Dental Sleep Medicine in Restorative Practice Part 9: Marketing Dental Sleep Medicine 

February 28, 2024 Todd Sander, DMD

Dental Sleep Medicine in Restorative Practice Part 9: Marketing Dental Sleep Medicine 

By Todd Sander DDS 

How do you start reaching out to physicians and other providers to build a dental sleep medicine practice? Start with the ones you know. Start with your own personal physician and start a conversation. If your dental patient is on CPAP, get permission to converse with their doctor. I spend time contacting many primary care doctors and find they are the ones who know patients are non-compliant with their CPAP therapy. They help me get patients re-evaluated by a sleep specialist. 

This may not be true in your community, but in Charleston, SC, where I practice, many primary care doctors don’t know what to do with their non-compliant CPAP patients. They are thrilled to have someone to refer them to try alternative therapy. 

Years ago, I reached out to sleep testing centers to communicate my services. Both independent sleep labs and hospital-based sleep labs have been great sources of referrals. For many years, I was the dental advisor to a sleep lab. A great conversation starter with sleep physicians, is the potential of combining CPAP and an oral appliance. This often allows the CPAP air pressure to be turned down so their patients be more comfortable and compliant. 

When you screen your dental patients for airway issues such as sleep apnea and snoring, the next step is referring your patients with issues for a sleep study. When the patient discusses their symptoms with their primary care physician or a sleep physician, you are mentioned and often documented as making the referral. Over time, physicians come to know you as a go-to provider of dental sleep appliance therapy. This process is sped up when you take the time and initiative to contact your patient’s primary care physician with your patient’s permission. You can guide physicians and remind them of the recommended standards-of-care, including appliance therapy in place of or in combination with CPAP therapy. 

Some patients self-refer to me, as friends and family talk about their experiences in my office, but I am not spending money on digital advertising to bring in dental sleep medicine patients. Mostly, they are referred to me by physicians, dentists, and other patients.  This is the same for my dental practice. 

As mentioned in a previous part of this series, our hygienists have attended dental sleep medicine courses with me and screen for airway issues. They adeptly educate and guide patients who have signs and symptoms to schedule an examination and consultation with me. 

Note: When patients are referred to me for dental sleep medicine, I never encourage them to become dental patients in our practice. This is a choice they might make but I am extremely careful to refer patients referred by a dentist back to their referring dentist for all dental needs. I am an adjunct to help other dentists’ patients fulfill a prescription for a dental appliance. 

If a patient comes in for sleep-disordered breathing but is also experiencing facial pain or TMD, I understand that this patient’s two issues are likely connected and I will not be able to successfully treat one without treating the other. This is an opportunity to communicate in depth with the referring dentists and let them know I plan to treat the patient for both issues simultaneously. This has been easier for me to do because I have had years of experience in treating facial pain and TMD issues in my dental practice, as well as sleep apnea and snoring. 

Related Course

Mastering Business Essentials

DATE: August 7 2025 @ 8:00 am - August 15 2025 @ 12:00 pm

Location: The Pankey Institute

CE HOURS: 22

Regular Tuition: $ 3295

Single Bed with Ensuite Bath: $ 345

The Blueprint for Running a Practice with Long-Term Growth Dr. Pankey’s original philosophy encouraged dental professionals to be proficient in 3 specific areas: technical mastery, behavioral excellence and business savvy….

Learn More>

About Author

User Image
Todd Sander, DMD

Dr. Todd Sander is a graduate of The University of North Carolina at Chapel Hill, the School of Dentistry at Temple University, and a one-year Advanced Education in General Dentistry residency with the US Army at Fort Jackson, SC. He completed three years of active duty with the US Army Dental Corps and served in Iraq for 11 months. Dr. Sander completed more than 500 hours of postgraduate training at the Pankey Institute for Advance Dental Education and is one of only three dentists in the Charleston area to hold such a distinction. Dr. Sander is also affiliated with the American Dental Association, South Carolina Dental Association, American Academy of Cosmetic Dentistry, Academy of General Dentistry, and American Academy of Dental Sleep Medicine. Areas of special interest include: TMJ disorders; advanced dental technology; cosmetic dentistry; full mouth reconstruction; sleep apnea /snoring therapy; Invisalign orthodontics.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Dental Sleep Medicine in Restorative Practice Part 7: Team Investment

February 12, 2024 Todd Sander, DMD

Dental Sleep Medicine in Restorative Practice Part 7: Team Investment 

By Todd Sander DMD 

If a dentist wants to provide dental sleep medicine within a restorative practice, everyone needs to be on the same page when making room on the schedule for sleep patients. It would be best to have a couple of champions on your team to support you in your efforts. 

The first champion you need is a sleep patient coordinator who has excellent phone skills and a high interest in what you want to achieve. This team member needs a working knowledge of sleep medicine and to be able to talk with patients about dental sleep medicine over the phone. Ideally, this team member has excellent phone skills and cares about sleep-related breathing disorders and pulmonary issues.  

If another receptionist receives a sleep dental medicine inquiry, our protocol is to take a message and have our sleep patient coordinator call the prospective new patient right back. This has worked well in our practice with a high rate of conversion. 

The second champion you need is a motivated clinical assistant. Hygienists and expanded-function dental assistants make phenomenal sleep assistants because they are driven to learn and do new things. In Parts 3 and 4 of this series, I described tasks my clinical assistant typically performs, so I can best use my time with the patient. For many years, one of our hygienists who had a passion for dental sleep medicine worked with me in developing the sleep side of the practice and was my clinical assistant with sleep patients. In our practice, her role was half traditional hygiene and half sleep dental medicine. 

For years, I have taken our entire staff to sleep courses, even team members who are not helping a lot with dental sleep medicine. I want my team to understand why I am developing the dental sleep medicine practice inside my restorative practice, how they can support it best, and receive formal training to pitch in when needed.  

Don’t forget to invest in yourself because you are the key team member. Today, there are several good sleep dental medicine courses, including at The Pankey Institute. The Pankey Institute courses and its dental sleep medicine study club are excellent.  

Related Course

TMD & Orofacial Pain: Managing Complex Patients

DATE: January 29 2025 @ 8:00 am - February 2 2025 @ 1:00 pm

Location: The Pankey Institute

CE HOURS: 37

Dentist Tuition: $ 7200

Single Occupancy with Ensuite Private Bath (per night): $ 345

TMD patients present with a wide range of concerns and symptoms from tension headaches and muscle challenges to significant joint inflammation and breakdown. Accurate thorough diagnosis is the first step…

Learn More>

About Author

User Image
Todd Sander, DMD

Dr. Todd Sander is a graduate of The University of North Carolina at Chapel Hill, the School of Dentistry at Temple University, and a one-year Advanced Education in General Dentistry residency with the US Army at Fort Jackson, SC. He completed three years of active duty with the US Army Dental Corps and served in Iraq for 11 months. Dr. Sander completed more than 500 hours of postgraduate training at the Pankey Institute for Advance Dental Education and is one of only three dentists in the Charleston area to hold such a distinction. Dr. Sander is also affiliated with the American Dental Association, South Carolina Dental Association, American Academy of Cosmetic Dentistry, Academy of General Dentistry, and American Academy of Dental Sleep Medicine. Areas of special interest include: TMJ disorders; advanced dental technology; cosmetic dentistry; full mouth reconstruction; sleep apnea /snoring therapy; Invisalign orthodontics.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Dental Sleep Medicine in Restorative Practice Part 6: The Question of Software

February 9, 2024 Todd Sander, DMD

Dental Sleep Medicine in Restorative Practice Part 6: The Question of Software 

By Todd Sander DMD 

Numerous companies offer software solutions for dental sleep medicine that integrate with billing services. These companies can take over the paperwork and billing for medical insurance. Some of them have letter templates built into them.  

I look at software all the time, and when I do, I evaluate the efficiency we would gain versus the number of appliances I would need to deliver to make using the software worthwhile. Their billing service fees are high. Currently, I average 10-15 dental sleep medicine patients per quarter and not all of these are candidates for oral appliance therapy. Remember, I have a busy restorative practice. Colleagues who practice full-time dental sleep medicine may see this number in a week! 

I’ve been fortunate to have team members who don’t mind researching how to file medical insurance claims for appliances. Most of my colleagues use a software platform designed for dental sleep medicine. So far, I have chosen not to use one. Instead, I have assigned the duties to team members and they have taken dental sleep medicine, Eaglesoft, and medical billing courses. Currently, we have customized template forms and letters in our Eaglesoft system but it is not set up for filing medical claims.  I must admit, it is getting harder to do this. and I may be forced to decide about dedicated software soon. However, the decision will be made considering financial feasibility as a primary concern. 

It did take time to develop our template forms and letters in Eaglesoft but now we are highly efficient. I dictate the notes for our records, the SOAP note for medical insurance, and the information we want to share in letters with physicians. In addition to the cost savings, I like that I am recording the data I want in my documentation in a structure I want for how I practice—not just for the SOAP note and representing my findings to referring physicians. 

One of my mentors has me considering the possibility that I might want to separate my dental sleep medicine patients’ charting from my dental patients’ charting. Using software designed for the practice of dental sleep medicine would give me a clean way to segregate the patients on my computers. So far, I’ve decided that the expense of the software will not give me a return on my investment. 

Related Course

TMD & Orofacial Pain: Managing Complex Patients

DATE: January 29 2025 @ 8:00 am - February 2 2025 @ 1:00 pm

Location: The Pankey Institute

CE HOURS: 37

Dentist Tuition: $ 7200

Single Occupancy with Ensuite Private Bath (per night): $ 345

TMD patients present with a wide range of concerns and symptoms from tension headaches and muscle challenges to significant joint inflammation and breakdown. Accurate thorough diagnosis is the first step…

Learn More>

About Author

User Image
Todd Sander, DMD

Dr. Todd Sander is a graduate of The University of North Carolina at Chapel Hill, the School of Dentistry at Temple University, and a one-year Advanced Education in General Dentistry residency with the US Army at Fort Jackson, SC. He completed three years of active duty with the US Army Dental Corps and served in Iraq for 11 months. Dr. Sander completed more than 500 hours of postgraduate training at the Pankey Institute for Advance Dental Education and is one of only three dentists in the Charleston area to hold such a distinction. Dr. Sander is also affiliated with the American Dental Association, South Carolina Dental Association, American Academy of Cosmetic Dentistry, Academy of General Dentistry, and American Academy of Dental Sleep Medicine. Areas of special interest include: TMJ disorders; advanced dental technology; cosmetic dentistry; full mouth reconstruction; sleep apnea /snoring therapy; Invisalign orthodontics.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Dental Sleep Medicine in Restorative Practice Part 5: Selecting Appliances

January 31, 2024 Todd Sander, DMD

Dental Sleep Medicine in Restorative Practice Part 5: Selecting Appliances 

By Todd Sander DMD 

This article is written for dentists who are thinking about or just starting a dental sleep medicine practice. I do both restorative dentistry and dental sleep medicine, and by sharing what I do, I hope to help others with their planning. 

There are many other types of appliances you can consider and I am always looking at them. But to become most efficient, I have narrowed down the types of appliances I deliver. Most commonly, these are Dorsal and Herbst appliances. Both are titratable, as the patient needs more advancement over time. 

The dorsal appliance resembles a custom-fitted mouthguard, worn only during sleep. It uses advancement blocks with an orthodontic screw to advance the jaw. There are many manufacturers, and it is easy to deliver. It doesn’t impinge on the tongue, so patients find it comfortable. It is fairly durable and repairable, especially if milled out of acrylic. This is my go-to type of appliance for most patients because patients respond favorably to them. 

A Herbst appliance is more durable for parafunctional patients and fairly comfortable. Patients are sometimes intimidated when they first look at this type of appliance but I always point out that the advancement bars are in the dead space of the cheeks, and they won’t feel them. There are many types of Herbst appliances with different types of advancement arms. 

I sometimes deliver an EMA appliance or a TAP 3 appliance. I have found that the screw and bar assembly of TAP appliances can impinge the tongue a little. My preference is to use appliances that provide more room for the tongue to move forward. Milling and 3D printing have introduced many low-profile, stable, and comfortable appliances that deserve investigation.  

Whatever appliance you decide to use, become knowledgeable and proficient with it. You want to convey confidence to your patients. The more they trust in the appliance, the more compliant they will be with wearing it and the sooner they can achieve improvement of their sleep breathing issues. Oftentimes, they will feel better within a week or two and report this during their first recall visit. When they report improved symptoms, we can move on to confirming the treatment position with a home sleep monitor and refer them back to their physician. Treatment position can also be confirmed prior to appliance fabrication by using a MyTAP temporary appliance.  This can improve the initial treatment position and is necessary for non-titratable appliances. 

With most patients, we take two steps forward and one step back as we titrate an appliance to an effective treatment position. Sometimes I need to send an appliance back, so I’ve become used to taking a bite registration myself and sending it to the lab to reset the appliance in a more forward position.  Using a MyTAP to determine treatment position ahead of time helps prevent this. We prepare our patients for this possibility and provide encouragement to stay on course. Working as a team with our patients, we will get there! 

Related Course

TMD & Orofacial Pain: Managing Complex Patients

DATE: January 29 2025 @ 8:00 am - February 2 2025 @ 1:00 pm

Location: The Pankey Institute

CE HOURS: 37

Dentist Tuition: $ 7200

Single Occupancy with Ensuite Private Bath (per night): $ 345

TMD patients present with a wide range of concerns and symptoms from tension headaches and muscle challenges to significant joint inflammation and breakdown. Accurate thorough diagnosis is the first step…

Learn More>

About Author

User Image
Todd Sander, DMD

Dr. Todd Sander is a graduate of The University of North Carolina at Chapel Hill, the School of Dentistry at Temple University, and a one-year Advanced Education in General Dentistry residency with the US Army at Fort Jackson, SC. He completed three years of active duty with the US Army Dental Corps and served in Iraq for 11 months. Dr. Sander completed more than 500 hours of postgraduate training at the Pankey Institute for Advance Dental Education and is one of only three dentists in the Charleston area to hold such a distinction. Dr. Sander is also affiliated with the American Dental Association, South Carolina Dental Association, American Academy of Cosmetic Dentistry, Academy of General Dentistry, and American Academy of Dental Sleep Medicine. Areas of special interest include: TMJ disorders; advanced dental technology; cosmetic dentistry; full mouth reconstruction; sleep apnea /snoring therapy; Invisalign orthodontics.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Dental Sleep Medicine in Restorative Practice Part 4: Treatment Monitoring

January 26, 2024 Todd Sander, DMD

Dental Sleep Medicine in Restorative Practice Part 4: Treatment Monitoring 

By Todd Sander DMD 

One week after a dental sleep medicine patient is given their appliance I have them return for a follow-up appointment with my clinical assistant. During this appointment, we want to determine if the patient is having any issues. It takes a little time for patients to become accustomed to wearing their appliance and most patients have questions, so this appointment is a time to reassure them and reinforce instructions for advancement if the patient has a titratable appliance. After one week, many start to experience the benefits of 50 to 60% advancement. 

We bring them back again at four to six weeks, at which time, we review their medical history and see if there have been changes. We also evaluate their compliance. We have a sleep log for patients to fill out every morning after they wake. We ask them to make notes about the quality of their sleep. We also have a report form for the patient’s bed partner if the patient has one to make note of the patient’s sleep quality. Believe it or not, spouses/bed partners are accurate 80% of the time when compared with sleep monitors. My clinical assistant reviews the sleep logs and medical history, performs a preliminary appliance check, and lets me know the highlights. Then I come in and perform a thorough examination and lead a discussion to determine how well the patient is adapting to the appliance. 

If the patient is doing well with compliance and feels the therapeutic value of the appliance is adequate, I might decide to skip the eight to ten-week appointment and go straight to confirmation of resolution of symptoms with some sort of monitor. If the patient is not doing well or cannot advance comfortably, then we work out a plan. It is important to note that there are many effective appliances that are non-titratable and fabricated in a fixed position. With these appliances, I work out the titration to the treatment position in My TAP following a similar protocol before prescribing a treatment position in a final appliance. 

Note that we often see issues that cross over into the area of facial pain and temporomandibular joint problems. Many patients doing sleep appliance therapy have these problems, so if you want to do sleep dental medicine, be prepared to also manage your patients through facial pain and TMD issues as you titrate their appliances. 

Usually, in eight to ten weeks, we have successfully taught our patients to self-titrate the appliance to a comfortable treatment position, and we can move to monitor its effectiveness. We are always available to answer questions.  

People wearing Fitbits and iWatches can use snore lab apps. By self-monitoring, they have a good sense of when their appliance is in a good treatment position. In our practice, we always confirm this with either a high-resolution pulse oximetry monitor or a peripheral arterial tone monitor. These two types of monitors provide data we give the referring physician. I always send a letter and report back to the patient’s sleep physician and general dentist (if the patient is not also a general dentistry patient), and I ask the patient’s permission to include their primary doctor in the loop.  

After this, I see my sleep dental medicine patients for a six-month visit, then once a year for an annual visit. Often there are issues to be addressed. Sometimes the appliances need to be titrated a little bit more. Sometimes patients have been seating them improperly. Sometimes we see bite changes to address and document. 

Related Course

TMD & Orofacial Pain: Managing Complex Patients

DATE: January 29 2025 @ 8:00 am - February 2 2025 @ 1:00 pm

Location: The Pankey Institute

CE HOURS: 37

Dentist Tuition: $ 7200

Single Occupancy with Ensuite Private Bath (per night): $ 345

TMD patients present with a wide range of concerns and symptoms from tension headaches and muscle challenges to significant joint inflammation and breakdown. Accurate thorough diagnosis is the first step…

Learn More>

About Author

User Image
Todd Sander, DMD

Dr. Todd Sander is a graduate of The University of North Carolina at Chapel Hill, the School of Dentistry at Temple University, and a one-year Advanced Education in General Dentistry residency with the US Army at Fort Jackson, SC. He completed three years of active duty with the US Army Dental Corps and served in Iraq for 11 months. Dr. Sander completed more than 500 hours of postgraduate training at the Pankey Institute for Advance Dental Education and is one of only three dentists in the Charleston area to hold such a distinction. Dr. Sander is also affiliated with the American Dental Association, South Carolina Dental Association, American Academy of Cosmetic Dentistry, Academy of General Dentistry, and American Academy of Dental Sleep Medicine. Areas of special interest include: TMJ disorders; advanced dental technology; cosmetic dentistry; full mouth reconstruction; sleep apnea /snoring therapy; Invisalign orthodontics.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Dental Sleep Medicine in Restorative Practice Part 3: Exam and Appliance Delivery Protocols

January 22, 2024 Todd Sander, DMD

My regular examination and treatment protocols for dental sleep medicine patients are based on what I learned from mentors, but I’ve molded them for my style of practice.  

Screening—Years ago, I offered 15-minute consultations for anyone who wanted to learn about dental sleep medicine and alternatives to CPAP. I found that patients were already well-versed, so I don’t do that anymore. When my team members answer the phone, they often answer insurance-related questions, and my team members have learned to answer those questions astutely. While on the phone, they weed out those just curious about how a dentist might help them and focus on those likely to be committed to my process and accept treatment. I have team members who are knowledgeable about oral appliances and quickly answer questions about them over the phone. 

Pre-Examination Records—Referred patients scheduled for a comprehensive dental sleep medicine exam are sent paperwork to complete before their examination. My clinical assistants gather the paperwork, including a detailed medical history, the referral from a sleep physician, the letter of medical necessity, and their polysomnogram, if they have had it, and the hypnogram. We gather as much data from the physician as possible. I review this in advance of seeing the patient. 

Pre-Examination Records Created by My Clinical Assistant—When patients arrive for their initial two-hour appointment, my clinical assistant takes digital impressions (sometimes we take traditional PVS impressions) and x-rays. She also collects vitals and interviews the patient just as a medical assistant would in a medical office. 

Examination—During a thorough examination, I voice-record the information needed for the medical documentation. By the end of the exam, I know what the patient’s treatment options are going to be and the anticipated charge for treatment. Sometimes the patient is not a candidate for a sleep appliance and I refer the patient to their physician. We still get paid for the comprehensive exam. Our patients are prepared for this. Even if we can’t help them, they appreciate the time we spend. When each patient leaves the comprehensive exam, we have all the information we need, including a protrusive bite registration if the patient is to receive an appliance. 

Medical Reimbursement—In my practice, payment is due upfront for the examination. If they know this is coming in, they’re accepting of this. We have chosen to do our best to help patients seek medical reimbursement and submit the required medical documentation for their insurance. We operate on a fee-for-service model, and this requires intentional conversations with patients so they will value our care, skill, and judgment whether insurance reimburses them or not. 

Second Appointment to Start Appliance Therapy—My clinical assistant helps by initially trying in the appliance we have had lab-fabricated. She educates the patient about warming the appliance in warm water if it is a thermoplastic material and fabricates a morning repositioner. Then I come in and do a fit check, spend more time adjusting the appliance if needed, answer questions, confirm that the appliance has been fabricated correctly, and review instructions for wearing the appliance and using the morning repositioner. For titratable appliances, I usually start an appliance at 50 to 60% protrusive if it’s a mandibular advancement appliance. I ask the patient not to advance the appliance for one week. If the appliance is titratable, we educate the patient on how to advance 1-2mm every two to three days until symptoms alleviate.  

Part 4 of this series will discuss how I monitor my sleep dental medicine patients. 

Related Course

TMD & Orofacial Pain: Managing Complex Patients

DATE: January 29 2025 @ 8:00 am - February 2 2025 @ 1:00 pm

Location: The Pankey Institute

CE HOURS: 37

Dentist Tuition: $ 7200

Single Occupancy with Ensuite Private Bath (per night): $ 345

TMD patients present with a wide range of concerns and symptoms from tension headaches and muscle challenges to significant joint inflammation and breakdown. Accurate thorough diagnosis is the first step…

Learn More>

About Author

User Image
Todd Sander, DMD

Dr. Todd Sander is a graduate of The University of North Carolina at Chapel Hill, the School of Dentistry at Temple University, and a one-year Advanced Education in General Dentistry residency with the US Army at Fort Jackson, SC. He completed three years of active duty with the US Army Dental Corps and served in Iraq for 11 months. Dr. Sander completed more than 500 hours of postgraduate training at the Pankey Institute for Advance Dental Education and is one of only three dentists in the Charleston area to hold such a distinction. Dr. Sander is also affiliated with the American Dental Association, South Carolina Dental Association, American Academy of Cosmetic Dentistry, Academy of General Dentistry, and American Academy of Dental Sleep Medicine. Areas of special interest include: TMJ disorders; advanced dental technology; cosmetic dentistry; full mouth reconstruction; sleep apnea /snoring therapy; Invisalign orthodontics.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Dental Sleep Medicine in Restorative Practice Part 1 

September 8, 2023 Todd Sander, DMD

Early in my career, I was introduced to oral appliances for treating OSA. While I was doing my residency in the Army, we saw patients with sleep disorders who couldn’t pass their flight physicals. Pilots were desperate for an alternative to CPAP because CPAP would ground them. Today, in my adult restorative practice, it’s clear that many patients benefit from an integrated approach to their oral health care and OSA therapy.

I started my private practice in Charleston, SC, in 2005. I was working with occlusal disorder and facial pain patients and several of them were non-compliant CPAP patients. One day, I was thumbing through my mail and noticed Dr. Henry Gremillion would be speaking at the Hinman Meeting on the connection between bruxism and sleep apnea. After hearing his presentation and reading the recommended literature, I thought sleep-disordered breathing may be at the root of many of my patients’ parafunction, evidenced by their persistent symptoms and the wear on their occlusal appliances. And it was this same population of patients who needed significant reconstructive restorative dentistry.

At the time, the American Academy of Dental Sleep Medicine was the only place where dental sleep medicine courses were available. So, I started with its introductory courses. It was clear that integrating dental sleep medicine into my practice protocols and educating my team and patients would take deliberate effort. There were questions I would have to address:

  • How much time would I need to invest in training for myself and my team?
  • How should I work sleep patients into my schedule?
  • Which of the 32 FDA-approved appliances should I use? (Now, there are several hundred to choose from.)
  • Should I invest in special software?
  • Which medical providers could I work with, and how?
  • How would I manage referrals?

My partner advised me to develop a vision and framework for my practice that would allow me to guide my team and focus my energies. I knew I would not be able to compete with others who were treating only sleep apnea patients. I decided that developing relationships with my patients would be as important for sleep dentistry as it is for restorative dentistry. And because I would also be dedicated to restorative dentistry, I would need to efficiently use my time to develop a niche practice in both restorative dentistry and dental sleep medicine.

With intentional forethought, my team learned how to screen interested patients and prequalify them for a comprehensive dental sleep medicine examination and consultation. I developed key people on my team to answer questions, gather the necessary information, and do preliminary work with incoming new sleep medicine patients. This preliminary work is much the same as that done by dental assistants in a restorative practice…reviewing the patient’s medical and dental history and taking digital impressions and X-rays.

When a comprehensive restorative patient comes to my practice, I do a 90-minute co-discovery examination, including sleep apnea screening. Then I take time in my lab doing diagnostic work with mounted models and plan treatment based on the radiographs, photographs, and other records we took during the comprehensive exam. The patient then returns for a consultation. If it is a complex restorative case, I spend time going over the treatment options, answering the patient’s questions, and developing my relationship with the patient. At this point, the patient is often ready to select treatment, and we move ahead with dental treatments. If the patient has the signs and symptoms of OSA, time is spent discussing the oral and systemic health benefits of having a sleep study and prescribed therapy. I refer my patient to sleep specialists I have developed a relationship with and know will provide a thorough evaluation. These specialists continue the OSA conversation and order a polysomnogram (sleep study) if deemed appropriate.

When a patient is referred to me by a physician to provide an oral appliance to replace CPAP or to be used in combination with CPAP, my comprehensive examination is a little different—with adaptations for medical documentation, but it is still 90 minutes. I have found that dental sleep medicine patients referred for sleep apnea treatment can usually be processed through their examination and treatment consultation in a single two-hour appointment. How I schedule my patients and the protocols I use will be discussed in future parts of this series.

Related Course

Smile Design: The 7 Deadly Sins

DATE: August 9 2024 @ 8:00 am - August 10 2024 @ 3:00 pm

Location: The Pankey Institute

CE HOURS: 16

Regular Tuition: $ 2195

Single Occupancy with Ensuite Private Bath (per night): $ 290

Designing Smiles is What We Do! From direct to indirect restorative – to clear aligners – to interdisciplinary care – designing smiles is what we do. Those who understand and…

Learn More>

About Author

User Image
Todd Sander, DMD

Dr. Todd Sander is a graduate of The University of North Carolina at Chapel Hill, the School of Dentistry at Temple University, and a one-year Advanced Education in General Dentistry residency with the US Army at Fort Jackson, SC. He completed three years of active duty with the US Army Dental Corps and served in Iraq for 11 months. Dr. Sander completed more than 500 hours of postgraduate training at the Pankey Institute for Advance Dental Education and is one of only three dentists in the Charleston area to hold such a distinction. Dr. Sander is also affiliated with the American Dental Association, South Carolina Dental Association, American Academy of Cosmetic Dentistry, Academy of General Dentistry, and American Academy of Dental Sleep Medicine. Areas of special interest include: TMJ disorders; advanced dental technology; cosmetic dentistry; full mouth reconstruction; sleep apnea /snoring therapy; Invisalign orthodontics.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR