3 dental sleep medicine courses to start 2019 with

As with every New Year, we always want to start with our best foot forward. I know it is only November, but now is the time to get started on your preparation for 2019. If you start now, you can get the best deals on airfare (if needed) and hotels.

Here are three dental sleep medicine courses to attend in the first couple months of 2019.

January 25-26 in Jupiter, Florida. The topic is TMJ for the Dental Sleep Medicine Practice. In this lecture we will take a look at the connection between TMD and sleep apnea. With 36 states now mandating TMD coverage in health care plans, it is important to understand how to incorporate these services into your practice. A dental professional is the primary care provider for TMJ dysfunction because they are capable of significantly improving the quality of life and overall health of these patients. And in the realm of dental sleep medicine, the American Academy of Sleep Medicine practice parameters for OSA put the responsibility clearly on dentists to catch and treat TMD problems in sleep apnea patient follow-up exams. Sign up for this course to gain step-by-step guidance on identifying, diagnosing and implementing TMD treatment.

February 8-9 in Atlanta, Georgia. If you have not already attending the first three sessions, this might not be for you. However, it is a great sleep and pain mini residency. Session 4 is the last of this mini-residency 2. The program is designed to give dental practices the knowledge and guidance to fully incorporate obstructive sleep apnea treatment into their practice. It also aims to help dentists overcome obstacles in order to grow and flourish in dental sleep medicine.

March 8-9 in Atlanta, Georgia. This is the third installment of the Sleep and Pain Mini Residency. If you weren’t able to sign up for the previous sessions, now is the time to sign up for session one! This is a 4-part, 64 CE credit program led by Dr. Mayoor Patel and Dr. Terry Bennett. By attending this mini-residency series you will learn about dental sleep medicine with an emphasis on hands-on and practical learning. Dentists will gain the skills and confidence they need to incorporate sleep apnea treatment into their practice successfully.

To learn more about upcoming lectures, please visit http://mpateldds.com/upcoming-lecture/. I look forward to seeing you an an upcoming lecture or mini-residency!

Dental sleep medicine mini-residencies: Prepare for 2019

To help you better serve your patients and provide advanced care in your dental office, mini-residencies might be just what you need. For 2019, make the most of your year by signing up for dental sleep medicine mini-residencies. These residency series are a 4-part, 64 CE credit programs that provide a completely comprehensive educational experience for implementing dental sleep medicine in your dental practice.

Mini-residency overview

These sessions are taught by leading educators in dental sleep medicine, Mayoor Patel, DDS, MS, and Terry Bennett, DMD. Each course will emphasize hands-on and practice learning. Dentists who attend these sessions will gain the skills and confidence you need to incorporate sleep apnea treatment into practice successfully.

Dentists will receive two sleep apnea oral appliances and will go through the entire experience of examination, impression and bite registrations, appliance delivery and fitting, and follow-up/calibration exams. There is also an opportunity to shadow an American Academy of Sleep Medicine accredited sleep lab throughout the program.

After each session dentists will be given homework assignments to complete, but don’t worry, these won’t be too hard. The assignments will include literature to read and cases to prepare. Team members will also be given tasks to work on, including communication scripts and physician outreach goals.

At the end of the fourth session, each dental practice should feel confident in their ability to:

  • Treat obstructive sleep apnea patients.
  • Have referral networks in place.
  • Medical insurance reimbursement implemented.
  • Ready for various dental sleep medicine accreditation programs.

Sign up for our dental sleep medicine mini-residency programs in 2019. We look forward to seeing you at an upcoming lecture!

Let’s talk about medical marijuana and sleep apnea

Lately we have been seeing a lot of news articles about medical marijuana. We have new states popping up every month in support of the legalization of marijuana. Canada has also recently legalized the use of recreational marijuana for the entire country, something that was banned since 1923.

While the United States still has not legalized marijuana, many states have taken it into their own hands to either legalize it completely or just for medical purposes. We continue to learn more about the benefits and hear various opinions, but it is important to take a closer look before deciding what side you’re on. For sleep apnea, many people believe medical marijuana is a good option and it might be possible, but I don’t think we’re ready to jump on that train just yet.

Either way you look at it, this is a discussion we should be having now and in the future. Medical marijuana is potentially safe and a good idea, but it is all based on state-by-state regulations and we really need to pay attention to that. In the meantime, let’s look at both sides of the narrative.

Yes, medical marijuana can be used for sleep apnea treatment.

When searching the internet, I found several “yes” answers for use of marijuana for the treatment of sleep apnea. Their reasoning behind this is that medical marijuana has promise as a treatment for sleep apnea because it may help process serotonin in the brain at a critical failure point. It also often helps patients fall asleep quicker, sleep more deeply and find relief from mood disturbances.

In a 2002 study, rats with sleep apnea showed that Delta-9 tetrahydrocannabinol (THC) promoted normal breathing. The study was based on observations that cannabis can limit the effect of serotonin in cells in the inferior ganglion of the vagus nerve—this nerve plays a major role in breathing sensations. This then led to further research with the use of human subjects.

The first study on human subjects—conducted by David Carley, PhD, a professor of biobehavioral health sciences at the University of Illinois at Chicago—tested effects of different doses of THC on 17 sleep apnea patients. It found that patients experienced an average symptom reduction of 32 percent. The study also suggested that higher doses of THC result in better effects for patients. Unfortunately, though, with such a small number of participants, more research is needed. Most research on sleep apnea and medical marijuana out now are only in preclinical stages.

No, do not use medical marijuana for treatment of sleep apnea.

According to the American Academy of Sleep Medicine (AASM), medical marijuana should not be used to treat sleep apnea. The AASM warned that the drug and its synthetic extracts have not been shown to be safe, effective or well-tolerated by patients with sleep apnea.

The important thing to note here is that, until further research and evidence is found on the use of medical marijuana for treatment of sleep apnea, we should be avoiding this subject. Be sure to discuss proven treatment options with your patients. However, if your patient does bring this idea up for treatment of sleep apnea, provide proper education and inform them that there has been no proof just yet. This does not mean it will never be approved, but, for now, we need to do our due diligence to protect our patients and have their best interest in mind.

States are also discussing qualifying conditions. Many states have discussed adding obstructive sleep apnea as a new qualifying condition for their medical marijuana program, such as the Minnesota Department of Health. However, the AASM’s statement in the Journal of Clinical Sleep Medicine, urged states to exclude sleep apnea from the list of chronic health issues that might be included in medical marijuana programs.

Current treatments for sleep apnea still include CPAP therapy and oral appliance therapy, but should not include medical marijuana (at least not yet). While medical marijuana runs the risk of daytime sleepiness and other side effects, further studies are needed to determine the effectiveness.

Until there is significant scientific evidence of the safety and efficacy of medical marijuana, we should continue to do our research to learn more about this as a potential treatment for sleep apnea. Use your judgement and keep your patient’s best interest in mind.

Treating sleep apnea may improve stroke outcomes

If treatment of sleep apnea occurs immediately after a stroke or mini-stroke, new research shows that it may improve patients’ neurological symptoms and daily functioning. More than 20 million adults in the U.S. have obstructive sleep apnea, which has been linked with increased risk for heart attack, hypertension, sudden death, stroke and faster progression of cardiovascular disease.

In a recent study, researchers found that stroke patients who were diagnosed with sleep apnea saw greater improvements in both neurological symptoms and daily ability to function when they used treatment for OSA. This was in comparison to patients with sleep apnea who only received typical medical care.

Sleep apnea and stroke

The study looked at 252 adults that were hospitalized for an ischemic stroke or a mini-stroke, which is known as a transient ischemic attack (TIA). Every participant was screened for sleep apnea. Researchers found that three-quarters of patients had sleep apnea and about two-thirds of those patients with sleep apnea were assigned to one of two interventions that included receiving CPAP therapy, training and encouragement. The other one-third with sleep apnea served as a control group and received usual medical care, plus recommendation at the end of the study to seek CPAP treatment.

Patients’ neurological symptoms and their ability to function in normal activities, such as walking and self care, were assessed at the beginning of the study and six months to one year later. At follow-up, all patients experienced improvement in both neurological symptoms and functional status. However, 59 percent of the patients who used CPAP had neurological symptoms scores at or close to normal. This was in contrast to 38 percent who had just received typical medical care.

If you treat sleep apnea early, the better your stroke outcome will be. Contact Dr. Mayoor Patel to discuss this further. What are some ways to help your patients now and in the future? My guess is that we will need to continue to build upon our relationships with physicians in our communities.