Understanding Sleep Medicine
Payam Ataii, DMD
The US Centers for Disease Control and Prevention (CDC) estimates that 50 to 70 million Americans suffer from a sleep or wakefulness disorder.1 The agency has been monitoring our sleeping habits since 1998, and their research is consistent with how most of us feel: tired.
Well, after many decades of studying sleep and sleeping disorders, researchers have concluded that many individuals have conditions that directly impact the way they breathe. More specifically, their breathing is disturbed. And, generally, the areas involved in the disturbance are directly in our responsibility of care. I don’t mean that teeth are causing people to suffer from insufficient sleep; I mean that patients who suffer from the majority of sleep disturbances typically suffer from conditions that involve the oral cavity. For example, if the patient snores, we can prescribe a dental appliance that can help reduce or eliminate the snoring. This is because snoring is usually caused by defects in the soft palate and/or a tongue that partially blocks the airway in its resting position.
More importantly, snoring is a sign that the patient may be suffering from a more serious condition known as obstructive sleep apnea. Although many patients with this condition must wear a CPAP (Continuous Positive Airway Pressure) device; fortunately, this is another area where dentistry can assist. Similar to how oral devices are used to treat snoring, the use of an appropriate (and FDA-cleared) sleep appliance may be employed as alternative treatment to eliminate the need for the CPAP device or even surgery.
Aside from the great benefits that we may bring to such a large number of potential patients, there is another reason why we are hearing more about sleep dentistry: money. We are told there is a great opportunity to make substantial profits by moving into this area of dentistry. However, like any story, this one has two sides. It is a great opportunity, but also a challenging one.
The dental sleep industry is filled with companies that provide one service or another to help us capitalize on the opportunity, but many dentists soon become frustrated and lose interest. How can that be? We hear of some practices that generate more than $500,000 a year from sleep appliances alone. So why can’t everyone do it?
Because implementing a new treatment model, especially one that is as complex as dental sleep medicine, is simply not something that everyone can do successfully. We have to understand all of the aspects of sleep medicine, including how to collaborate with qualified physicians, grind money out of the medical insurance companies, and choose the best appliances for our patients from a multitude of options.
It is no wonder that the dental sleep industry is now more than 3 decades old, but we still have less than 10,000 dentists actively helping the more than 80 million sufferers.
The truth is that it is not that easy to implement. It has taken me more than 7 years, and I haven’t quit my day job yet. I have tried everything. I’ve bought some of the greatest (and most expensive) toys around such as home sleep testing equipment and CBCT machines, hired billing companies, partnered with supply companies, learned hundreds of hours of repetitious content from “sleep education” programs, and sent my patients to sleep testing companies—all hoping that I could get good momentum. However, after lecturing to thousands of practices around the nation and realizing that we all had similar problems, I almost called it quits.
Then, I remembered that it took just as long for many of my colleagues to get into implants and learn to do them right.
Fortunately, there are better answers today. I partnered with a company that provides my practice with one solution, and now, my staff is no longer struggling to determine who to call and what to say. We just focus on treating those patients and being a small part of the fight to solve this huge problem.
About the Author
Payam Ataii, DMD, is a national and award-winning speaker who lectures on topics such as Invisalign and dental sleep medicine. His treatments often combine the use of Invisalign and sleep appliances to achieve great patient outcomes.
1. US Centers for Disease Control and Prevention (CDC). Insufficient sleep is a public health problem. https://www.cdc.gov/features/dssleep/. Accessed July 5, 2017.