet

🍭Stuff so sweet you might get a cavity..

The first video game that rewards - catching some zzz’s

Miscellaneous

😅P.S. … I forgot something

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