Kevin, Tammy, Allan discussed on The Dental Hacks Podcast
Well I got diagnosed with sleep apnea well. I got this while I got that and so I I've heard it in. I heard the mentioning it. The there's this part of me. It's in a rational part of me. That is like when I went to dental school. I did not sign up to have. I didn't WanNa have have conversation with people about snoring and sleeping and I just want to do some fillings and do a root canal and you know a bridge or something like I. Just don't WanNa talk about this. I don't want to do it. I don't that's almost like I. KINDA WANNA pretend. It's not there even though I'm going to add this to this this seems seems like a very medical thing to me. This is sort of outside of our scope. I'm a little uncomfortable with having the diagnosis done by a remote doctor. I don't know anything about that. That's that's a problem to me a little bit as well like I'd much I'd feel better if if I actually the doctor that was reading these things. 'cause I'm assuming assuming Kevin that when they get this. That's the diagnosis like you're not in the spring. Another Sleep Dr. We're also in contact with their physician so We're we're we're in communication with their physician so that they know what's what's happened any. Have you gotten any pushback from physicians on this it because I I could easily see a physician. This is Dennis. He's trying to make money off my patients like that's you haven't gotten that I haven't gotten that I haven't got mad at all. I mean anything's possible. Of course but no of course we'll also more in my head. Then I haven't had that accelerates mind goes let me ask you this I ah I don't want I don't want this to be a crass or Just dollars and cents but have you guys ever GonNa Crown on number fifteen. Have you ever done crown on number fifteen on a guy with a huge tongue and his gagging can't swallow their most. Every time I do a chroma fifteen eighteen this that's the guy that blessed and what's your reimbursement for that. I mean we know about same crown on number twelve. Yep Yep so The other day Tammy was scanning a patient for a sleep appliance and I was walking down the hall drinking a cup of coffee and and producing twice that much Is that crown. There was no strain on my back or my brain or my anger or whatever it was. It's just that you're gonNA hit your some people are GonNa go dude. Sign me up and some. We're GONNA go. That's not right that's wrong that's not like like to sit there and go sleep treating sleep apnea is about making more money. There's going to be people that push back on that of course worse and that's why I had had a couch that but it's as grass. I didn't think I was much more crass than that given. I mean as far as being good for look. I'm fifty six years old. It's getting harder to do those crowns on number fifteen it. You know what I mean it. I had a after couple of weeks ago. I had that conversation with Tammy like your I was talking around with her. You're extending my career. You know you're you're you're you're allowing me to practice longer without the strain on my body or whatever by and also helping out our patient tremendous having listened to you talk about this a few times the one thing I can. I what you've done with like a invisible line and sleep apnea and and I've heard you know to ruin talk about this as well as differentiating your services in in a in a world where there's going to be more dentist Damore DSO's and especially if you don't participate with load of insurances. Some of these like fillings things in in crowds or that kind of dry up some you know and you if you don't have oh that's another different things offer unless you're a massive unless you take every insurance in Hmo there is that's another in mature practice. I've probably done all the fillings crowns on my regular recall patients that are there and that's fine nine This is another service that I can provide to them. There's no doubt that it's it seems like the the incidents of sleep apnea seems to be increasing with time and I think there's no doubt that I don't think that this is one of those things where it probably is because we're getting getting fatter but I think the other thing is the dig- our our understanding of of sleep as a concern for a lot of lifestyle diseases out there is getting bigger. I don't agree. I don't yeah I don't disagree with that at all. I mean it's I'm I'm a contradiction because there's why do I feel totally fine about quote unquote making money on doing restorative dentistry right. But I but I feel weird and it's because I still feel like it's kind I think probably where I'm hanging up is is is that I feel like it's out of our scope a little bit like like on some level but you're right every day. Yes but I'm that I'm the guy to to treat the patients mouth is part of their airway and the evidence is once you see like you said you can't unsee it and and the evidence is there and those teeth that you're trying to treat are being affected by the patient grinding the crap out of them as they're struggling to breathe at night. It's all home once that was all connected in my brain. You know the ideal case. I haven't had this happened yet. I maybe one of these in the works. You know someone someone who has a deep bite tunnel wear correcting them orthodontic and then getting them in a sleep appliance as their retainer. Hainer that to me would be you know the the holy grail of the sort of treatment. That's coming down the pike for me with one patient But the again these patients are staring you right in the face and you you can do something about it and when you see a a printout from someone sleep test it says. The treatment of choice is either c-pap or a mandibular advancement appliance. So it is within then. You don't want your physician giving you on oral appliance. That's in your scope. We are as dentist much better. What are the only ones that should be able to take an impression or whatever and take a bite and all the things that we need to do? This isn't can't understand that or even do that or want to do. Do that and you know that you spoke to me. Though in terms of like I agree with you is like part of me is like you know if I do a filling or root canal and something goes badly valley icon or something doesn't go my way. I know how to fix that. I know that like steps to take with this Iraq. I feel this feeling that like it's like are the best qualified person to do this. What if my appliance doesn't do the job? This feels a little. It feels serious to me in terms of like you know the repercussions since or whatnot. That's the benefit of knowing Aaron there's a sleep apnea group so when things go weird or stings. You haven't having encountered before I even told patients. I told the patient this last month or two months ago. I'm not really sure what's happening here but I know someone who will I you know. I know a leader in in in sleep apnea in this in this country I'm going to text her when you after you leave and we'll talk it over and then I'll we'll get back to you and that's that's a great way to to to help figure those things out. What kind of what kind of follow up is required after after you've you start with with Late like how often are you seeing them. How are you evaluating the effectiveness of what you're doing like are you following up? I look at any kind of appliance. Clients that they wear for a certain amount of time has potential to kind of to change. TM joint issues as well. Not that not that it necessarily will but it's like how are you following following up on on what your treatment has done for better for worse for different. Yeah so after a month we're GONNA test them again another home sleep test with the appliance in so we can measure. Is your that and do that. Long enough events or away from so they've gotten used to it because as a new appliance is always weird absolutely. Yeah so they've got to wear it for a while and then we're gonNA test them and we're also going to do some subjective testing you know like the patient night led this off with. He's not snoring anymore and let let them know about so. That's that's a good clue. But that's just subjective data. We need hard fast data from sleep test and then we're going to make recommendations from there as far as appliance maintenance goes after that they're going to bring it to their recall. I'll check it out if if something's broken or we need to remake make them we're GONNA re remake them at personally like making the opt asleep which is a total. You Know Serono Syrup product that you you know. Do you make that on site or is that made by Rona at a lab is made in Germany Germany. Yeah so that the workflow for that and again you don't need the stuff of course what I've told me. Understanding to that like multiple appliances can do the same thing in this is one that allows them to keep all the workflow simple for you. It's it's simple people. We we scan scan the patient in the Sara Ganim in the codeine hit a button and it sent off to Germany. Couldn't couldn't be better Kevin and we all have patients that even like just your flat plain bite splints or you know th they won't they won't wear those either what what's your. What's your gut feeling? Is this anecdote on your percentage of people that actually use the things that you make versus Moore like no all right so I have an N. of one in that department department. I have a patient that we I think advanced or too far out of our ignorance and Didn't allow her to well. We we caused some TM J. Pain and struggling to get that one advanced unst are struggling to get that one fixed We've probably lost her on that but most people take time pretty well. This is at high high. High percentage of wear in your haven't pretty pretty good success overall with them and in compliance. Okay Well Allan you've got anything more for proteomic as we're already very shooting overtime on this year. Alaska last thoughts or anymore hater aid aid hatred on the like. I like the Blue Kind Kevin. I can't argue with any of it. I can't argue with. I think you humint. I wanted to go get folding chairs and hit you cross the back with. There's my thing is that I suspect there are a lot of clinicians that are like me where it's it isn't it isn't that it can't be done well. It's that it's stuck in their brain and I mean there's a lot of things in dentistry with me stuck in my brain and with the things that I don't do implants are them on some level too. But I I mean your cases well-made to ruin his always made a good case for it too so it's for those of you who don't have weird hang ups like I do Three dentists gives great courses on this stuff. I've got great courses on everything. Setup is so good yeah you take errands one on one class. Even if you're not GonNa do it you need to at least be aware of it. And that's my challenge to. I don't know if you've taken it Ellen but back doc I took it private for you did. Yeah I have not taken it. That's my talents. dixie Oh yeah okay. Well thank you Allan for stepping stepping in for Mac. Who hopefully as hairs clear should be just leeming? You Bet you bet. So we're Allen Megyn for Kevin. Prior Zach Myers. Thanks for joining us. And we will catch you X. Time..