Quote:
Originally Posted by DocL
I've been away for a few days and didn't check up on this thread.
I've been treating people with OSA for a few years. As a dentist there was a lot for me to learn before I started treating people with Severe OSA. It doesn't matter if you are tall or short, fat or skinny, male or female, young or old, as I have many patients who fall into any category aforementioned. I have a HST device I can send home with any patient, or I can use one of the many virtual HST providers depending on insurance or how long it takes to get the results. There are some new HST devices that I have questioned the results of and have had the patient use my device. One in particular knew she had an AHI of 48, yet the virtual company device indicated an AHI of 5, no OSA. My device reported an AHI of 47, but since she was a medicare patient I couldn't use my device results because the company I use t interpret and diagnose is outside of the Medicare system. So unfortunately this person got screwed by Medicare who said she has no OSA now, so no treatment unless out of pocket. Which of course is much more than she can afford. SMH.
As for determining how to treat the OSA, if being treated by a dentist, one way to observe the airway is to have an MRI at rest, then one wearing the oral device to compare the airway manipulation, and then a third once the appliance has been titrated. I don't know of any dentists who do that, and I couldn't get any of my patients to agree with getting three scans done. So, I purchased an ultrasound which uses sonar to help identify the diameter of the airway. I can also simulate a collapse and know exactly where it happens, by how much, all while the patient is awake in my office. This has been instrumental in my restoring patient's airway while using the oral device. One of my patient's has been a medical advisor for the WH since Clinton, and he is one of my patients who stopped using his CPAP. He travels from DC to Florida for my treatment because he wasn't able to find a qualified dentist.
Sleep Apnea can contribute to a myriad of health issues including HTN, Hypothyroid, Acid Reflux, Stroke, Cardiomyopathy, Arrhythmias, MI, and even ADHD if not diagnosed by the age of four. As a dentist I can tell just by looking at your tongue and teeth and have a good idea if you have silent acid reflux, and a Sleep Related Breathing Disorder (SRBD). I am not allowed to make a diagnosis of OSA, however I can successfully treat OSA, and I am credentialed to bill medial insurance and Medicare. Not many dentists can do that. Medical doctors make the diagnosis but are not allowed to make the oral appliance. This is the big disconnect with OSA between the tow professions. I have done a great job teaching some of the local doctors in my area, but many just don't know much about the treatment besides the CPAP with 40% of CPAP users become intolerant too.
I am open to answering any questions regarding sleep apnea, but I cannot give specific recommendations.
-Robert
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Thanks for the post, Robert! I have a question about your post.
I had a mouth guard made by my dentist, one of the best around my area, but I couldn't stand wearing it. It's a mouth guard for TMJ, is this the same as an oral device that you are mentioning or is it something that holds the jaw differently? I assume the one you use moves the jaw in a more forward position to open/keep open the airway?
I do already have some of the conditions you mention, and being in my mid 30s I need to get this figured out before it takes an even larger toll.
Thanks again!
