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Educating Patients about Infection Control

infection control curtainsEducation about infection control is actually one of the most important tools in the fight against the spread of infection. As well as educating the healthcare professionals involved, it is also important to take steps to educate the patients, so that they can play an important part in protecting themselves and others.

Start with the very basics

Teaching patients the very basics of infection control can drastically cut down on the spread of disease. Simple things like washing their hands with soap and water, rather than just washing with cold water can help to save lives. Another trick is to sneeze into your elbow, rather than onto your hands. If people sneeze into their hands, and then subsequently touch things around them, infection can spread easily. Many germs can live on a surface for a significant amount of time, so germs which are transferred from a patient’s hands to the door handle, can then be picked up by another person who touches that door handle.

Make infection control education reassuring, not frightening

If you are teaching patients about essential aspects of infection control, make the process a reassuring one, rather than a terrifying one. Patients are more likely to respond to something if they are comfortable with the notions that are being taught. Remember that patients tend to be in a lonely and vulnerable position, because of their current health condition, and taking a frightening approach to infection control can leave patients in a mentally unstable position. Scaring patients can lead to paranoid actions and over-engagement in the process, which can both lead to health concerns of their own. Taking a frightening or negative approach to the issue can also leave patients afraid to ask questions, meaning that they will not be happy to clarify things that they don’t understand properly. For some patients, it can be helpful to carry out the majority of the educational process when they have a friend, family member or advocate with them.

Reinforcing by doing

Reinforce the need for proper infection control by doing the steps that you have been teaching. This shows that your words were not hollow, and that you are also following the same steps, to help to prevent the spread of infection. For example, you can say “I’m just going to wash my hands”, before you carry out a procedure, so that they patient feels reassured and reminded of the importance of handwashing. You can also gently remind them to do the same thing. The more that they do something, the more likely it is to stick in their minds in future.

Provide education in multiple formats

It is important that everyone fully understand the need for infection control, so be willing and able to provide infection control advice in multiple formats. For example, some people respond well to pamphlets about infection control, because these pamphlets allow them to read and re-read the information, meaning that they can take it all in properly. Pamphlets also offer the opportunity for information in multiple languages.

More about the infection control process at http://orange-restoration.com/additional-services/san-diego-infection-control/

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The Dentist San Diego Residents Trust Focuses On Both Big And Small

Dental Trust
For San Diego dentist Dr. Daniel Vinograd, focusing on both the big picture and the small one is essential. This commitment to details and to overall health is why many consider him the best holistic dentist San Diego has.


Attention To Detail

For a dentist, details are essential. Fillings must not be too shallow or built up too much. Crowns must fit exactly. Dentures and dental implants must align properly or the patient will experience pain, problems eating and never be completely satisfied.

While a mouth may be generally healthy, a single tooth can need careful attention. Just for a moment, then, all efforts and attention must turn toward restoring that single tooth so that complete health and wholeness is possible. And a biocompatible dentist makes sure everything used for every restoration is okay for usage in the mouth.


The Bigger Picture

But a holistic dentist like Dr. Vinograd is concerned with much more than just teeth and oral health. A good holistic dentist understands that oral health and the overall health of the patient are intertwined. The bacteria that decays teeth can also cause heart disease. An acid mouth means an acidic body, and there are health implications from that. An infection in the mouth can spread, and ill health elsewhere in the body can lead to a decline in oral health.

It simply isn’t possible to treat the mouth without considering the whole body. That’s how Dr. Vinograd has established a reputation as the dentist San Diego residents trust above all others: he treats every patient as a whole person, not just a mouth.

In fact, that’s what holistic dentistry is: a focus on a healthy body and its connection to a healthy mouth. Doesn’t that seem like a smart approach to dentistry?


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What’s The Best Toothpaste Available In Stores?

If you want the best toothpaste for your money and for your family’s health, you’ll have to look beyond the most common brands to smaller, less-well-known brands that are more careful what they put in their products.

You can find Sodium Lauryl Sulfate, Carrageean and Sorbitol in some brands. And most brands include Sodium Saccharin, a questionable artificial sweetener that’s the same thing as those pink packets some people once used in their tea or coffee before better alternatives were available.

Worst of all the chemicals found in big-name toothpastes is Sodium Fluoride and the other forms or Fluoride. While this was once considered essential to healthy teeth, there are better choices now that are non-toxic and don’t have the side effects. If you want the best toothpaste available, you want a fluoride-free toothpaste.

So which brands can be trusted? You need to carefully read the label of any product you’re considering, but you can trust some products from Tom’s of Maine, now made by Colgate, Jason and Kiss My Face.

Other brands you may be able to trust are:

  • Dr. Ken’s
  • The Natural Dentist
  • Tea Tree Therapy
  • Vicco
  • Desert Essence
  • Weleda, and
  • Spry.

Reading labels and staying vigilant is as essential when choosing a toothpaste as it is when choosing vegetables, packaged foods and other products for your family. It’s so important to choose the right toothpaste because it goes into your mouth every day, is absorbed through your gums and some of it is inevitably swallowed, especially by children who don’t know any better.

Remember that even trusted makers change their formulas all the time, so a product that’s acceptable one week could be bad for you the next. Remember also that some products from trusted makers are better than others. Not every choice is a fluoride-free toothpaste that deserves to be called the best toothpaste for your precious family.

If you are willing to put in the time, here is a health homemade toothpaste recipe.

Your Simple Guide To The GoWiWi Attack Strategy

golemWant to learn how to use the GoWiWi attack strategy? Stay with us here and learn everything necessary to be successful using this strategy. That includes things like how to deploy, matchmaking and army composition.

So what is GoWiWi? Simply put, it’s a troop composition plan that many of the game’s top players are finding very powerful. When you use it correctly, you can get two stars on absolutely ANY base. Proven players are calling GoWiWi the most consistent attack strategy ever available in the game. It’s made up of Golems, Witches and Wizards. There are also Barbarians and Archers for the purpose of luring and Wallbreakers to make sure your army runs strong through the base. You will need 3 Golems, 4 Witches, 5 to 7 Barbarians, a dozen or more Archers, between 12 and 22 Wallbreakers and 10 to 15 Wizards.

I have 3 Golems, but I only have 10 Wizards. That’s the case because at Town Hall 9, there is reduced army camp space compared to what’s available at Town Hall 10. To deal with this, you have to either have a Golem in your Clan Castle or 5 Wizards. My strategy is usually to take 15 Wizards along with 2 Golems (in addition to the one in the Clan Castle) since my Golems are only level 1 for the moment.

Choosing The Best Base To Attack

When choosing which base you’d like to attack, it’s important to think just the opposite of how you’d think if you were attacking with Hogs. In that case, you’d want the most compact base with defenses that are close together. With GoWiWi, however, you want to work with a base that’s spread out so your Golems and Skeletons have plenty of room. If you’re trying to attack a tighter base layout, rather check out these GoWiPe variations (like HoGoWiPe).

This base has three wall segments around the Town Hall, but there are no sections that intersect. That makes it really easy for my Wallbreakers to get in. Plus, luring is easy since both heroes and the Clan Castle are outside the base.

A Bit About Spells

The Lightning, Jump, Rage and Freeze spells all work with GoWiWi. It’s your choice what will work best. In general, you only want to use Jump when using 8 to 14 Witches. At Town Hall 9, I would recommend using 1 Lightning and 3 Rage. At number 10, I would use I Lightning, 2 Rage and 2 Freeze for the Infernos.

The Lightning spell works for taking down CC troops. The Rage spell does its job for breaking through to the Town Hall.

Something About Deployment

Deployment is the most important part now that you have a grasp on the basics. Step one for a successful raid is to lure the Heroes and Clan Castle troops out. That requires either dropping an Archer or a Barbarian near them.

Then, you’ll want to bring the Heroes to the side from which you’d like to stage your attack. I also like to go in from the bottom, so that’s how I do it most of the time. Once they’re there, put a few Barbarians and Archers in front of them and then put Witches in the corner. Once the Witches are set, drop 3 or 4 Wizards on top to help manage the BK.

After you’re certain that both of the heroes are destroyed, it’s time to bring on the Golems. This is a bit tricky because you have to juggle a lot of things at the same time. And it takes practice to get it right. Start by putting down a single Golem on either the right or left. The base will determine how far apart the Golems need to be.

Drop a single Golem, then 2 or 3 Wallbreakers, then 6 or 7 Wizards. Repeat this on the opposite side so that you can clear away all outside buildings. This makes a clear pathway for the Wizards, Witches and Heroes headed for the center of the base. Then put down one more Golems in the middle of the Witches as soon as defenses appear to start targeting the Witches.

NOTE: You may need to put down the middle Golem before the one on the other side sometimes.

With all three Golems down, use a Rage spell on the middle entrance. As your troops move through, keep a stream of your Wallbreakers moving. Don’t drop them all in a single line, otherwise a Mortar or Wizard Tower could take all of them out at once and mess up your raid.

When you see only a single layer of walls left around the center, send in your last Wallbreakers and move on to Town Hall.

All you need to do now is drop in your Heroes, and then you grab your two easy stars.

Oh no! It looks like we forgot one of the buildings outside, so the Heroes went after it instead of heading to the center. That costs us 3 stars, but we got 2 stars, so the overall success of the raid is pretty good. How about that?

Not quite there yet? Start by learning to set up a th7 war base.

Selling Beauty – Botox Training

Facial care – Botox ApplicationBeauty has been a huge market ever since advertising and media blew up out of proportion. There are tons of products launched every year that promise people to correct their uneven skin tone, or make their lashes look longer, or even make them lose all the excess weight instantly. Lots of promises are made, only to be broken almost immediately after they are bought. Unfortunately, none of the beauty products that guarantee you freedom from wrinkles, crow’s feet and fine lines really work. One product that does work beautifully for the elimination of wrinkles and fine lines, and is non-surgical, is called Botox.

Considering the fact that Botox is extremely popular among the aging baby boomers and is continually growing to become the hottest commodity available to people out there,  it is not shocking to know that there is also a growing demand for medical professionals that are certified to perform this procedure. While many medical professionals in the United States qualify to receive the Botox injections training, not many realize how easy it is to do so. For starters, Botox training can be completed in just one day including the practical training. You can opt for the one day training at National Laser Institute’s medical aesthetics school if you are short on time allowing you to complete your Botox training course in just one weekend. It is a great opportunity if you have plenty of other things that keep you busy during the week. If you are not hard-pressed on time, then you can consider getting yourself enrolled in an intensive 12 days training. Besides the wonderul time factor, National Laser Institute’s medical aesthetics school also grants you your continuing medical education (CME) credits while you are doing your Botox training. It is a great way to reach your minimum 40 credits criteria for the year without having to spend too much time. Another added advantage to completing a Botox training, is the fact that there is no insurance middleman for this cosmetic treatment. With an average cost of a Botox treatment being $500, and customers willing to spend that kind of money, it is very likely that  this price tag will be all going to you.

Besides being relatively less expensive and less painful than its surgical counterparts, Botox provides almost immediate results to its clients. It is also a lot safer than going under the knife and is super fast with no downtime. It is, however, important for you as a Facial Esthetic Healthcare Professional to understand the needs of your patients and to suggest to them a procedure accordingly. In order to be able to provide to your patients effectively, you must consider offering procedures such as facial injection therapies, non-surgical face lifts, brow lifts, lip augmentation, and laser skin treatments among others.


Filing Insurance For Oral Appliance Therapy P6

So, it’s going to take a lot of effort from your part to actually get in bed, if you would, with a sleep doctor.  What I would do is look at the area first of all.  See who your initial GPs are.  If you already have a GP, start talking with them for a start.  The other big group is cardiologists.  If you have a cardiologist, start talking with them about what it is you’re interested in doing and what you can do.

Get in on there and get some literature.  Make sure you get all your diligence and your homework so that when you sit down and talk with them, whether it be a lunch or an after-hour, a meeting or something of that nature that they feel very comfortable and confident that you know what it is that you’re talking about what you’re doing.

I happen to be fortunate enough to be in an area where there are a lot sleep doctors.  They are primarily internists who basically have done an initial residency in sleep.  So, that’s where I hook into with those guys, and I’m also tapping in to a lot of cardiologists as well.  So, it’s going to take a lot of networking, but you’ve got to be able to present the fact that you really are confident and know what you’re doing when it comes to sleep in order to get them on board.



Excellent.  The next question really regards your case fee and courtesy billing.  They’re kind of interested in know what ledge you did that, the particular method, and what, in your experience, is the biggest plus of that facet?


Dr. Cress:

Oh, two things.  Let me go with the biggest plus.  What you do that day, you make that day, you take home that day.  It’s really nice.  All your overhead costs and everything is covered, whether it’s a DNA appliance from Arrowhead or it’s one of their oral appliances that you’re using.

If you recall that and this gentleman may not have heard this story ahead of time, we decided early on that if we’re going get into this, we’re not going to be married to insurance companies.  We’re going to present the cases as a case fee.  I’ll tell you what my case fee is.  It’s $3750 whether it’s a DNA appliance for orthodontics or it’s a DNA appliance for OSA or it’s an additional OSA appliance with a SUAD or SomnoDent, it’s $3750.  That is inclusive of everything.

Well the patients that up front, and we do billings to their insurance.  Again, I’ve given checks back for $3750 all the way down to $68, but the patients already know that.  So, it was just a mindset that we had early on, and we’ve learned, for example, the Blue Cross Blue Shield example that I gave where we got no reimbursement all the way up to the gap exclusion.  Those are lessons that we’ve learned, but we were never penalized for it early on.  The patient’s penalized for it, if you would, so to speak, but they’re going to have to pay for treatment either way.

So, again, it was just a mindset.  I learned it from making my wife do it, from the insurance perspective in her psychiatry practice, and it’s just been a win-win situation. It just gets rid of so many headaches and so many issues and stuff associated with trying to collect.



Excellent.  The next question I’m still trying to paraphrase it as best as possible.  The question starts off with, “It sounds as though you were a traditional dentist initially.  How did you make the transition to sleep dentistry, and how do you present sleep dentistry to your patients that were part of your general practice?”


Dr. Cress:

He was absolutely right. I was a general dentist for a period of time, getting burned out, and started snooping around.  Actually, I went to a sleep meeting in, again, San Antonio, the TDA, and I just got totally turned on by the whole area.  So, I couldn’t get enough, and I probably have 300, 400 hours in sleep in the past year with regards to CE courses.

So, that has just kind of transpired and grown and fueled my fire going on with regards to it, but, again, I started and looked at the patient as an overall individual from a health care perspective, not from how many fillings I can do, do they need a crown, what’s my production for the day.  Basically, I focused in on the patient and their overall healthcare and providing their healthcare to them.

I will tell you, every single patient picks up and reads that.  “Oh, he doesn’t really care about this filling or this cavity.  He cares more about my health.  Yes, I do snore.  Yes, I am tired.  Yes, I bark at my kids too much.  My husband and I are having issues,” but really, what is it?  It’s because you’re tired.  You don’t have the cognitive responses that you should have from an individual that’s been well-rested.

So, that basically is what turned me on, what fueled the fire, and how I started at it is the basic Epworth.  Then, again, like I said earlier, if you guys sign up for additional courses in dental sleep medicine, you’ll learn that when we see bruxism and we see tori and we see all this, we think it’s overstress or it’s genetics.  No, there’s research out there that supports the fact that all those are associated with sleep, and then you have the co-morbidities associated with sleep.

When you start talking about people’s overall health, their cardiovascular issues, their diabetes, their impotence to you name it, their weight gain, their weight-associated lost in weight, weight gain and fluctuation, they start getting turn on and they go, “Hey, you’re more than my dentist.  You’re becoming my health care provider.”


Excellent, and I guess this question is a follow-up to that.   It says, “I’m a dentist who uses a CPAP machine, and I find it to be very complicated process at night.  In your experience, how do patients receive these OSA treatments that you present?”


Dr. Cress:

Well, I will tell you this.  If I give them their appliance and they wear it, I go back to them and take their appliance away from them, we’re in Texas.  So, in Texas, we pack guns, they’re probably going to shoot me.  They will never go back to CPAP.  People who we have talked about CPAP with and trying to get them off those appliances into oral appliances have been phenomenal.

Two of the cases I just received, full-mouth cases, I just seated this past week, both of them were CPAP users.  Those CPAP machines have dried out their mouths, have run out their teeth, and I have done full mouth rehabilitation on both of those patients as a result of a side effect from CPAP.  So, that’s a real simple sell.

Even though it’s a huge dollar amount, they’ll do anything about it.  Now, keep in mind, when I do a full mouth rehab on a patient with CPAP, I’ll automatically give them the oral appliance.  It’s very well-received.  I mean in Houston, we have a lot of travelers who do a lot of international traveling, a lot of traveling for CPAP wearers, and the fact that they can just throw that device in their bag and go is, again, an immediate sell.

A lot of those patients, I would say a good 90% of those patients when we talk about insurance benefits to them, they don’t care.  They write a check.  They throw in a credit card.  They could care less.  They want an appliance. If they get something back from medical insurance, great, but they’re so sick of the CPAP device.  I will tell you, 95% to almost 100% of the CPAP wearers have no clue that there’s an alternative to them, have no clue, and we are the alternative, the oral appliance.



Excellent.  We have three questions remaining.  They’re short ones.  The first one is in regards to the Epworth Sleep Scale.  Can you have your assistant ask those questions, or is it required the doctor be the one doing the questioning?


Dr. Cress

No, our hygienists do it.  Our oral hygienists do every one of them, and they do it.  We do it from kids on up. Actually with the younger kids, we ask the parents those questions a little bit.  Those things help because they’re not going to be driving, stopping the car, but we screen every single patient with an Epworth.



Okay, the next question is a specific ine I guess on billing.  It says, “When billing a Panorex, can you bill medical and dental simultaneously, or is it a one or the other type of deal?”


Dr. Cress:

Well, you know, Matt.  That goes back to the whole thing.  I mean, how much do you really want to chase that?  Seriously, and if you get more reimbursement on the dental side that’s fine.  If you get more reimbursement on the medical side, that’s fine, but that takes a lot of effort and time and staff time and cost.  So, the variance between the two isn’t going to be really that great.  You’re basically stepping over the dollars to pick up the pennies.

So, my recommendation on that is do it on medical.  They’re going to want to see it or they’re going to want to know anyway.  Just send it on one side and be done with it.  I personally wouldn’t cross the two for the variance of money.  Then, definitely don’t double bill.  That’s just not right.


Great.  The last question, then, is, “If you are a fee-for-service, do you still have to submit all necessary documents that the insurances are requesting for the patient’s that are out-of-network? What’s your experience with that?”


Dr. Cress:

Yes, absolutely. Here’s the catch:  You ask the patients themselves, “Do you want to see if you have medical coverage for mandibular devices, or do you want to just go ahead and pay for it?” What they’ll do is they’ll go ahead and say, “Yeah, we’ll go ahead and pay for it and see if we got something.”

So, we, again, collect up front, and then, we submit it.  So, we do ask them.  I mean, I have patients that are like, “I don’t care whether you submit or not. I just want the appliance.”  So, if you’re going to do that, we absolutely do, no matter what.  Now, if you don’t have medical coverage, for example, this falls under DME, and if you have the example I gave earlier, if the individual has a deductible on their DME for $5000, what difference does it make?  Go ahead and collect the cash, the $3750.  You give them the paperwork.  They submit to the insurance.  It goes to the deductible.

God forbid they get in some type of accident or something and they need a wheelchair, they’ve met most of their deductible.  So, we do submit no matter what, but we do collect up front for every one of the OSA devices that we do.



Excellent.  So, that concludes our question and answer period, Dr. Cress. Thank you so much for your time and your expertise on this matter.

Filing Insurance For Oral Appliance Therapy P5

So, if you use these basic simple codes right here, and you have the case fee, whether it’s $2500, $3000, $3500.  Whatever the fee is, if you have your diagnostic information and all the codes associated with your medical billing, you use straight codes here, and you collect up front. Tell the patient you don’t know what the reimbursement is, but, based on the information that you have gathered, they have a percentage back.  Bingo, you’ve collected your total fee.  You submit it.  The checks come back.  They’ll come to you or the patient depending on how it’s in-network or out-of-network.  When they come to you, hand them a reimbursement and be done with it.

Every Thursday afternoon, I usually write anywhere from one to five, six, seven reimbursement checks from the medical side of it, and I’d much rather do that than go through the hassle of continually building each one of the codes.

What’s next?  Filing the paperwork. You’ve got everything from EOBs to electronic filing to status checks for claims to denials and appeals to peer reviews.  I mean it’s exhausting.  Here’s that CMS 1500 if you’re not familiar with.  My software spits that out.

I’m going to run through these really quickly as far as the 1500 because I see we’re getting a little tied up on time, but filling out the form, make sure that you always have the diagnosis codes listed in order of importance. For example, it’s OSA.  Diagnosis of the OSA, that’s going to always provide medical necessity.  Always make sure that you list your CPT codes ranging from the most expensive all the way down.  Make sure you complete all the fields on the forms and make sure you stay inside the lines because they’ll look for any reason to kick you out.

The first 13 boxes is basically patient information; 14 and 15 is when the symptoms occur.  Box 17 is your referring physician, and guess what?  Boxes are going to have sub-boxes so they’re going to want stuff like NPI numbers for your physicians.  For additional notes, CPAP intolerance.  By the way, with the sheet that you get those forms, the directions, you can go online, and they’ll tell you what these boxes are for and what to fill in each one of them.

Box 22 is for Medicaid only.  Box 23 is your pre-authorization number and so forth, dates of service, places of services.  You usually won’t need that one.  You’ll list your CPT codes, your diagnostic codes, charges for each code, list of the units, your NPI number, your TIN number, optional.  If you want to accept your insurance assignment, you say “yes” or “no” there.  Charges for record.  Again, these codes just go on and on and on.  They go in all these boxes.  The total for the claim, that’s really important for you guys to know, and your signature. Then, the last part of it is going to be the location in which your services took place and the name and so forth.

Now, you want answers to all those questions?  Here’s where you get your pen.  Get your sharpener out and get it going.  Here we go. I have a software. I got online with a software company called Nierman Practice Management.  Some of you guys may already have this.  Their update is phenomenal.  It is literally the most customizable software out there.

What’s great about Nierman Practice Management, and that’s the number, 1-800-879-6468.  Rose Nierman owns the company.  She’s phenomenal.  Glenina is great.  The software program is about $4500, and the in-office training is about $1500.  That $1500, to me, outweighs the $4500 that you pay for the software.  Glenina comes in, and she customizes it for you.  She’ll show you a lot of tricks to the trade with regards to filling out the information.

What I love about the Dental Writer is it has a diagnostic and questionnaire reporting exam. Basically what you do is in each one of my computer rooms, I have a flat screen, touch screen computer on the wall, and we pull up the Dental Writer.  Basically, what it is that there’s tabs that you go through.  You click on the tabs, and my assistant reads the part of the exam that I do. I do it with the patient, whether it’s the Epworth or the Mallampati or the tonsils score or this or that, and she just clicks and touches the button and fills in all of it.  When that tab’s completed, she goes to the next tab, and she reads off all the things that I need to do.

Once we go through all the tabs, this software will then go to a diagnostic report.  It automatically writes your SOAP note. It automatically writes your medical necessity, the one that I showed a minute ago.  It automatically writes everything for you. It will also send a “thank you” letter to the referral doctor.  It does everything for you.  It is absolutely the most phenomenal thing I have ever seen.

If there’s components that you don’t one, they can go and delete those for you so you never have to see them again.  If there’s stuff you’re looking for that’s not there, it’s easily customizable.  They’ll show you how to do it yourself, or they’ll do it for you.  It is a great, great way to do it.  It will print out that CMS 1500 form with all those boxes already filled in.  You don’t have to worry about it, and it just fills it in the line so the insurance companies can’t keep track and say, “Sorry, we’re not going to pay for it.” Then, there’s cross coding for medical as well.

I really highly recommended.  I use it.  It’s great.  It’s been a really great work force.  It also keeps track outside of our [46:06], which patients are using OSA and so forth.  Then, the other one is this company out here.  There’s several of them out there.  This is obviously a Texas-based company in San Antonio.  Basically, they don’t get paid unless you get paid.  What they do is they take over the information, and they submit all the claims, make sure everything’s done correctly before they submit it.  Once the reimbursement comes back, you pay them.  For example, if you submit $3000 and you get $2500 back, you owe them $250, but you don’t have to go through all the stuff we went through in order to do some courtesy bill.

Again, dental sleep medicine and craniofacial dentistry has been great for me this past year.  I’ve been happier in dentistry than I ever had in my entire life.  I’ve done more full-mouth rehabilitation cases this year than I ever had in practice in 18 years, looking at people’s airways, opening them up, and getting them back to where they need to be at a better place in life, and I just say enough great things about it.

If you guys have any questions or any comments, we’re going to take a couple of questions, comments, if I’m not mistaken. I’ll be glad to answer them, and here’s my information.  Feel free to call me. I always return phone calls, and I always return e-mails.  They may not be right at that second, but they will usually get done by the end of the day.

Again, thanks Arrowhead for letting me participate in a webinar, and thank you guys for listening to me.  I hope I didn’t carry on too long or talk too fast.  Matt, do we have any questions?



Thank you very much, Dr. Cress.  I’ll give you a quick second to catch your breath.  I just want to remind all the attendees that we did go over a lot of information.  This PowerPoint will be available if you want it.  The only thing that we ask and the reason that we ask is we don’t want to be accused of spamming our attendees, but if you’d like that, make sure you fill out the question on the survey where it asks if you’d like it e-mailed to you.  We’ll go ahead and take care of that for you.

With that, we’ll go ahead to some of the questions.  We got a number of questions from your presentation, Dr. Cress, and I’ll just try to go into those now.  The first one is from a doctor.  He asks, “In your opinion, do you feel that OSA is going to become a viable means for a dentist to access the more lucrative medical insurance?”


Dr. Cress:

Oh my gosh.  You have no clue.  I don’t know who the dentist is, but give them my number.  I’ll give them the financial numbers directly.  It has been phenomenal, and I will tell you.  It’s really a great adjunct to help your patients.  Yeah, I mean, we can do bleaching and we can do all kinds of interesting cosmetic things and so forth, but when you start talking about their overall health and putting them in a better overall position in life, from a mood perspective, it’s just incredible.

So, to answer your question, absolutely yes.  It’s alarming to see the number of memberships who have grown in the American Academy of Dental Sleep Medicine and the American Academy of Craniofacial Pain.  It’s just been leaps and bounds.  The answer to the question is absolutely, 100%.



Great.  The next question is, this is a doctor asking, “What things do I need to have in place to start offering sleep dentistry, in your opinion?”


Dr. Cress:

Well, again, where I actually generated after the TDA meeting in San Antonio, was I came back that Monday, and I printed out the Epworth.  I got it off the internet. I printed up the Epworth.  I put it in my format, and I started asking every single question.  Those individuals that come back that have 8 or greater, I then started looking from a diagnostic standpoint with regards tyou o their work facades or sore eye, their scalped tongues [49:30] and so forth, keeping in mind that that particular lecture is given at Arrowhead for the sleep component of it.  I encourage everyone to sign up for those and learn how to do that.

Then, you start looking beyond Ts and you start seeing things that are very suggestive of OSA. The next step is obviously a sleep study and/or a home sleep study in order to confirm your initial diagnosis.



Okay.  The next question kind of regards your mentioning sleep doctors or sleep MDs.  The question is, “With OSA and sleep dentistry, what is the type of interaction I’m going to be having with MDs?”


Dr. Cress:

Well, here’s the catch.  As everyone knows, it’s very hard for doctors to make money because they have to see so many patients.  So, what you do this doctors going in and out, in and out in order to meet their quotas for the day.