1. Why is it critical to address and/or diagnose and treat sleep before large restorative cases?
● Sleep patients clench and/or grind 4-5 times more than any other patient. Hence the inability to control the biomechanical forces that will destroy or foreshorten the life of expensive dentistry we do no matter how well it is done.
2. Why should we be concerned with TMJ while diagnosing and/or treating sleep?
● In order to do a comprehensive treatment plan we must properly assess jaw joint and airway health, otherwise your patient will lose faith in your large treatment plans if their bite changes after a sleep appliance.
3. Who is your “Go-To” help with Sleep, Jaw Joint or Phase II after the Denta4 course?
● First: David, James, Tyrel or Curtis at Ocean Ceramics
● Second: Dr. Liem and Dr. Marangos
4. What are the College’s key guidelines that we must know?
● All patients that exhibit signs or symptoms must be referred to a medical doctor or sleep specialist
● All sleep devices can result in permanent bite change and patients must be forewarned
5. What are key dental signs and symptoms of patients with sleep disorders?
● Scalloping of tongue, poor mallampati, excessive bruxing grind, cuspid rise worn away
6. What percentage of sleep patients also have TMD?
7. Which patients are most likely to have a daytime or permanent bite change?
● Patients with large deviation or deflection, popping or clicking jaw joints while opening and closing jaw
8. What is the challenge when referring sleep patients to a medical doctor?
● Patients rarely ever report back for a sleep appliance and are gobbled up by the large CPAP industry and are rarely ever even offered sleep appliance options
9. What are the three common levels of constricted airway or apnic levels in a sleep period?
● Mild Moderate Severe
● 0-15 15-30 30 or more
● Apneic events in the night
10. What is a simple screening form that is recognized by the medical community to take action and explore sleep apnea further?
● Sleep Epsworth Form
11. What percentage of the Canadian adult population according to stats Canada has either snoring and sleep apnea?
12. If sleep apnea goes untreated what is the average decrease in life expectancy?
● 8-10 years
13. What level of sleep apnea (Mild, Moderate, Severe) is not suggested for sleep appliances?
● Severe (Unless patient is 100% non compliant)
14. Why is a phonetic “airway” bite such a good starting relation position for bite for a sleep appliance?
● It is an optimal vertical and A.P. position that will not cause harm to your patients
15. What impression material is best for quality records for any sleep appliance?
● “Status Blue” DMG product that Ocean’s sister company Trio sells and distributes. An inexpensive polyvinyl that is stable and guarantees a perfect fit – no remakes!
16. What are the three common sleep appliances that Ocean provides?
● Narval ($620), Denta4 Guard ($230), EMA ($357)
17. After a sleep appliances is delivered to a patients, is it necessary to do another take home sleep study?
September 15-16 2017
- Treatment protocols for the different diagnoses
- Completing Phase 1 Orthotic Treatment to Maximum Medical Improvement
- Advanced imaging (reading CBCT) (hands-on)
- Moving your practice into Dental Sleep Medicine
- Sleep Physiology and Disorders within your patients
- Learn how each treatment plan successfully fits into your practice efficiently
- And more…