As Patel prepares to inject 2% lidocaine, assistant Otilia Gustke stands by with fluoromethane spray to numb the jaw area.
On the strictly pain side, Patel uses appliances for clenching/grinding, in addition to splints and orthotics. Specifically, he favors Glidewell Laboratories, Great Lakes Dental Technologies, True Function Laboratory, and Apex Dental Sleep Lab. “Bio Research is a company that sells lasers for pain,” Patel adds. “Whip Mix has a Gem Pro, an ambulatory unit that looks at bruxism/snoring/pulse ox, to see if there’s an underlying sleep issue that will require a referral to a sleep physician. I also recommend pharmaceuticals such as over-the-counter NSAIDS and prescription antiinflammatories.” For injection therapy, he buys anesthetic from a dental distributor. For software to manage his TMJ and sleep practice, he prefers Nierman Practice Management for its clinical data capture, letter writing templates, and medical claim forms. (Patel also lectures for Nierman Practice Management.)
With pharmaceuticals, oral appliances, splints, and orthotics as possible solutions, Patel cultivates a continuum that is entirely dependent on patient needs.
While so-called “turf wars” are not a thing of the past, Patel seems confident that day will come, preferably sooner than later. “The level of respect for dental sleep medicine has come a long way,” he says. “Today there is a lot of awareness and we have a lot of medical practitioners who are oral appliance-friendly and understand that many patients are not able to tolerate CPAP. They understand that when that happens, they need to offer alternatives. I look forward to a time when respiratory therapists, nurse practitioners, physician assistants, and MDs all have a firm understanding of oral appliance therapy.”
[sidebar] Continue this discussion in person at an industry supported event at the American Academy of Dental Sleep Medicine annual meeting. Patel is doing a clinical Q&A on dental sleep medicine and pain on June 7 at 7 pm at the Marriott Rivercenter in San Antonio. Contact host Nierman Practice Management for details. [/sidebar]
Greg Thompson is a Loveland, Colo-based freelance writer.