Tag Archives: dental

Oral Appliance Therapy for OSA: Are you qualified to own the Risk?

Every so often I hear about yet another professional aside from a

Oral Appliance Therapy for OSA: Are you qualified to own the Risk?
Oral Appliance Therapy for OSA: Are you qualified to own the Risk?

Dentist providing Sleep Apnea Appliances: Denture Therapists, ENT’s, Sleep Physicians, Chiropractors etc. This begs the question; who is actually “Qualified” to own the risk of providing this therapy.

 

This week, a local “Sleep Experienced” Dentist complained to his lab when the Dorsal appliance he just inserted extracted 3 teeth on removal. Of course, these periodontally compromised teeth should have been considered in the treatment planning stage, an omission that was clearly, his and only his responsibility. I am not criticizing this Dentist’s efforts, unfortunately, errors happen. But tell me, when a Denturist, ENT or Chiropractor makes a Sleep Apnea Oral appliance, whom is expected to take on this responsibility? Only adding to the significance of this issue, keep in mind that this responsibility does not end, ever! As long as a patient is wearing an oral appliance, the professional that placed it has taken on an obligation to monitor not only the continued effectiveness of the appliance but also the continued health of the dentition, supporting structures and TMJ. So, unless a professional is accepting of this responsibility it would be medico-legally and ethically prudent for them to leave this area of practice to those qualified practitioners that are able and willing to do so; within their licensure. For those remaining unconcerned about this caution. Consider this, often liability insurance does not cover issues that arise from venturing outside of licensure, but don’t sweat it. A very good friend once pointed out to me that there is no such thing as “No Insurance”. Everyone is insured, even if it is with their “Beach House”.

This may leave some wondering if their “Scope of Practice” includes the management of Sleep Apnea with an Oral Appliance. The American Academy of Dental Sleep Medicine (AADSM) provides readily available guidance in this regard. Look up “Standards for Dental Sleep Medicine Facility Accreditation”, if what they are mandating is outside of your scope of practice (ie. you are not licensed to perform those requirements) and you continue practicing Sleep Disorders Dentistry I suggest that you make sure your liability insurance is paid up. It’s not a matter of “if” this will catch up with you it’s a matter of “when”.

John Viviano B.Sc. DDS Diplomate ABDSM

John Viviano B.Sc. DDS Diplomate ABDSM

John Viviano B.Sc. DDS Diplomate ABDSM; from Mississauga ON Canada,obtained his credentials from U of T in 1983, he provides conservative therapy for snoring and sleep apnea in his clinic, Limited to the Management of Breathing Related Sleep Disorders. A member of various sleep organizations, he is a Credentialed Diplomate of the American Board of Dental Sleep Medicine, and has lectured internationally regarding management of Sleep-Disordered Breathing and the use of Acoustic Reflection. Dr Viviano has also conducted original research, authored articles and established protocols on the use of Acoustic Reflection for assessing the Upper Airway and its Normalization. For more info or to contact Dr Viviano click: Sleep Disorders Dentistry

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Scottsdale Study Club Announces and Sets Dates for Clinical Workshops and Meetings Focused on Dental Treatments of Sleep Disordered Breathing, Bruxism and TMD/Headache

The Scottsdale Study Club announces its 12-month meeting schedule to include monthly club meetings as well as monthly hands-on clinical workshops with patients. The focus of this educational environment is to provide direct one-on-one experience with Dentists who have successfully integrated sleep dentistry into their practices.

About the Workshops and Meetings

General session fees are $1,499 and Workshops are $2,200. Each Dentist is welcome to bring an assistant or auxiliary to the club meeting. For information or to register to attend the meeting, please call 760-633-4162..

Topics and focus of each meeting will be determined by the mentors and may change without notice depending on the number attendees and perceived areas of academic interest. There will be no exhibits at the Study Club meetings.

Background on the Mentors

Dr. Edward Spiegel, DDS: After treating a series of patients in the 1980’s with temporomandibular joint disorder by way of oral appliances, in 1992, he discovered an interesting correlation. As he treated these patients with oral appliances their snoring stopped. Having confirmed this finding after a retrospective case review, he began to evaluate the use of oral appliances to stop patients snoring and in turn the utility of oral appliances in solving a much larger health problem: Sleep Disordered Breathing conditions such as Obstructive Sleep Apnea (OSA).

He designed a rudimentary treatment protocol within his own office based on the dental management of Sleep Disordered Breathing by way of Oral Appliance Therapy.  The local success of his clinical program in Erie, PA was mirrored nationally by dental practices emulating his treatment plan. He then created a clinical protocol intended for the dental assessment and treatment of snoring and other airway-related sleep disorders. The result is a turn-key system for the dental management of Sleep Disordered Breathing.

 

Bradley Eli, DMD, MS: Bradley Eli has a 20 year history of work in the field of Orofacial Pain management (head and neck). Upon completion of his UCLA program there were less than 10 like providers within the United States. In 1995, he began the work in the field of Sleep Medicine and then began the STAR (Sleep Treatment and Research) Institute.  This unique early look at the field has assisted him in the development of methods and solutions to assist patients with these life changing pain and sleep disorders.

 

Location

SleepScholar Study Club General Session

14635 N Kierland Blvd., Ste. 154

Scottsdale, AZ, 85254

Seating is limited and will be assigned on a first come first serve basis

 

Calendar of Events 2011

September 16- 17, 2011

Where are the patients?

  • Evaluation of dental patients at each dental appointment for signs and symptoms of untreated sleep disorders
  • Conversion from dental to medical
  • Dental insurance vs. Medical Insurance including Medicare
    AASM as well as AADSM guidelines for treatment in the dental office
  • Hands-on workshop for patient evaluation and treatment

 

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Michael Childres, Bradenton, FL

Dr. Michael Gluhareff, Ocala, FL

Dr. Edward Spiegel, Scottsdale, AZ

Dentists and one staff member will learn proper patient evaluation, examination, jaw registration, and dental and medical records.

October 14-15, 2011

Bruxism, TMD and Sleep

  • Etiology of Bruxism, use of the Ordinal Scale as well as tie in to TMD and Sleep Disorders
    Home Sleep Test Nox T3
  • Evaluation of the patient, documentation and medical billing for ABI
  • Treatment options in the pediatric patient as well as adult patient
  • Orthodontic evaluation and early treatment
  • TMD evaluation of patients as well as treatment planning
  • Sleep patient present with symptoms of pain and pre existing conditions
  • Hands-on evaluation of patient dentition and treatment planning
  • Proper medical referral and medical billing

 

Mentor Spotlight

Dr. Devin Croft, Orthodontist, Peoria, AZ

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

 

November 4-5, 2011

Diagnostic Testing

  • Diagnostic testing in the dental office for TMD and Oral Appliance
  • Evaluating diagnostic testing for use id the dental office
  • Literature support, clinical guidelines for treatment planning as well as follow-up records and documentation to insurance carriers
  • AAOP as well as AACP Guidelines for treatment and evaluation of patients
  • Hands-on evaluation for patients as well as discussion on treatment planning

Mentor Spotlight

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

December 2-3, 2011

Oral Appliance Selection

  • Discussion on the most used oral devices for Bruxism, TMD and OSA
  • Pricing as well as indications and contra indications of oral devices with a 510(k) number
  • Various jaw registration devices for recording the maxillary/mandibular relationship
  • Long-term use of Oral Appliances
  • Trouble-shooting problems associated with oral appliances
  • Materials for accurate impressions for oral devices

Mentor Spotlight
Mr. Randy Clare, Aliso Viejo, CA

Dr. Edward Spiegel, Scottsdale, AZ

 

Calendar of Events 2012

February 10-11, 2012

Where are the patients?

  • Evaluation of dental patients at each dental appointment for signs and symptoms of untreated sleep disorders
  • Conversion from dental to medical
  • Dental insurance vs. Medical Insurance including Medicare
    AASM as well as AADSM guidelines for treatment in the dental office
  • Hands-on workshop for patient evaluation and treatment

 

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Michael Childres, Bradenton, FL

Dr. Michael Gluhareff, Ocala, FL

Dr. Edward Spiegel, Scottsdale, AZ

Dentists and one staff member will learn proper patient evaluation, examination, jaw registration, and dental and medical records.

March 9-10, 2012

Bruxism, TMD and Sleep

  • Etiology of Bruxism, use of the Ordinal Scale as well as tie in to TMD and Sleep Disorders
  • Evaluation of the patient, documentation and medical billing for ABI
  • Treatment options in the pediatric patient as well as adult patient
  • Orthodontic evaluation and early treatment
  • TMD evaluation of patients as well as treatment planning
  • Sleep patient present with symptoms of pain and pre existing conditions
  • Hands-on evaluation of patient dentition and treatment planning
  • Proper medical referral and medical billing

Mentor Spotlight

Dr. Devin Croft, Orthodontist, Peoria, AZ

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

April 13-14, 2012
Diagnostic Testing

  • Diagnostic testing in the dental office for TMD and Oral Appliance
  • Evaluating diagnostic testing for use id the dental office
  • Literature support, clinical guidelines for treatment planning as well as follow-up records and documentation to insurance carriers
  • AAOP as well as AACP Guidelines for treatment and evaluation of patients
  • Hands-on evaluation for patients as well as discussion on treatment planning

Mentor Spotlight

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

May 11-12, 2012

Oral Appliance Selection

  • Discussion on the most used oral devices for Bruxism, TMD and OSA
  • Pricing as well as indications and contra indications of oral devices with a 510(k) number
  • Various jaw registration devices for recording the maxillary/mandibular relationship
  • Long-term use of Oral Appliances
  • Trouble-shooting problems associated with oral appliances
  • Materials for accurate impressions for oral devices

Mentor Spotlight
Mr. Randy Clare, Aliso Viejo, CA

Dr. Edward Spiegel, Scottsdale, AZ

 

June 8-9, 2011

Where are the patients?

  • Evaluation of dental patients at each dental appointment for signs and symptoms of untreated sleep disorders
  • Conversion from dental to medical
  • Dental insurance vs. Medical Insurance including Medicare
    AASM as well as AADSM guidelines for treatment in the dental office
  • Hands-on workshop for patient evaluation and treatment

 

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Michael Childres, Bradenton, FL

Dr. Michael Gluhareff, Ocala, FL

Dr. Edward Spiegel, Scottsdale, AZ

Dentists and one staff member will learn proper patient evaluation, examination, jaw registration, and dental and medical records.

July 13-14, 2012

Bruxism, TMD and Sleep

  • Etiology of Bruxism, use of the Ordinal Scale as well as tie in to TMD and Sleep Disorders
  • Evaluation of the patient, documentation and medical billing for ABI
  • Treatment options in the pediatric patient as well as adult patient
  • Orthodontic evaluation and early treatment
  • TMD evaluation of patients as well as treatment planning
  • Sleep patient present with symptoms of pain and pre existing conditions
  • Hands-on evaluation of patient dentition and treatment planning
  • Proper medical referral and medical billing

Mentor Spotlight

Dr. Devin Croft, Orthodontist, Peoria, AZ

Dr. Bradley Eli, UCLA 2-year residency, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

Clinical Workshops

The intention of the workshop format is to exercise the new skills as learned at the general session in a controlled environment. There will be time provided in this forum for attendee case presentations and the exchange of information that will lead to an excellent educational outcome.

The Apnea and TMJ/Headache workshop will be conducted in small groups with patients in a dental office.

The PSG course will be conducted in a hotel room where a complete sleep diagnostic facility will be re-created for the purpose of demonstrating and teaching the process of collecting sleep study data.

 

Location for Apnea and TMJ/Headache Workshops

Vistancia Ortho

9772 W. Yearling Rd Suite A-1600

Peoria, AZ 85383

(All materials for the training will be provided onsite)

 

Location for the Overnight Polysomnography Workshops

Embassy Suites

4415 E. Paradise Village Pkwy South
Phoenix, AZ 85032

 

Calendar of Events 2011

September 23-25, 2011

Overnight PSG (Limited to 12 Dentists)

  • Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
  • Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
  • Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel

 

October 21-22, 2011

Chairside Sleep Apnea

  • Medical legal aspects involved in treating the Bruxing, TMD and Sleep patient
  • Health care attorney will review medical insurance guidelines. Medicare guidelines including anti-fraud, anti-kickback and Stark Laws.
  • Informational seminars for Snoring, TMD as well as Sleep Disorders.
  • How to organize market and follow-up.
  • Working with the sleep lab.  How to legally refer patients with medical insurance as well as Medicare.

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

November 18-19, 2011

TMD and Headache

  • Headache classifications relationship between Headache/TMD/Sleep
  • Diagnostic Process-unique for headache and unique for sleep
  • Recommended Communication with Physicians
  • Medications in Headache Management
  • Oral Appliance Therapy

Headache

Jaw Disorders

Sleep Disorders

  • Injection uses in Headache Disorders
  • Injection techniques for Headache
  • Injection technique for TMD
  • Review of Tx  method of action PAP vs Mandibular advancement

 

 

Mentor Spotlight

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

December 16-18, 2011

Overnight PSG (Limited to 12 Dentists)

  • Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
  • Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
  • Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel


Calendar of Events 2012

February 24-25, 2012

Chairside Sleep Apnea

  • Medical legal aspects involved in treating the Bruxing, TMD and Sleep patient
  • Health care attorney will review medical insurance guidelines. Medicare guidelines including anti-fraud, anti-kickback and Stark Laws.
  • Informational seminars for Snoring, TMD as well as Sleep Disorders.
  • How to organize market and follow-up.
  • Working with the sleep lab.  How to legally refer patients with medical insurance as well as Medicare.

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

March 23-24, 2012

TMD and Headache

  • Headache classifications relationship between Headache/TMD/Sleep
  • Diagnostic Process-unique for headache and unique for sleep
  • Recommended Communication with Physicians
  • Medications in Headache Management
  • Oral Appliance Therapy

Headache

Jaw Disorders

Sleep Disorders

  • Injection uses in Headache Disorders
  • Injection techniques for Headache
  • Injection technique for TMD
  • Review of Tx  method of action PAP vs Mandibular advancement

 

Mentor Spotlight

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

April 27-29, 2012

Overnight PSG (Limited to 12 Dentists)

  • Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
  • Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
  • Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel

 

May 25-26, 2012

Chairside Sleep Apnea

  • Medical legal aspects involved in treating the Bruxing, TMD and Sleep patient
  • Health care attorney will review medical insurance guidelines. Medicare guidelines including anti-fraud, anti-kickback and Stark Laws.
  • Informational seminars for Snoring, TMD as well as Sleep Disorders.
  • How to organize market and follow-up.
  • Working with the sleep lab.  How to legally refer patients with medical insurance as well as Medicare.

Mentor Spotlight

Dr. Rodney Willey, Peoria, IL

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

June 22-23, 2012

TMD and Headache

  • Headache classifications relationship between Headache/TMD/Sleep
  • Diagnostic Process-unique for headache and unique for sleep
  • Recommended Communication with Physicians
  • Medications in Headache Management
  • Oral Appliance Therapy

Headache

Jaw Disorders

Sleep Disorders

  • Injection uses in Headache Disorders
  • Injection techniques for Headache
  • Injection technique for TMD
  • Review of Tx  method of action PAP vs Mandibular advancement

 

Mentor Spotlight

Dr. Bradley Eli, San Diego, CA

Dr. Edward Spiegel, Scottsdale, AZ

July 27-29, 2012

Overnight PSG (Limited to 12 Dentists)

  • Overnight Sleep Polysomnography two-night PSG of patient for diagnosis as well as second night treatment with CPAP and Oral Appliance.
  • Dentist will see actual examination of patient as well as patient prepared for PSG with evaluation and live data being recorded.
  • Discussion of PSG results as well as a comparison of CPAP and OA treatment as recorded by the PSG.

Mentor Spotlight
Mr. Jeffory Wyscarver

Mr. Randy Clare

Dr. Edward Spiegel

 

Randy Clare

Randy Clare

Randy Clare brings to Sleep Scholar more than 25 years of extensive knowledge and experience in the sleep field. He has held numerous management positions throughout his career and has demonstrated a unique view of the alternate care diagnostic and therapy model. Mr. Clare's extensive sleep industry experience assists Sleep Scholar in providing current, relevant, data-proven information on sleep diagnostics and sleep therapies that are effective for the treatment of sleep disorders.

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