Good morning. This is More Than Teeth. The newsletter that helps dental sleep professionals get 1% better every week.

This Week We Cover:

• Which IOS to Choose

• Sleep Bruxism and OSA

• How Sleep Quality Affects ADHD

• ‘Selling’ Our Patients

• Inspiring Dentist Keeps on Running!

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/ Unpacking the Global Intraoral Scanner Study

The Institute of Digital Dentistry partnered with Semmelweis University for an expansive, international study on intraoral scanners (IOS). This landmark research garnered responses from a whopping 1,072 participants across 109 countries. And today, we're here to break down some of the most interesting tidbits.

The Faces behind the Data 🌎

After a bit of necessary filtering, we analyzed 61.2% of the total responses. Our top contributing countries spanned the globe, with India (17.4%), the United States (11.4%), Egypt (4.9%), Australia (4%), and Canada (3.9%) leading the pack.

Here's the professional breakdown:

• General Dentists: 75.8%

• Dental Specialists: 16.2%

• Dental Technicians: 4.7%

• Dental Students: 2.3%

• Dental Assistants: 0.7%

• Dental Hygienists: 0.3%

The Status Quo of IOS 📈

Here's an encouraging stat: 81.9% believe that IOS technology trumps traditional casting methods. 78.8% use IOS in their daily work, with the average respondent owning 1.5 scanners. Of these, a significant 85.6% used IOS for crafting fixed prosthetic appliances.

Self-assessed expertise varied: 24.7% claimed they were pros, 29.6% admitted they were still learning, and the bulk of respondents (45.7%) identified as intermediate-level users.

The Rise of Digital Design 🖥️

Computer-aided design (CAD) software is making a splash, with 38.62% of participants rolling up their sleeves with in-house CAD software. Additionally, over 31.5% reported having in-house computer-aided manufacturing (CAM) tools. Digital dentistry is indeed on the rise!

The Institute of Digital Dentistry is currently seeking dentists to beta-test their exocad training. Interested?

The IOS Hall of Fame 🏆

When it comes to satisfaction, the Medit i700 wireless stole the show, followed by Medit i700 and Dentsply Sirona's Primescan. As for CAD software, exocad reigned supreme, with CEREC and 3Shape hot on its heels.

The Bottom Line 💸

Costs of CAD software spanned a broad spectrum, from absolutely free to a hefty US$20,000. IOS maintenance costs varied as well, with 53.1% spending nothing, while a smaller group (2.5%) paid more than US$5000.

The Rationale for IOS: Why Buy? 💡

The top reason for choosing a particular scanner? Recommendations from colleagues. This was followed by perceived accuracy, brand name, price, and software design.

What's the crux? Intraoral scanners have cemented their place in modern dental practice, offering a diverse ecosystem of systems, software, and applications. Although costs and maintenance can vary, the rise of digital dentistry is undeniable.

2/ Sleep Bruxism and OSA

Today, we've got some fresh intel about a link between two sleep-related issues we often see in our patients: Obstructive Sleep Apnea (OSA) and Sleep Bruxism (SB). A study has thrown a spotlight on this pair, and the results may just change the way you approach your sleep-related cases.

The Study Lowdown

Researchers rounded up a group of 110 adults and put them under the microscope (well, under polysomnography, to be precise) to examine the prevalence and connection between OSA and SB.

The results? 86.37% of patients showed signs of OSA, while 50% were caught grinding their teeth in their sleep. 

The Twist

Here's where it gets interesting: the severity of OSA seems to affect the occurrence of SB. Patients with mild-to-moderate OSA (with an apnea-hypopnea index, or AHI, less than 30) were grinding away more than their counterparts with severe OSA (AHI of 30 or more).

In fact, these mild-to-moderate OSA patients showed a positive correlation between their AHI and their Bruxism Episode Index (BEI). That means, the higher their AHI, the more they were grinding. 😮

Key Predictors

The study also revealed some key predictors for increased BEI in those with an AHI under 30: a higher AHI, being male, and having diabetes were all associated with more tooth grinding.

Takeaways for Your Practice

So, what's the moral of this sleep story? When you're dealing with patients showing signs of SB, it could be worth considering a sleep study to rule out OSA, especially if they're male, diabetic, or both.

Remember, the link between OSA and SB isn't just a one-size-fits-all situation. It's a sliding scale where severity matters. So, keep your eyes (and polysomnographs) peeled for these nuances when treating your patients.

3/ Sleep Quality’s Role in ADHD

We're all about enhancing the patient experience and helping you grow in your practice. Today, we're talking about a crucial topic that influences both: Attention-Deficit/Hyperactivity Disorder (ADHD) and its connection with sleep. Yes, you read that right – your patient's sleep patterns might be affecting their ADHD symptoms more than you think.

A study recently published in the journal SLEEP has made some important strides in this area. Let's dive into the highlights:

1. The Genetics and Environment Dance 🧬 ADHD is undoubtedly shaped by genetics – multiple genes each contribute a small piece to the puzzle. But it's not all DNA. Environmental factors, particularly sleep, also play a key role. Essentially, our genes and environment are waltzing together, impacting the severity of ADHD symptoms.

2. The Sleep-ADHD Connection 😴 The study found a clear link between sleep and ADHD symptoms, regardless of a formal ADHD diagnosis. Insufficient sleep often leads to neurocognitive issues. The better the sleep, the less likely the symptoms of inattention or hyperactivity are to occur.

3. Sleep and ADHD: A Complex Affair 🛌 However, it's not just about getting enough sleep. Sleep quality is a big player too. Common sleep concerns include restless sleep, early waking, and difficulty falling asleep. Sleep disorders like motor restlessness, parasomnias, and restless legs syndrome are also frequently seen in children with ADHD.

4. The Need for More Research 🔬 While the connection between sleep and ADHD is clear, there's still much to learn. Studies are showing inconsistent results on certain aspects, like variations in sleep duration or sleep latency. This calls for more in-depth research on the topic.

So what does all this mean for your dental practice?

Actionable Steps: 📝

1. Early Screening: It's critical to identify sleep disorders in children with ADHD as early as possible. The American Academy of Pediatrics recommends screening for comorbid conditions, which can include physical conditions like sleep apnea.

2. Educate Parents: Help parents understand the link between their child's sleep and ADHD symptoms. Empower them with knowledge and resources to manage and improve their child's sleep.

3. Improve Sleep Quality: Consider interventions to enhance sleep quality, not just quantity. This could mean referring to sleep specialists or providing educational materials about good sleep hygiene.

By staying up-to-date with this evolving research, you're not only helping to improve patient outcomes but also positioning your practice as a trusted, knowledgeable resource. Together, we can help our patients lead healthier, happier lives.

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Business of Sleep

📈Better businesses = more lives saved!

Let's address the elephant in the room - 'selling' dental services. Yes, we're talking about that uneasy tension between advocating for patient health and the perception of pushing unnecessary treatments. We're delving into an insightful article by Ben Waldman, "Schrödinger’s Dentist", to unwrap this mystery.

🎯 The Sales Conundrum: The term 'sell' often brings a rush of emotions to dentists and patients alike. To dentists, selling is about persuading patients to make the best choices for their health. To patients, however, it often evokes feelings of deceit or disappointment. Hence, we're faced with a disconnect between the intent and perception of care.

✨Why Bridge the Gap? In dental sleep medicine, for example, undiagnosed sleep-disordered breathing can lead to serious conditions like heart attack, depression, or even motor vehicle accidents. Thus, it's crucial to encourage patients to accept treatments that they need but might not necessarily want.

🏹 How to Bridge the Gap with Integrity: LD Pankey's cross of dentistry, with its four tenets – "Know your Work", "Know Your Patient", "Know Yourself", and "Apply Your Knowledge" – provides a robust framework.

1. Know Your Work: Exceptional patient care starts with a deep understanding of your work. In this context, understanding the impact of sleep disorders on oral health is critical. When you’re knowledgeable, your confidence radiates, instilling trust and safety in your patients.

2. Know Your Patient: Dive deeper into your patient’s world. Understand their motivations, values, decision-making processes, and barriers to care. The better you know your patients, the more effectively you can tailor your care to their unique needs.

3. Know Yourself: We often set up our own roadblocks, be it in the form of time constraints, presumptions about a patient's affordability, or miscommunications. Recognize these obstacles, and proactively work to remove them.

4. Apply Your Knowledge: Connect your professional knowledge with individual patient insights. The same treatment might be 'sold' differently to different patients, depending on their motivations.

👣 Taking Action:

1. Invest in Knowledge: Seek out quality courses to enhance your professional competence.

2. Build Patient Connections: Understand your patients on a personal level. Their wants, needs, and values should guide your practice.

3. Self-awareness: Be mindful of your biases. Ensure they don't hamper your ability to connect with patients.

4. Personalize Treatments: Frame treatment recommendations in a way that resonates with each patient's unique motivations.

'Selling' is inevitable, but it doesn't have to be deceptive. By mastering the art of persuasion and applying it with integrity, we can encourage our patients towards better health, and in turn, ensure the vitality of our practice.

Something Sweet

🍭Stuff so sweet you might get a cavity..

This dentist keeps on running after surviving a stroke when she was 27, in addition to running during the Boston Marathon bombing, showing Dr. Christy Kirk’s resilience to keep “pushing forward”. Incredible!