Dental Sleep Medicine Insider January DSM Insider 2018 | Page 28

RICK VAN GURP WHAT DO YOU DO FOR A LIVING? A it’s important for patients to know where we are coming from and what is involved in what we do. Look closely, these are two very dif- ferent answers. For example, when I consult with patients, certainly I will show pro- spective patients examples of dental devices, how they work and even the pluses and minuses of therapy, but the consult primarily centers around how I can potentially di- rectly help or facilitate helping the patient improve their quality of life and breathe better while sleeping. Oral Appliance Therapy happens to be one aspect of how I will do it. s dentists involved in Dental Sleep Medicine, are we providing a commodity or a service? Put an- other way, on the occasion that you happen to find yourself engaged in small talk with a stranger and he/ she asks you what you do for a liv- ing, how do you reply? 1) “I’m a den- tist and I make dental devices for sleep apnea.” or 2) “I’m a dentist and I treat/help patients who have sleep apnea”. Partially, I bring this up as a con- cern. Having practiced dentistry for 30 years, I’ve seen our profession in some respects being reduced to a commodity. A filling is a filling is a filling, whether it gets done at Dr. Smith’s, Dr. Jones’ or Dr. Wilson’s of- fice. It’s still a filling. In my opinion, certain outside influences want this because if it’s all the same no matter where you go, then it comes down to the price. If there is no perceived difference in the item, there is no difference in the value. Answer 1 reduces dental sleep medicine to a commodity. But patients don’t belly up to a den- tal device vending machine and on a whim, select A4 for a Dorsal de- vice, and C2 for a Herbst, and D1 for a Dream TAP. Instead, in essence, we provide therapy; we’re treating pa- tients as in Answer 2 above. I think It is extremely important for the pa- tient to know that it’s oral appliance therapy and not a piece of plastic. I cannot emphasize this enough. I’m not going to order their device on Amazon Prime, get it in 2 days, stick it in their mouths and be done with it. With that in mind, it’s important to make sure patients understand the process – the importance of the comprehensive examination, de- vice selection, the initial protrusive position, the acclimation period, ti- tration to find what I call the “sweet spot” that maximizes the positive effects and minimizes side effects and finally facilitate a titration sleep test to make sure we are hitting the mark. As Dr. Yatros and Dr. Drake say, “I want to first help you to feel better and then I want to make sure you are breathing better.” When I explain this to patients, usu- ally a light bulb goes off. It’s not a widget (commodity), and it is espe- cially not an item that can be picked up online; there’s much more to it than that. It’s a therapy…. But oral appliance therapy may only be part of the process. Is position- al therapy necessary? Nose cones? Perhaps, a referral to an ENT is war- ranted to address issues with nasal patency. If a patient comes to us for help, we have to have a mind- set of helping a patient who has a serious, potentially life-threatening disorder, and not as one who sim- ply needs a dental device. Be the patient’s advocate. We may even be part of a team of healthcare profes- sionals who help the patient and I dare say, on occasion, we may find ourselves as the leader of that team. Dental Sleep Medicine is a service and includes a therapy that can change lives and save lives. It’s much more than a piece of plastic. Make sure your patients are aware of this. So doctor, if I may ask, what do you do for a living? RICK VAN GURP, DDS, FACD Dr. Rick Van Gurp is a general den- tist in Charlotte, North Carolina. He has a solo general dental prac- tice and a separate solo dental sleep medicine practice. He has over 150 hours of continuing education in dental sleep medicine including having recently completed the Tufts University mini-residency. Dr. Van Gurp can be reached at [email protected] and 704-220-1930.