Tips for Being Your Own Best Advocate for Healthcare!

Ultimately, it’s your body so you are most suitable to be the best steward for your own health. 

That being said, sometimes it can take a lot of ‘trial and error’ to do your research and find a doctor that you can feel comfortable with, rely on, and trust with your most vital medical care and personal information. You can spend years searching for the right one!

Finding the "best" doctor is what we all want, of course, but what you really may need is the best one for YOU. 

Doctors take their Hippocratic Oath to provide the most up-to-date care for their patients, to the best of their ability, but it is always a good idea to take time and effort to make sure you are arming yourself with as much research and information as you can about your personal health and medical care.

At Pennsylvania Dental Sleep Medicine (PDSM) we specialize in the treatment and management of Obstructive Sleep Apnea (OSA) and chronic snoring. We understand how overwhelming it can be for someone to go through the process of learning about his or her condition and ways it can be remedied. 

A sleep disorder can affect your overall health, safety, quality of life, work productivity, and can increase your risk of other health problems, so it is important to understand what you are going through and what to expect if it goes untreated.

Being an informed self-advocate will help you to prepare in advance for what a certified sleep dentist can, and should, do for you, different methods of treatment for OSA, how your insurance covers those treatments, follow-up visits, and how soon you should start feeling well again. Below are some tips and answers to frequently asked questions that you may be having.

1. HOW DO YOU KNOW IF YOU HAVE SLEEP APNEA?

Some of the most common symptoms that you, or your sleeping partner, should look for are:

• Loud snoring
• Excessive daytime sleepiness
• Paused breathing during sleep
• Abrupt awakenings accompanied by gasping or choking
• Awakening with a dry mouth or sore throat
• Morning headache
• Difficulty concentrating during the day, mood changes, or irritability
• High blood pressure
• Nighttime sweating
• Decreased libido or erectile dysfunction
• Clenching jaw or grinding.
  
  

2. WHAT SHOULD YOU DO IF YOU HAVE SLEEP APNEA SYMPTOMS?

The first thing you will want to do is see a physician (MD or DO) to discuss your symptoms, behavior, and family history. Your doctor will most likely refer you to a sleep disorder center or sleep medicine specialist. There, a sleep specialist can help you determine your need for further evaluation, which often involves overnight monitoring at a sleep center or a home sleep test.

3. WHAT HAPPENS WHEN YOU ARE DIAGNOSED WITH SLEEP APNEA?

If the results of your sleep test are abnormal, your doctor might refer you to an ear, nose, and throat doctor to rule out a blockage in your nose or throat; an evaluation by a heart doctor (cardiologist) or a doctor who specializes in the nervous system (neurologist); or recommend an appointment with a doctor who specialized in dental sleep dentist.

4. HOW IS SLEEP APNEA TREATED? 

For milder cases of sleep apnea, your doctor may recommend only lifestyle changes, such as losing weight or quitting smoking. If you have nasal allergies, your doctor will recommend treatment for your allergies. If these measures don't improve your signs and symptoms or if your apnea is moderate to severe, a number of other treatments, devices, or surgery can help to open up a blocked airway.

Your treatment path depends on your overall health and the severity of your sleep apnea. In cases where an underlying medical condition might be to blame, treating that condition is often the first step.

Some people respond well to a therapy called continuous positive airway pressure, or CPAP. This involves wearing a mask that directs a steady stream of air into your airway while you sleep.

When CPAP is not an option, or you prefer a different approach, a certified sleep dentist can provide Oral Appliance Therapy as a formidable alternative. These devices are worn in your mouth while you sleep to help keep your airway open. They are noninvasive and nonintrusive, are custom fit, and are easy to wear. Other reasons why patients like oral appliance therapy include: 

• Comfortable
• Quiet
• Portable (no hoses or machine)
• Convenient for travel
• Easy to care for

5. DO YOU HAVE TO USE CPAP OR CAN YOU PROCEED TO GET AN ORAL APPLIANCE?

While CPAP is an effective form of treatment for obstructive sleep apnea, the downside is more than 50% of patients that undergo treatment are unable to tolerate it. 

Today, doctors focus on recommending a treatment that the patient is more LIKELY to use and work hard to make that choice the most effective. Now that many insurance companies approve the oral appliance as a first-line treatment for mild to moderate sleep apnea, patients have a choice.

Some organizations, such as the American Academy of Dental Sleep Medicine (AADSM) have taken the position that oral appliance therapy should be prescribed as a First-Line of therapy for the treatment of obstructive sleep apnea, especially during the COVID-19 pandemic.

The AADSM has indicated that PAP therapy potentially exposes individuals, especially those in proximity to the patient, to increased risk of transmission of COVID-19.1 This recommendation is being made based on the following information:

• A number of studies have found evidence that COVID-19 can remain suspended in the air in aerosol particles.2
• It is unknown whether it is possible for patients to be re-infected by re-using PAP tubing, filters, and/or masks.
• There have been reported shortages of distilled water and other supplies necessary for optimal use of PAP machines.
• Oral appliances do not generate aerosols and can be easily disinfected by patients to kill the COVID-19 virus.

6. CAN ANY DENTIST PROVIDE ORAL APPLIANCE THERAPY OR PRACTICE DENTAL SLEEP MEDICINE?

Education in dental sleep medicine is required for dentists to provide safe, quality care to patients using oral appliance therapy for sleep-related breathing disorders. At a minimum, dentists should meet the educational requirements defined by the AADSM to be a “Qualified Dentist” in dental sleep medicine. Learn more about Dr. Becky Fox at Pennsylvania Dental Sleep Medicine.  Dr. Fox has achieved Diplomate status from the American Board of Dental Sleep Medicine.

7. WHAT DOES IT FEEL LIKE TO USE AN ORAL APPLIANCE?

During your consultation at Pennsylvania Dental Sleep Medicine, Dr. Becky Fox will work with you to determine what type of oral appliance is right for you. You will be fitted with a device to the exact specifications of your mouth, and you receive detailed instructions on when and how to wear your oral appliance and how to care for it so you can reap the benefits of oral appliance therapy for sleep apnea, or snoring, for many years. 

8. WILL MY MEDICAL INSURANCE COVER ORAL APPLIANCE THERAPY?

Oral appliance therapy for the treatment of OSA is covered by medical insurance plans -- not dental insurance -- as obstructive sleep apnea is a medical condition. Many insurance companies will allow you to receive an oral appliance as a first line of treatment for mild to moderate sleep apnea, but be sure to review your insurance coverage policies and ask your provider about their medical coverage policies and requirements for oral appliance therapy.

Some insurance plans require that you try CPAP or BiPAP treatment first before they will pay for an oral appliance. Medicare and some other plans DO NOT have this requirement.

When a proper medical protocol is followed and delivered by a dentist who is qualified to treat Dental Sleep Medicine, most insurance companies will cover much of the cost of treatment. The dentists at Pennsylvania Dental Sleep Medicine are in-network and participate with most medical insurance plans.

At Pennsylvania Dental Sleep Medicine, our staff will check your insurance plan for you to see what your requirements are and will help with the process of getting your treatment authorized.

9. DOES MEDICARE COVER ORAL APPLIANCE THERAPY?

Oral appliance therapy (OAT) IS covered by Medicare. However, there are a few things you need to know if you proceed with OAT through Medicare.

•  the oral appliance must be custom-fabricated to be covered.
• Medicare has specific documentation requirements, so you will need to work with both your physician and dentist to ensure that you have everything you need to ensure coverage.
• Under the “same and similar” clause, Medicare will only pay for one form of treatment of sleep apnea within a five-year period. This means that if a patient is using CPAP provided to them through Medicare, but they are intolerant, the patient MUST RETURN THEIR CPAP MACHINE before the first 90-day period ends in order to proceed with oral appliance therapy. Be sure to talk with your PCP early on if you feel like CPAP may not be tolerable for you for any reason.

10. HOW WILL ORAL APPLIANCE THERAPY CHANGE THE WAY I FEEL?

Treating snoring or OSA with oral appliance therapy can help you feel like a new person. You will find that your symptoms and your quality of life can improve dramatically when you remain committed and use your appliance each night. You will likely sleep better, have more energy, and feel sharper throughout the day.

Pennsylvania Dental Sleep Medicine is a leader in the treatment of oral appliance therapy because we provide the most up-to-date medical advances in dental sleep medicine technology for the treatment of sleep apnea. We adhere to the standard of care that exists to coordinate the best level of communication between our providers and our patient's doctors for the health and increased wellness of the patient.

HAVE MORE QUESTIONS?? Our website can provide a lot of direct answers to other questions that you may have. Take a tour around our site and read about how oral appliance therapy can be a better option for you to treat your sleep apnea.  call us at (717) 995-3590 or send us a message and we’ll get back to you right away!