Health care issues are too important to allow them to be trivialized with cliche’ and I won’t condescend to you who are willing to spend some of your precious time reading my essays. However, if you have read my articles before you may recognize that I tend to call it as I see it and I see no reason to change now.
Our health care system has always seemed to be in some sort of crisis, maybe now more than at any other time I have witnessed in my 26 year career and I certainly can’t tackle the issue in these few paragraphs. Providers with staggering education and equipment debt load, shrinking revenue sources from government, insurance and even private pay clients, an aging population who have more complicated health issues and diminishing financial resources at their disposal, a declining pool of primary care professionals etc. all make the business of being a health care provider more challenging than ever before and being a health care consumer more frightening.
The inevitable cliche’s like “Apples to Apples”, “Buyer Beware”, “Do It Right The First Time”, “Ain’t No Lovin Like...(wait, maybe not that one)..., often come to mind when I counsel my patients regarding treatment options and attempt to help them make informed decisions. Treatment that may be ideal for one person may not be appropriate for the next and while it is never acceptable for me to make treatment recommendations based on what I think someone’s financial status is, it may be necessary and perfectly appropriate to consider less costly options if the patient requests. When dollars are tight, I attempt to provide people with options such as phased treatment plans, payment arrangements, materials choices, etc. and always delivered with a heavy emphasis on prevention programs. There is also an effort made to identify the cause of the health issue at hand and not merely be content with treating the symptom. The goal, of course, is to help provide customized quality care and control costs as needed. That is how I believe you best stretch health care dollars. Am I on “Thin Ice” yet?
While on the subject of costs we should talk specifically about the difference between sleep apnea and snoring, a subject that I knew little about three years ago and have studied extensively since. It has become a true passion of mine; my “Soap Box”. Be aware that minimizing snoring and managing apnea are not the same thing! There are a plethora of misleading and confusing marketing campaigns today advertising inexpensive devices to stop snoring and they can work, though not predictably. Snoring can be little more than an annoying social problem and may respond to treatment with a ‘snore guard’ which can be easily provided by most dentists. However, to properly manage a person who has sleep apnea with oral appliance therapy (the dental alternative to CPAP breathing machines) and achieve a predictable and medically significant result, requires much more time and a certain level of expertise delivered only by a dentist with proper training.
Sleep apnea is a life threatening medical condition which increases ones risk of stroke, diabetes, heart attack, traffic accident, depression and much more. When a dentist accepts the responsibility of attempting to manage this condition, it becomes a “Whole New Ball Game” compared to making a ‘snore guard’. Proper protocol requires that a dentist not treat apnea without a diagnosis from a physician. Apnea therapy should incorporate the use oral airway dilator devices FDA approved for apnea management and there should be a method to evaluate airway volume especially in the nose. The dentist should work closely with physicians and make referrals as needed to pulmonologists, ENT and primary care physicians, cardiologists, etc. It is also critical to be able to measure the results of the therapy with objective data as with home sleep tests or polysomnogram evaluation. To accept a patient report that “I’m not snoring as much” as being a successful case is unprofessional and demeans the essential role that we as dental sleep medicine providers are being asked to play.
Dollars are tight and you should spend them wisely. When making health care choices I would encourage you to be very proactive regarding prevention philosophy, and be careful to choose the professionals most qualified to provide you with the specialized care you may need. Cheaper may not be better, and though there is a significant difference in the cost between a ‘snore guard’ and being provided with a comprehensive apnea management program, there is an even greater difference in the service provided. Making a proper decision here can save your life!
Most importantly, make sure you compare “Apples to Apples” and make informed choices. Your health is too important to let a cliche’ get in the way.
JC Goodwin, DMD, DACSDD, has practiced dentistry in the Prescott area since 1987. He has completed post-graduate training in dental laser surgery, non-surgical periodontal therapy, bonded ceramic dentistry, dental sleep medicine for apnea therapy and management of chronic facial pain, TMJ disorders and headache. His practice is affiliated with the Centers for Dental Medicine and he holds a Diplomate credential with the Academy of Clinical Sleep Disorders Dentistry. He is a member of the American Dental Association and the American Academy of Dental Sleep Medicine. He runs the Sleep Effect Center for Apnea Management at 928-778-4555, www.sleepeffect.com., or can be contacted at his general dentistry practice, 928-708-9444, www.fitnessdental.com. Your comments and questions are welcome.