Interested in Sleep Dentistry?

Dentists are already well-versed in the intricacies of oral health and the anatomy of the oral cavity, and they can use that knowledge to help patients achieve better sleep and improve their overall health. Oral appliance therapy is a specialized, non-surgical approach to treating sleep-disordered breathing conditions, such as obstructive sleep apnea (OSA) and snoring. It involves the fabrication and delivery of custom-designed oral appliances to help patients maintain an open airway while they sleep and breathe more easily. Oral appliances work by gently repositioning the lower jaw and, in some cases, the tongue. In doing so, these devices prevent the upper airway from collapsing, which is a common problem with OSA. Due to the risks that oral appliances can pose to a patient's occlusion, it is important to complete an appropriate amount of education and training before providing this treatment.

The first step in integrating oral appliance therapy into your dental practice is to get your team members on board with sleep medicine. You do this by turning them into sleep advocates. Because every practice is made up of individuals with unique learning styles and preferences, there is no one-size-fits-all approach to how this process should work. Regardless, every practice that wants to implement sleep medicine can benefit from a training or coaching program. When choosing a sleep medicine training or coaching program, there are many factors to consider, including the following:

• The number of people on your team

• How your team members respond to instructions (eg, are they mostly self-starters or do they benefit from accountability and more guidance?)

• Your team members' preferences for digital training and coaching options versus live, in-person ones

• The financial and time commitments involved in completing the program

Everyone in your practice, from the receptionists to the dental assistants, should understand the significance of sleep-disordered breathing and the role that oral appliances can play in its management.

Helping patients improve the quality of their sleep takes a village. Dentists should screen all of their patients for signs of reduced airways and sleep-disordered breathing conditions, and they should collaborate with medical professionals, including physicians and sleep specialists. Dentists can screen for OSA and treat it through oral appliance therapy, but they are not permitted to diagnose it. If a dentist suspects that a patient has OSA or other sleep-disordered breathing issues, the patient must be referred to a sleep physician for a diagnosis and determination of the most suitable treatment plan. Although continuous positive airway pressure (CPAP) therapy is typically the first-line treatment for OSA, it is often used in conjunction with an oral appliance, and patients who poorly tolerate it often pursue treatment with an oral appliance only. Therefore, dentists who want to offer sleep dentistry services, including oral appliance therapy, should build relationships with local physicians, sleep specialists, and even ear, nose, and throat doctors. This leads to enhanced patient care as well as increased business through referrals.

Medical billing can be a complicated and confusing process. Dentists should confirm whether or not oral appliance therapy is covered under patients' medical insurance plans, and if it is, check the specific coverage details, including copayments, deductibles, and pre-authorization requirements. If patients' medical insurance plans are to be billed, dentists need to ensure that they use the appropriate medical billing codes for oral appliance therapy, including the Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes. They also need to ensure that their patient records contain documentation to support medical necessity. This might include the results of sleep studies, physician referrals, and/or clinical notes. In addition, dentists should obtain pre-authorization from insurance companies before initiating treatment. This can help prevent claim denials due to a lack of coverage.

Once dentists decide to implement sleep dentistry and oral appliance therapy into their practices, they should let their existing patients and communities know. Creating marketing efforts that highlight the benefits of oral appliance therapy for sleep-disordered breathing issues and offering current patients educational materials to raise awareness and answer questions are excellent strategies. Implementing sleep dentistry services can be a very rewarding experience from both a business and patient-centric perspective. By entering into this specialized branch of dentistry, practices can broaden their horizons while positively impacting the quality of life of patients seeking relief from sleep-disordered breathing.

Meghna Dassani, DMD, maintains a private practice in Houston, Texas, that offers sleep apnea treatment for adults and children.