The Dental Sleep Medicine Recipe for Success:

Episode #286 – Part 2 – Screening with Dr. Mark Murphy

You already screen patients for oral cancer — now, do it for sleep apnea! In part two of this series, Kirk Behrendt brings back Dr. Mark Murphy to teach you the best practices for screening your patients. Screening is quick, easy, and noninvasive. And the best part is, you don't need to figure out billing before you do it! For more of Dr. Murphy’s advice, listen to Episode 286 of The Best Practices Show! If you missed part one, be sure to go back and listen to Episode 285!

Main Takeaways:

Patients and their lives are very dynamic. You can't just screen them once.

Dentists are responsible and capable of screening for sleep-related breathing disorders.

Create curiosity and interest so your team wants to screen patients.

Use the STOP-BANG questionnaire to screen at-risk patients.

Use the BEARS questionnaire to screen at-risk children.

You don't need to figure out the billing to start the screening.

Have intentional conversations with patients about their risk, with hope of treatment.

Quotes:

“The algorithm we use has age as one of the eight factors that we look at very closely. And if you have three of the eight factors, you're at moderate risk. Four, you're at high risk.” (05:56—06:05)

“Even though the incidence of you finding an oral cancer, the incidence of you impacting somebody’s life is very small, you're willing to invest the time, the effort, and energy no matter what. You would never think of skipping that oral cancer screening exam . . . So, what if I told you that I needed you to screen for something during that hygiene visit, like oral cancer, that happens in 20% to 25% of your patients, and then when you do that you can save their life? Could you commit to that, no matter what?” (08:19—09:23)

“That's not the reason to do [screenings], to cover your ass . . . It’s about helping your patients be healthier.” (12:37—12:53)

“You don't have to treat sleep. I'm not suggesting you have to treat sleep . . . I don't have to be a specialist. I don't have to be a sleep doctor. I don't have to be a sleep dentist. But I've got to screen. And it doesn't take long.” (12:55—13:29)

“The idea here is, I have an algorithm that's pretty darn predictive for sleep apnea. And it’s not very invasive to get that information. Intentional conversations will do it.” (28:55—29:07)

“You have a chance in these kids to maybe change a long lineage. And to the person who says, ‘Man, you sure you want to do that to a five-and-a-half-year-old?’ What, you want them to have five years of hell and treat them when they're 11?” (32:33—32:45)

“You don't have to treat perio. Right? But you have to get started in screening for perio and making a referral. Same thing. So, I have to get started in screening [for sleep apnea]. I don't have a choice. I care about my patients, and I have a responsibility — moral, ethical, maybe even legal — so I want to get started in screening.” (35:39—35:56)

“When you go to some of the Scandinavian countries, 30% to 70% of the patients get oral appliance therapy first, CPAP therapy last. Hardly anybody wears a CPAP. Give a CPAP to 100 people, 40% will be wearing it at the end of the year. Give an oral appliance to 100 people, 90% will be wearing it at the end of the year, maybe 95%.” (42:37—42:59)

Snippets:

Dr. Murphy’s screening process. (02:41—05:00)

Are patients static or dynamic? (05:20—06:53)

Best practices for screening. (07:34—10:28)

Not screening is inappropriate practice. (11:11—14:15)

How to help your team understand the importance of screening. (15:06—18:24)

Ask high-quality questions. (18:25—22:36)

STOP-BANG questionnaire and six other questions...