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There are ~200 sleep appliances that are registered with the FDA. Which one to choose?

Today we will cover the basics. We won’t talk about specific brands today because More Than Teeth is unbiased and much of the decision comes down to subject preference rather then the material or warranty.

Oral appliances are not silver bullets, but there are a few things you need to get right before you order.

In Today’s Edition:

• Definition of an Effective Oral Appliance

• The Safety of Oral Appliances

• Choosing the Right Oral Appliance

• Maximized Medical Reimbursement

• Spend less on CE Events

• Feel-good dental story

7-minute read today, lets do it!👇

Clinical Corner

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

🔑Key Takeaways

1/ Definition of an Effective Oral Appliance

The AADSM recently updated their definition of what makes an effective oral appliance. They looked at a ton of studies to make sure it's up-to-date with the latest research. Check the quick list below to make sure you’re using compliant appliances!

📌 Quick Points:

• Effective OAT: This device should be FDA cleared to treat OSA, snoring, and other symptoms. Only trained dentists should provide it.

• Use it Every Night: When worn nightly, it reduces apneas, snoring, and other issues.

• Custom & Safe: They should fit well and not have any metal, for those with allergies.

• Adjustable & Checkable: You should be able to change its position in tiny amounts. You also need to check its setting.

• User-Friendly: People should easily put them on and take them off. They should also stay in place.

• Modern Materials: The latest devices use things like elastic, plastic, or magnets to connect.

• Proven Results: Studies show custom devices work better than ready-made ones. They help with breathing, daytime alertness, and muscle activity.

👉 Why You Should Care:

This isn't just a small update. It is the standard dental sleep professionals should stick to as we raise the bar for how we treat sleep problems with . It makes sure we're giving our patients the best.

2/ The Safety of Oral Appliances in OSA Treatment

A recent study looked at how safe oral appliances (OAs) are for people with Obstructive Sleep Apnea (OSA). They checked out 64 Japanese folks, average age 57.7, over about 4.3 years. They wanted to see if dental stuff changed during treatment.

Why It Matters

This study's big for dental experts focused on sleep. It tells us about possible side effects of OAs. This info helps us give patients better care.

What They Found:

• They noticed that some teeth stuff (like overjet and overbite) changed a lot. There were changes in the lower front teeth compared to the jawbone.

• Bigger overjet changes were connected to how long the treatment was, how often the OA was used, and how much the lower jaw moved.

• People with fewer upper teeth had more overjet changes. So, fewer teeth could mean more risk of changes.

• No big changes were seen in the bigger bone structure. Most changes were just in the teeth.

What You Should Do:

• Check Patients First: Look at patients' teeth, especially the maxiallary teeth, before starting OA treatment. This helps predict possible side effects.

• Think About Other Treatments: For patients at higher risk, think about other options like CPAP machines, surgery, clear aligners, laser therapy, etc.

• Talk to Patients: Tell patients, especially those with fewer upper teeth, about risks.

• Watch Patients Closely: Regularly check overjet. It's a good sign of dental changes during long-term OA use.

• Adjust OA: If someone's at higher risk, think about changing the position of the lower jaw in the OA.

• Treatment Length & How Often: This study hints that side effects might be tied to how long and often OAs are used. If patients are only trying to fix snoring, maybe they shouldn't use the OA every night.

Wrap-Up:

This study tells us we need to know about the things that might change teeth during treatment. Most patients didn't really notice big changes, and no one reported bad teeth or jaw damage. But to make sure our patients are happy and to give the best care, we need to really think about these possible changes.

3/ Choosing the Right Oral Appliance: A Guided Journey for New Dental Sleep Specialists [opinion]

"Have you ever thought about how important the right oral appliance is for treating sleep problems? It's a key part of dental sleep medicine. Let’s understand the choices out there and find the best and safest tools for our patients. This ensures they sleep well and keep smiling!”

Section 1: The Basics

Why Does It Matter?

Oral Appliance Therapy (OAT) helps people who snore or have Obstructive Sleep Apnea (OSA). It's a good alternative to other treatments. The AADSM's latest update isn’t just a small change. It really shows the key parts of OAT needed for treating OSA and snoring effectively.

Things to Keep in Mind:

• Material: Use custom-made and safe materials, especially if patients can't handle metals.

• Fit: The appliance should fit both the upper and lower teeth well without pain.

• Adjustments: Pick tools that can be finely adjusted for the lower jaw.

• User Design: Go for easy-to-use designs. Patients or caregivers should find them easy to put in or take out.

• Regulatory Clearance: cover your liabilities by making sure your appliances and manufacturers are registered and cleared.

Section 2: Safety First

What Are the Possible Side Effects?

We need to know about any side effects of Oral Appliances (OAs). A study with 64 Japanese people found some teeth changes after using OAs for around 4.3 years.

What Should We Do?:

• Check Patients and Inform: Dentists should look at how many upper teeth patients have. They should also tell them about any risks.

• Other Treatments: Think about other treatments for patients who might have more risks.

• Check and Adjust: Keep an eye on the overjet (OJ) and change the OA's position if needed, especially for those with higher risks.

Section 3: Putting Knowledge to Use

How Do We Use What We Know?

Understanding more about the details of oral appliances is a big deal for dental sleep medicine. Using this knowledge and picking the right tools can make your treatments successful and patients happier.

Wrap-Up and Next Steps:

Finding the right oral appliance takes work, but it's key for helping patients. Let's use what we've learned here to do even better in dental sleep medicine. Want to make better choices for your patients and help them sleep? Keep learning with us and let’s improve dental sleep medicine together!

Business of Sleep

📈Better businesses = more lives saved!

Dental Sleep Insights: Unlocking Maximized Medical Reimbursement

Navigating the medical insurance labyrinth can be a daunting task for dental sleep professionals, specifically in areas focusing on obstructive sleep apnea (OSA) treatments such as oral appliances, myofunctional therapy, and laser therapy. With common challenges like "The insurance doesn't have you in the system" and "Additional documents are needed," it can seem almost insurmountable.

Strategic Approach to Insurance Navigation While some may feel adept at dealing with medical insurance after surmounting initial issues, there’s more to uncover. The question arises: Are you truly optimizing your reimbursement while lessening the patient’s financial burden? And importantly, are financial impediments inhibiting the attainment of requisite treatment for your patients?

Comparing it to a football game, much like TCU capitalized on turnovers against Ole Miss in the Peach Bowl, dental practices need to similarly strategize to leverage what insurance should rightfully cover for their members.

Being Network-Savvy Understanding your network status, scrutinizing the patient's benefit structure, and decrypting insurer guidelines are pivotal. A keen awareness and a strategic playbook can significantly maximize your patients’ benefits consistently.

Out-of-Network & Clinical GAP Exceptions Most dental practices operate as out-of-network providers with medical insurers. It can be advantageous, provided there’s an effective, opportunistic defensive playbook. Here's where the concept of a clinical GAP exception is crucial. It applies when there isn’t a contracted provider within a set mile radius on the patient’s medical insurance policy, typically 25 to 30 miles, allowing the patient to use the in-network benefit level even with an out-of-network provider.

Example Scenario:

Patient: Joe Sample (Typical PPO Plan)In-network benefits:

• Deductible: $500 total ($300 met, $200 remaining)

• Coinsurance: 80% insurance responsibility, 20% patient responsibility

Out-of-network benefits:

• Deductible: $1,000 total ($0 met, $1,000 remaining)

• Coinsurance: 60% insurance responsibility, 40% patient responsibility

In essence, with a clinical GAP/in-network exception, the patient is only liable for $200 plus 20%. Without it, the patient bears $1,000 and 40%.

Pursuit of GAP Exceptions Securing a clinical GAP or in-network exception can be strenuous but crucial. It requires due diligence and often involves extensive communication with insurance representatives, who might initially be unfamiliar with the request due to its uncommon nature.

This effort is instrumental in treating patients who would normally be obligated to pay 100% cash. It also amplifies the practice’s ability to market OSA services broadly, asserting acceptance of all insurances, a significant draw for acquiring referrals.

Patient-Centric Study ReferralsStarting with potential OSA patients identified at the dental practice, determining the referral pathway for a sleep study is critical. Aligning with insurer guidelines and cooperating with the medical community safeguards the patient's interests throughout the process. Maximizing reimbursements and minimizing patient’s out-of-pocket expenses facilitates higher patient conversion to treatment.

Steps Summary:

1. Investigate availability of clinical GAP or in-network exception with the patient's insurance carrier.

2. Strategically determine the path of the sleep study.

3. Secure a copy of the qualifying sleep study.

4. Submit all documents needed for clinical GAP/in-network exception approval.

5. Procure the approval and proceed with impressions.

Remember to leverage every available resource from medical insurance carriers to elevate your success. Every meticulous effort made goes a long way in assisting the patient, increasing reimbursement, and ensuring consistent coverage, thus promoting widespread acceptance of treatment plans for obstructive sleep apnea, a condition often underestimated but potentially life-threatening.

Insights Reminder:

Always ensure to apply astute situational analysis and to employ an effective playbook to optimize the realization of patient benefits consistently. Keep the game strategic, the patients informed, and the operations seamless, and watch the reimbursements roll in. After all, the goal is not just winning the game; it’s about making the most out of every play for both the patient and the practice.

Something Sweet

🍭Stuff so sweet you might get a cavity..

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