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Tips and Tricks for Implementation of Sleep Dentistry into your Practice

February 1, 2016

I have been attending entry level Dental CE courses for snoring and sleep apnea for over 20 years. It has always been fascinating to me that a dentist can take hundreds of hours of course hours but never really manage to get Sleep Apnea Dentistry implemented into his or her practice. This is an all two common occurrence and I thought the article below by Dr Erin Elliott does a great job setting out some really clear, real world. tips for beating "Wednesday Morning Syndrome". The condition that some staff members find themselves in when the Dr gets back from a course with lots of new ideas is this generally results in the staff going home late until the Dr gets back on the program. Dr Elliott managed to avoid Wednesday morning syndrome and has built a tremendous footprint in Sleep Apnea Dentistry in her community and as President of the American Sleep and Breathing Academy. -ed



Golf and dental sleep medicine - This article previously appeared in Dental Economics January 2016

What I have learned from 6 years of bad shots

That’s right your next six months don’t have to be like my six years in dental sleep medicine. You have skills. Here are some tips to help you avoid some of the pitfalls that come with integrating anything new into your practice. Following these tips will let you spend more time on the fairway and less time looking for an errant drive. Fore!

I have an amazing team. Gosh, I think they know me better than my best friends do. They also know that I love continuing education and dentistry. Therefore, over the years they’ve developed “Wednesday morning syndrome”. This means that when I come back from a course and I’m ready to implement a new program on Monday morning, all they have to do is avoid eye contact with me until Wednesday, and I’ll give up.

Unfortunately for them (or so they thought at the time) this didn’t happen with dental sleep medicine. I know it would be hard to navigate the medical world, and I knew trying to get paid from medical insurance would be an uphill climb. But I loved being able to screen otherwise undiagnosed patients and treat a life threatening disease. I was helping patients get their lives back.

So I kept it simple for a while. One main assistant and I did all of the dental sleep medicine. The other team members were happy to avoid all matters of sleep apnea because it was still very foreign, and I was afraid to “force” anything on them. Then came the turning point and the whole team had to jump in. We were busy- patients were calling and doctors were referring sleep medicine patients.

The best decision I made was taking an afternoon off to teach dental sleep medicine to my entire team. This enabled them to answer questions over the phone. Thereby saving the fate of hundreds of sticky notes. The hygienists learned how to screen for undiagnosed sleep apnea, and the office manager learned the tricks of billing medical insurance.

As in any dental office however, there was team turnover. Team members started showing up with baby bumps moving and of course, we had to terminate the rare team member who just wasn’t a good performer.

How did I teach the new employees years of experience and get them treating sleep apnea patients in a short time? My answer I didn’t. I had two chairside assistants for general dentistry and one main dental sleep medicine coordinator. My golf partner Julie was an ortho assistant with 25 years of ortho experience and zero years of general dentistry experience. When my chairside assistant left for maternity leave, I asked Julie to fill in. She became a permanent employee when my assistant decided to stay home with her bundle of joy.

General dentistry was foreign to Julie but she caught on quickly. Even though she was what we can call a “veteran” (i.e., older), she knew her way around computers, and she became a mama bear to the younger team members. As a bonus, she was able to help with my Six Month Smiles patients. She was always willing to help take impressions for our sleep apnea patients, but when it came time to do follow-up visits or deliveries, she bolted.

She said she didn’t want to look like an idiot or like she was too old to learn anything new. She said there wasn’t enough room in her brain to add sleep apnea. I gave her the bad news. We were moving to two and a half days of fulltime sleep apnea, so there was no avoiding it. She had to learn it. If a patient needed an appliance adjusted, she could easily perform it, as she was comfortable working with nightguards. But what if a patient came in with a (gasp) side effect? How could I teach Julie the ins and outs of the paperwork and familiarize her with medical billing? Can you see why it was the path of least resistance to have my already trained and willing dental sleep medicine coordinator take care of it all? I needed to give Julie a systematic approach to helping the team treat sleep apnea. It is an entirely different beast. I had her watch some of my past webinars to get the basics of dental sleep medicine, but more importantly, I sat down with her to go over how to do a consult, how to deliver, how to adjust and calibrate an appliance, and how to troubleshoot on follow-up visits.

This was a perfect analogy for the whole basis of our relationship— golf. She grew up on a golf course, and she was good at it and comfortable with it. I reluctantly learned golf as an adult, and I had been a beer cart girl for a local golf course in dental school. (I was a tutor and a beer cart girl. Isn’t that an interesting combination?) I didn’t want to learn golf because it didn’t come naturally to me, and I wasn’t instantly good at it. Besides, I grew up playing soccer. Now that was in my wheelhouse. Why learn something new now?

The biggest mistake I made was allowing many amateurs to coach me, and I practiced a horrible swing over and over again. I just jumped into it and got frustrated. But like any golfer, the one Ladies Professional Golf Association-type shot I managed to pull out once in a while is what brought me back for more, even though I had 100 other wayward shots. Plus, golf was a necessity with my family and friends. I couldn’t give up.

After 10 years, I finally took lessons from a professional, and my favorite sound in the world is my golf ball dropping into the cup. I love golf! But what if I had started with lessons from a professional immediately rather than listening to amateurs? I would have loved the game that much more. I wouldn’t have gotten frustrated, and I wouldn’t have wanted to give up. What’s my advice on becoming a good golfer? Take lessons from the start. Although I’m a far from perfect golfer, I can pull off a KP (closest to the pin) or longest drive award in my community golf tournaments. I can play a round with confidence. I can perform.

Just as the professional coach gave me confidence in my golf game, I have given Julie confidence in the dental sleep medicine world. I have even given her a few mulligans as she was learning. She speaks with authority and can answer any questions patients throw her way. She is capable of getting a “hole in one.” The only reason I was able to coach her was because I gained confidence by taking the best courses in dental sleep medicine and continue to learn. It’s persistence and practice, just like in golf. Become trained and get your team trained now. Don’t give them a choice like I did. It’s never too late to learn something new, and it’s way better to learn how to do it correctly from the start. Change from an attitude of frustration (all of those missed shots!) to one of “I can do this!” LPGA, here I come!

Erin Elliott DDS

Erin Elliott DDS

ERIN E. ELLIOTT, DDS, is a practicing general dentist in Post Falls, Idaho, where she has successfully integrated dental sleep medicine into her practice. She has lectured extensively, educating dentists on the benefits of incorporating this growing field of dentistry into their practices. She is an active member of her local and state American Dental Association components and is a member of the American Academy of Sleep Medicine and American Academy of Dental Sleep Medicine. She is the president and diplomate of the American Sleep and Breathing Academy. She can be contacted at

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