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Good morning. Welcome to your favourite Monday morning ritual. You have to admit, it beats doing the laundry, right?

You’re TikTok famous: Yes, dental pros, TikTok is becoming more than just catchy dances and awkward lip syncs. And it turns out, dental pros are quite popular on the feed. New research says that dentists are the platform's fifth most popular profession, just after chefs and before pilots, raking in 32.8 billion views since the app’s launch. Dental Hygienists also registered about 3.4 billion views. Ready for your close-up?

In today's edition:

• Impact of Delayed School Start Times

• Environmental Determinants of Sleep

• OSA and Bed Partners' Sleep Quality

• Coinsurance vs. Copay in Dental Billing

5-minute read today👇

Clinical Corner

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1/ Impact of Delayed School Start Times

What Happened:

This study systematically reviewed the effects of delaying school start times on students' sleep, health, and academic outcomes. Researchers followed PRISMA guidelines to analyze six studies, which included different designs like pre-post, randomized controlled trials, and quasi-experimental approaches. School start times were delayed by 25 to 60 minutes, resulting in an increase in total sleep time by 25 to 77 minutes per weeknight. The outcomes observed varied, with some studies showing reduced daytime sleepiness, depression, caffeine use, tardiness, and difficulty staying awake.

Why It Matters:

The study underscores the significant impact of school start times on adolescent health and academic performance. Adolescents are in a critical phase of growth and development, requiring adequate sleep for optimal mental and physical alertness. However, many adolescents do not meet the recommended sleep duration, largely due to early school start times conflicting with their circadian rhythms. Chronic sleep restriction in this age group can lead to health issues like obesity and diabetes, risky behaviors, and cognitive and academic deficits. The review supports the notion that delaying school start times can be a viable solution to these challenges.

Key Takeaways:

1. Increased Sleep Duration: Delaying school start times can effectively increase total sleep time for adolescents.

2. Health and Well-being Benefits: Improved sleep due to delayed start times can reduce daytime sleepiness, depression, and caffeine dependency.

3. Academic Improvements: There's evidence that later start times can reduce tardiness and improve students' ability to stay awake and perform in classes.

4. Policy Implications: The findings support the call for policies advocating later school start times as a long-term solution for chronic sleep restriction during adolescence.

5. Need for Further Research: Despite promising results, the study emphasizes the need for more rigorous research designs and consistent reporting methods, including objective sleep measures and consistent health and academic performance metrics.

2/ Environmental Determinants of Sleep

What Happened:

The study reviewed recent literature on how environmental factors at both household and neighborhood levels affect sleep in adults, children, and adolescents. It highlighted that both social (like family dynamics, safety, and neighborhood disorder) and physical features (such as light, noise, traffic, and pollution) significantly influence sleep patterns. The study noted that most previous research relied on self-reported sleep data and investigated cross-sectional associations, which may not accurately reflect objective sleep measures. It also found that minority populations might be more vulnerable to environmental effects on sleep.

Why It Matters:

Sleep is a crucial aspect of overall health and well-being. With the high prevalence of sleep disorders and insufficient sleep, understanding environmental impacts is vital for public health. This study sheds light on how our surroundings, from the comfort of our homes to the broader neighborhood context, can either hinder or promote healthy sleep. Given the association of poor sleep with numerous adverse health outcomes like obesity, diabetes, and cardiovascular diseases, this research underscores the importance of considering environmental factors in addressing sleep health disparities.

Key Takeaways:

1. Environmental Influence on Sleep: Both social and physical environmental factors play a significant role in sleep patterns and disorders.

2. Diverse Impacts: There's evidence that different population groups, especially racial minorities and those of lower socioeconomic status, might be more affected by environmental factors.

3. Research Limitations: Current research often relies on self-reported sleep data and cross-sectional studies, which may not accurately capture the complexity of sleep patterns.

4. Public Health Implications: Understanding these environmental influences is crucial for developing interventions to improve sleep health and address related health disparities.

5. Future Research Needs: More rigorous and longitudinal studies using objective sleep measures and a focus on household-level factors are needed to better understand the environmental determinants of sleep health.

3/ OSA and Bed Partners' Sleep Quality

What Happened:

This study assessed how snoring and obstructive sleep apnea (OSA) in one partner affects the sleep quality of the other partner in a marital relationship. Ten married couples participated, where one partner was suspected of having OSA. Both underwent simultaneous polysomnography, a type of sleep study. During the study, the patient with suspected OSA received nasal continuous positive airway pressure (CPAP) therapy. This intervention aimed to eliminate snoring and obstructive breathing events. The study measured sleep quality through apnea-hypopnea index (episodes per hour), arousal index (arousals per hour), and sleep efficiency (percentage of time asleep). Spouses of patients experienced a substantial increase in sleep efficiency, translating to about 62 additional minutes of sleep per night.

Why It Matters:

Snoring and OSA are not just individual concerns; they significantly impact the sleep quality of bed partners. Poor sleep in partners can lead to daytime fatigue, mood disturbances, and decreased overall well-being. This study highlights the relational aspect of sleep disorders, emphasizing that treatment can benefit not just the patient but also their bed partner. The improvement in bed partners' sleep with CPAP therapy underscores the importance of addressing OSA not only for individual health but for the health of couples.

Key Takeaways:

1. Impact on Bed Partners: Snoring and OSA in one individual can notably deteriorate the sleep quality of their bed partner.

2. CPAP as an Effective Solution: The use of CPAP therapy in patients significantly improved their partners' sleep, demonstrated by decreased arousal and increased sleep efficiency.

3. Quantifiable Improvement: Spouses of patients experienced a substantial increase in sleep efficiency, translating to about 62 additional minutes of sleep per night.

4. Broader Implications: The study suggests that treating sleep disorders can have a positive domino effect, improving the sleep and potentially the overall well-being of both individuals in a relationship.

Business of Sleep

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Understanding Coinsurance vs. Copay in Medical Billing

Navigating the complexities of medical billing in dentistry can be challenging, especially when dealing with terms like coinsurance and copay. These two terms, often used interchangeably, have distinct differences that are crucial for dental offices to understand. Accurate knowledge of these terms is essential for estimating out-of-pocket costs and setting clear expectations for patients.

Copay: A Fixed Amount for Specific Services

Copay, or copayment, is a predetermined fee that a patient agrees to pay for specific services under their health insurance plan. This fee is usually a fixed dollar amount and is more commonly associated with in-network benefits. Copays are often listed on a patient's insurance card and can vary depending on the type of service, such as:

• Primary Care Physician (PCP) Visits: A patient might pay a copay of $25.

• Specialist Visits: A copay could be higher, say $75.

• Urgent Care or Emergency Room Visits: These services might have a copay of $150.

• Other Services: Copays can also apply to prescription medications, radiology, imaging, and lab tests.

Coinsurance: A Percentage of the Service Cost

Coinsurance is the patient's share of the costs for a covered healthcare service, calculated as a percentage of the allowed amount for the service. This only kicks in after the deductible is met. For instance, a plan with "20% coinsurance" or an "80/20 policy" means the patient is responsible for 20% of the cost, while insurance covers the remaining 80%. Coinsurance percentages can vary within a plan based on the service type.

Out-of-Pocket Maximum: A Limit on Expenses

It's also vital to understand the out-of-pocket maximum. This is the most a patient will pay during a policy period (usually a year) for covered services. Once a patient reaches this maximum, they no longer need to pay copays or coinsurance for covered services; the insurance plan covers 100% of the allowed amount.

Importance for Dental Practices

Dental practices often function as out-of-network providers when filing medical insurance for medically necessary dental services. Thus, understanding coinsurance is particularly important for these practices. Accurately determining a patient's copay or coinsurance requires a benefit verification process performed by the provider's office or a third-party billing service.

Takeaway for Patients

For patients, understanding these terms is crucial for making informed decisions about their healthcare. Knowing whether a service will require a copay or coinsurance, and how much they might need to pay, can significantly impact their choices and preparedness for out-of-pocket expenses.

while copay and coinsurance are both out-of-pocket expenses, they differ significantly. Copay is a fixed amount for specific services, while coinsurance is a percentage of the service cost after meeting the deductible. Understanding these terms is crucial for dental offices in accurately estimating costs and helping patients navigate their healthcare expenses effectively.

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Miscellaneous

😅P.S. … I forgot something

We are big fans of Dr. Andrew Huberman and his fact based advice on living our best lives through practical protocols.

We also love who ever put together the quick list of all of his protocols in one convenient place!