Good morning. This is More Than Teeth. The newsletter that helps dental sleep professionals become legends!"

Kinda like having a pocket size Tony Robbins minus the giant hands.

In this week’s issue:

• Expansions’ Effect on Pediatric OSA

• Case Study: Pediatric MAD Therapy

• New Innovations with HSTs

• Trust: Secrets From High-Performing Offices

• We Love Our Moms!

This is a 7-minute read today. Let’s dive in👇

Clinical Corner

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

1/ Expansions Effect on Pediatric OSA

🔬 The Study

Researchers worked with 24 patients (11 with obstructive sleep apnea, and 13 with residual snoring, average age 10). Each underwent multi-slice computed tomography and nocturnal polysomnography before and after RME over a period of six months.

📊 The Results

Both groups experienced a significant increase in oropharyngeal volume (the part of the throat at the back of the mouth) after RME. 🎉 However, changes in oxygen saturation and the apnea/hypopnea index weren't statistically significant.

🤔 The Twist

Despite the increase in oropharyngeal volume, there was no correlation found between this and changes in oxygen saturation or the apnea/hypopnea index.

🎯 The Takeaway

While RME in patients with sleep-disordered breathing can significantly increase oropharyngeal volume, this doesn't necessarily mean improved oxygen saturation or a reduced apnea/hypopnea index. This underscores the complexity of sleep-disordered breathing and the need for more research.

2/ Case Study: Pediatric Mandibular Advancement Device Efficacy 

14-Year-Old with Severe OSA 

Our patient is a 14-year-old boy dealing with daytime sleepiness, frequent nighttime awakenings, and headaches – typical symptoms of severe OSA. He had his tonsils and adenoids removed at 4, but the OSA persisted.

His medical history included jaw asymmetry, mandibular hypoplasia, and other conditions. Although prescribed positive airway pressure therapy, he couldn't tolerate the machine. He was then referred to an oral and maxillofacial surgeon.

The Surgeon's Recommendation? MAD Therapy!

The oral and maxillofacial surgeon recommended MAD therapy as a transitional method until the patient is ready for orthognathic surgery. A custom-made adjustable MAD was fitted successfully, and the results were outstanding!

✅ Results? Complete Resolution of Sleep Apnea! His apnea-hypopnea index (AHI) went from 52/h to 0.9, and his daytime sleepiness drastically reduced. Even his headaches became less frequent and intense.

🔍 Takeaway:

While MADs aren't typically part of OSA treatment guidelines for kids, cases like this show they might be a viable option. Especially for those unresponsive to traditional treatments or awaiting surgery. Other options like myofunctional therapy, nasal hygiene, and laser therapies could potentially be good additions to these patients.

3/ New Innovations with HSTs

It's time for another look at how we can elevate the field of sleep dentistry. Today, we're diving into a study that shines a spotlight on crossover sleep apnea testing (XSAT) and how it could revolutionize our approach to diagnosing obstructive sleep apnea (OSA). Let's dive in! 🌊🦷

🧪 The Study

In this investigation, a group of patients (N=52) voluntarily chose XSAT and shared their experiences via a phone survey. The objective was to assess the satisfaction level with this novel approach to sleep testing.

📈 The Results

Out of the 52, only 2 dropped out, while 41 completed the survey – that's an 82% response rate! 👏

The consensus? People really liked it. 93% of all survey respondents rated their satisfaction with XSAT as high or very high. Among the 'sleep test newbies', satisfaction was a whopping 100%! As for technical issues, those were encountered by a minor 1.2% of respondents.

⚙️ The Mechanics

Here's how it played out: the average number of sleep-test nights was 2.8. For the newbies, it was 3.0, while the seasoned sleep testers averaged 2.5 nights.

🔍 The Findings

Among the 14 newbies, 12 were diagnosed with OSA (including 6 mild cases). The night-to-night variability was found to be 6.3 events/hr for the newbies, 6.0 for all survey respondents, and 6.4 for all patients.

Interesting to note – the benefit of "no need to return equipment" was deemed important by 85% of the experienced testers, compared to 64% of the newbies.

🎉 The Takeaway

XSAT is emerging as a game-changer for sleep testing. Not only is it user-friendly, but it also boasts professional-level accuracy, making it an excellent solution to address the underdiagnosis of OSA.

This innovative approach can allow more patients to step into the world of sleep healthcare, making diagnosis and treatment more accessible than ever.

Help Us Grow

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Business of Sleep

📈Better businesses = more lives saved!

We're uncovering the secret ingredient behind high-performing teams. Let's dive into the world of trust and learn how to foster it in our practices. Buckle up, and let's go! 🚀🦷

🔎 What is Trust?

Best-selling author Patrick Lencioni breaks trust down into two types:

1. Cognitive Trust: This comes from the head, based on your team's perception of your skills, accomplishments, and reliability.

2. Affective Trust: This comes from the heart, driven by feelings of closeness, empathy, and friendship.

And guess what? You need both to succeed as a modern dental office. Afterall, It is the foundation of team building.

💡 6 Steps to Accelerate Authentic Trust

1. Be Vulnerable: Show your human side, even if it means admitting to your faults and failures. It's about keeping things real and creating a culture of self-awareness and open-mindedness.

2. Be Personal: Build meaningful relationships with your team. Make an effort to learn everyone's name and something personal about them. Remember, eye contact is the window to a clear connection.

3. Be Explicit: Trust is a contract. Make sure you're clear about what's expected and how things should be done. Involve your team in setting these expectations for better adherence.

4. Be Decisive: Your culture is defined by what you tolerate. Make sure your actions align with your values. Don't be afraid to make tough decisions when needed.

5. Be Consistent: Keep your promises and provide a clear guide on how your team can engage with you. Regularity and predictability are key.

6. Be Receptive: Encourage your team to speak up when they see a problem. This creates a culture of accountability and high standards.

🔁 The Cycle of Trust

Trust is not static; it's a cycle that needs constant nurturing. By following these six steps, you'll set your dental office up for success. Remember, a high-trust environment doesn't just happen overnight, but the rewards are worth it. You'll see better teamwork, increased productivity, and a happier, more engaged staff. Now, that's something to smile about!

Something Sweet

🍭Stuff so sweet you might get a cavity..

Mother’s Day was yesterday! We want to wish all the mothers out there a Happy Mother’s Day!!

Miscellaneous

😅P.S. … I forgot something

We are looking for a Clinical Spotlight!

If you have a beautiful case but need a platform, we have you covered.

Reply to this email and we can share the details of getting your case featured in an issue of More Than Teeth!