Who has ever asked your dentist about getting help with your sleep apnea? Maybe a few of you have.
And how many times do patients learn that their dentist does not get involved with treating sleep apnea? Almost everyone who answered yes above.
If your dentist tells you they are not able to treat sleep apnea, or they would rather refer you as a patient to a different dentist who specializes in fitting oral appliances, don’t freak out. That is the common case right now in the year 2012. Most dental practices simply do not get involved with treating OSA. But take my word for it: this will change in the next 10 years. And it’s going to change in a major way. Why? There is too much money to be made by simply being a dentist who’s sitting on the sidelines.
Since I work in the field of sleep apnea, I know exactly how rare a dental practice treating sleep apnea actually is. Anybody in the United States could walk over to a dental office building, and after going into 10 offices, you’d realize the exact same thing. All you would really have to do is ask the receptionist, “Do you offer oral appliance therapy to patients to treat sleep apnea?” If one out of those ten offices you inquire with answers with a, “YES”, that is pretty good. But sadly, you very well might have to approach thirty or forty dental offices before you find a match.
It’s not the dentists who are the problem. It’s really not. The truth is that by and large, most dental schools teach absolutely zero in terms of recognizing and treating sleep apnea. And, if your dentist graduated from dental school thirty years ago, there’s a pretty good chance he/she doesn’t even know oral appliances exist. Sad, but true.
But there’s more to the reason for why dentists are completely missing the boat in terms of helping to treat OSA. It has to do with insurance companies and HMO groups. Most of the large carriers and insurance payors simply do not pay very much money on the reimbursement side of things for oral appliances. Medicare pays for oral appliances, but only $500-600 on average, and that is only if the doctor performing the installation is certified and qualified to work with Medicare. Private insurance companies are very hit or miss at the moment with how they cover this type of “durable medical equipment”.
So what is left for the patient, very few options. As a general rule, the average overall cost the few existing dentist charge for this type of therapy is about $2000-2500 on average for the full oral appliance fees. Yikes, that’s alot of money. You’re damn right it is. But before you start jumping the gun and thinking your dentist is ripping you off with such a high dollar figure, take a look at what is necessary to get you feeling and sleeping better.
The full oral appliance therapy from a dentist usually includes:
- An initial consultation and exam of the patients mouth
- Full impressions are needed to mold the oral appliance mouthpiece
- First visit fitting the appliance
- Follow up visits titrating or re-fitting the appliance
With all of the office visits, and with lab fees and the time needed for dental offices to obtain authorizations and payment from insurance companies, it sure is lots of work just to pull one of these off. And when the dental office is only doing 1 or two per month, they are almost re-inventing the wheel each time. This is one of the main reasons why so few dental practices have decided to get involved with providing appliances to patients.
In conclusion, the current landscape for getting all squared away with your sleep apnea from your dentist is pretty bleak. But, as more and more dentists get involved, and as more and more insurance companies realize the benefit of this type of therapy, positive changes will soon follow. More dentists should mean lower prices as the supply of providers offering this sleep therapy increases. And, with more patients receiving this therapy, more competition among the actual devices should increase as well also bringing down prices.
Here is a list of some of the current providers of Oral Appliances:
- TAP – Thornton Adjustable Positioner: http://amisleep.com/
- Respire Medical : http://www.respiremedical.com/index.html
- SUAD Device by Strong Dental: http://www.strongdental.com/
- Somnodent device by Somnomed: www.somnomed.com