Wasted Days & Sleepless Nights (Sleep Apnea) – a C.E. Review

I’ve known my friend, Dr. Kent Smith for a long time.  And, I’ve come to the conclusion that he is a Dental Jedi Master.  Before he was a dentist, he was an accountant.  So, he also knows how to “run the numbers” of anything being considered to be implemented in a dental practice.  And, the evidence is his uber-successful dental practice in Irving, Texas:  21st Century Dental.  His website (click on the link) is DEEP.  By “deep,” I mean that it is extensive and detailed.  It performs very well and is an integral part of his marketing program.

A Deadly Disease

Certainly, most of us have at least heard a little bit about treating snoring in the dental practice with dental appliances… if no other way than ads in dental magazines.  While snoring can be a social issue (for partners of snorers), Sleep Apnea is another, much more serious matter.  We are learning the potentially severe medical implications of sleep apnea.  Ultimately, it can be fatal.  NFL player Reggie White’s death was largely attributed to his sleep apnea.  He was 43 years old.

I’ve known that Kent has been involved in the treatment of Sleep Disordered Breathing for a number of years.  It turns out he’s got about 15 years of doing this under his belt.  He’s a real expert and is a Diplomate of the American Board Dental Sleep Medicine.

Honestly, I have mostly ignored this discipline in my dental career.  I figured I have more than enough going to add yet another item on my practice menu.  But, that changed as I have become increasingly aware of my OWN PROBLEM with sleep.  My wife has to move out of our bedroom on most nights due to my snoring, which has become progressively worse.  And, I’ve even caught myself waking up, gasping for air.  I’m 48 years old, and I know that I’m in that “danger zone” for the “sudden and unexpected” heart attack.  I decided to take Kent’s aptly-named course, “Wasted Days and Sleepless Nights” in Dallas, Texas.

Gimme Oxygen!

Sleep apnea is, at it’s most basic level, starvation for oxygen.  Our bodies, and more importantly, our organs need oxygen CONSTANTLY.  If deprived for even a short time, they can be damaged, or worse.  Our hearts and brain are especially susceptible to oxygen starvation.

What if it can be diagnosed and prevented?   What if we, as dentists, can help?

Diagnosis involves a sleep study.  After the diagnosis of sleep apnea, the “gold standard” for treatment typically includes a continuous positive airway pressure (CPAP) machine.  This is a mask worn by the patient that is connected to an air pump.  By providing a continuous positive pressure, the soft tissues that occlude the airway in sleep apnea are held open.

However, some patients either cannot or will not wear a CPAP at night.  For those patients an oral appliance can be an alternative solution.  And, oral appliances are the dentists’ dominion.  Naturally, we need to be educated on the diagnosis and treatment of sleep apnea rather than be blind appliance-makers.  Besides knowing HOW to make appliances, we need to know WHY and if they are EFFECTIVE.  There’s more to it than just taking impressions and delivering a piece of plastic.

The course is given at the upscale Four Seasons Hotel, which is a fantastic venue.  Lunch is included on both days, and I’ll just say they do it right!  Yum!  However, most of us lodged at the more economical, yet very adequate La Quinta across the street.

Day 1

Dr. Kent Smith’s 2-day course is an excellent introduction to understanding and helping treat sleep apnea patients.  On the first day, Kent goes into the details of sleep physiology, the pathogenesis of sleep apnea, and how the diagnosis is made.  I learned the medical sequellae of untreated sleep apnea are quite alarming.  This is serious stuff, folks!  We also learned about sleep studies (both lab and home studies).  We even learned about “sleep hygiene.”  It became apparent that I am a total “pig” when it comes to good sleep hygiene!  That night we all got a Watch-PAT sleep monitor for our own home / hotel sleep studies.  I was very anxious to see my results.

The chairs were THE most comfortable I’ve ever had for any C.E. course in my 24 year career! Hey… that’s important, especially for a 2-day course!

Before, we retired to our hotel rooms and donned our Watch-PATs, Kent took everyone out to a very nice dinner!  I missed the dinner, as I took the opportunity to visit with my sister who lives in Dallas.  But, the other course attendees did a good job of rubbing it in the next day, telling me how fantastic the dinner was.  🙂

Day 2

On the second day, Kent covered treatment options, again emphasizing the CPAP as the “gold standard.”  Then he covered the cornucopia of oral sleep apnea appliances on the market, elaborating on their strengths and weaknesses.  Kent is NOT a paid shill for any company.  While he has his favorites, he is truly independent and any bias is based on his own experience and opinions.

After lunch, we all went to Kent’s office only a few blocks away.  After a tour, we got our oral appliances delivered and checked for fit.  A few weeks before the course, we sent impressions of our own teeth and a bite record to the Somnodent lab.  We also had a hands-on exercise in learning how to take appropriate and accurate bite records, using the George Gauge.

Dr. Kevin Smith models his Somnodent appliance while Dr. Mark Warren looks on.

After the hands-on exercise, we returned to the conference room at the Four Seasons.  Kent then spent time discussing marketing and the insurance and financial aspects of sleep apnea treatment.

How bad is my apnea?

Finally, we pored over the results of our sleep studies.  Many of us were surprised at our results.  In my case, I was simply wondering how BAD it was.  I was just a few tenths of a point shy of “severe.”  Yippee!  Seriously, it was good to know.  After reviewing the sleep studies, we adjourned with our brains full of new knowledge.

Kent’s course is casual and open, which precipitates a lot of questions and discussions.  Kent has a very easy style of delivery, too.  I know I learned a lot and felt engaged the entire time.  And, no doubt, Texans know how to eat well!  🙂

Five Bullseyes!

I’m going to unveil a new Dental Warrior “rating system” in honor of Kent’s course!  “Wasted Days and Sleepless Nights” gets Five “bullseyes” out of five:    This is a course well worth attending!  Click here to land on his course web page.

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2 Responses to Wasted Days & Sleepless Nights (Sleep Apnea) – a C.E. Review

  1. Joe Hair says:

    Mike, You are dead on the money. Kent is a great teacher and a great guy willing to share with everyone. I first really met Kent at a dental meeting held at Disney World.

    Like most meetings at a venue like Disney World, an afternoon was unscheduled for the participants to go play at the park. Kent was not presenting at this course, but he made an announcement that he would be in his room to discuss OSA and the dentist’s involvement for all who were interested.

    I thought this would be a great opportunity to get a little taste of what sleep apnea was all about. I went to Kent’s room and was invited in. Kent’s room had a big conference table in the middle of it with about 7 or 8 other dentists around it. I believe I was the only one there with no experience in treating patients with sleep apnea; however, Kent (and everyone else) was very patient with my ignorance, and they freely answered all of my questions.

    This experience whetted my appetite for more – I knew I had to take Kent’s course. Mike, I had the same experience as you – except I went to dinner with Kent. Boy, you missed a great time. Kent is a great host at his hotel room, his course, and at dinner; he exudes Southern Hospitality and provides a great learning experience.

    A recent comment from one of my OSA patients sums up why I enjoy treating sleep apnea patients, and I have Kent to thank for this: “Dr. Hair, thank you for giving me back my life.”

    • The Dental Warrior says:

      When a patient thanks you for giving back his / her life, that’s powerful stuff, Joe.

      I’m originally from the “South,” and while I’m WAY south in Florida… to get to the South, we have to go north. And, down here I miss that “Southern hospitality.” You’re right that Kent personifies the “Southern Gentleman.” He’s just enjoyable to be around. And, he’s a fantastic teacher.

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