sleep dentistry: no one’s ever explained it like that before

This presentation is intended for educational purposes only. Statements of facts and opinions expressed are those of the educator/doctor individually, and unless expressly stated to the contrary, are not the opinion of the course sponsor, Vivos Therapeutics, Inc.

Sleep Dentistry: No One’s Ever Explained It Like That BeforePresenter Name: Dr. Kalli Hale, DDS, MPH, AFAAID


Statements of facts and opinions expressed are those of the educator/doctor individually, and unless expressly stated to the contrary, are not the opinion of Vivos Therapeutics, Inc.

Any use of the Vivos appliances outside of or “off label” from the FDA Cleared and/or Registered Indication(s) for use is the sole responsibility of the treating dentist at her/his clinical discretion and is not the teachings, guidelines, or recommendation of Vivos Therapeutics, Inc.

Vivos does not have an appliance to treat children diagnosed with Sleep Disordered Breathing. Any use of the Vivos appliances outside of or “off label” from the FDA Cleared and/or Registered Indication(s) for use is the sole responsibility of the treating dentist at her/his clinical discretion and is not the teachings, guidelines, or recommendation of Vivos Therapeutics, Inc.

Dr. Kalli Hale, DDS, MPH,AFAAIDNewTeeth Dental Solutions

League City,TX

Take a Starring Role in Sleep and Airway

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•Dr. Kalli Hale received her bachelor’s degree in biology and her Master of Public Health from Texas A&M University. She earned her Doctor of Dental Surgery degree from the University of Texas School of Dentistry at Houston.•She is passionate about how our teeth affect our systemic health, the long-term consequences of dental treatment, the link between dental infection/periodontal disease and heart attacks, and the relationship between chronic airway problems and tooth grinding.•Dr. Hale is a Clinical Advocate for VIVOS Therapeutics and works with dentists around the country to develop clinical protocols for the treatment of mild to moderate obstructive sleep apnea and sleep disordered breathing.

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"It ain't what you don’t know that gets you into trouble. Its what you know for sure that just aint so." - Mark Twain

This Photo by Unknown author is licensed under CCBY.

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"BREATHING IS LIFE"

HOW I SUCCESFULLY IMPLEMENTED

SLEEP DENTISTRY IN MY PRACTICE

$750K IN REVENUE FIRST YEAR

200+ CASES PER YEAR

SAVING LIVES

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"What do you mean I grind my teeth?"

pressly stated to the contrary, are not the opinion of the course•This presentation is intended for educational purposes only. Statemen sponsor, Vivos Therapeutics, Inc.

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"No I definitely don’t snore."


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"I sleep great! I get up once or twice to pee but

other than that I'm good!"


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How did he get here?https://www.hawkinsfamilydental.com/blog/teeth-grinding-signs-effects-prevention/

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And here?

https://www.cmaj.ca/content/187/11/826This presentation is intended for educational purposes only. Statements of facts and opinions expressed arethose of the educator/doctor individually, and unless expressly stated to the contrary, are not the opinion ofthe course sponsor, Vivos Therapeutics, Inc.

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http://www.hawkinsfamilydental.com/blog/teeth-grinding-signs-effects-prevention/

http://www.cmaj.ca/content/187/11/826

AirwayCentered Dentistry

Tongue ties Tori

Bruxism TMD

Headaches Lots of root canals?

Lots of cracked teeth/crowns?

DANGERS OF NIGHT

GUARDS

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T O N G U E T I E S

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UnderstandingOSA

https://www.fleetowner.com/resource-center/driver-management/article/21692512/debunking-myths-about-s leep-apneaThis presentation is intended for educational purposes only. Statements of facts and opinions expressed are those of the educator/doctor individually, and unless expressly stated to the contrary, are not the opinion of the course sponsor, Vivos Therapeutics, Inc.

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What can someone do about it?

MANDIBULAR ADVANCEMENT DEVICES

ORTHOPEDIC/EXPANSION DENTAL APPLIANCES

CPAP


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http://www.fleetowner.com/resource-center/driver-management/article/21692512/debunking-myths-about-s

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Candidate screening

Sleep test

So many suffering in your current patient family!


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Explaining the need for treatment

https://www.dentistryiq.com/covid-19/article/14175987/confusion-about-reopening-due-to-lack-of-cdc-guidance

•This presentation is intended for educational purposes only. Statements of facts and opinions expressed are those of the educator/doctor individually, and unless expressly stated to the contrary, are not the opinion of the course sponsor,VivosTherapeutics, Inc.

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http://www.dentistryiq.com/covid-

7/8/21

"Filter" Questions

• Do you get up to pee at night?• Do you feel fully rested when you wake up?• Do you ever wake up with sore jaw muscles?• Have you ever suffered from anxiety?• I see some signs of GERD – are you aware of

any reflux?• I notice you have tori present, has that ever been

discussed as a sign of SDB?• Does anyone in your family have OSA?• Have you had recent blood work to check for any

thyroid issues?

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SLEEP TEST INTERPRETATION

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"Now what?"

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50% DEEP SLEEP

25% LIGHT SLEEP

25% REM

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OSASeverity

Mild obstructive sleep apnea: AHI 5-15 (1-4 in kids)

Moderate obstructive sleep apnea: AHI 15-30 (5-9 in Kids)

Severe obstructive sleep apnea: AHI >30 (>10 in kids)

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DEFINITIONSAHI = Apnea/Hypopnea Index•# of times you stop breathing per. hour, 10seconds or longer•What is a hypopnea?

•A hypopnea is a significant reductionin airflow while sleeping that causes a drop in blood oxygen saturation and then an arousal.

ODI = # of times the oxygen desaturates per hour

RDI = This is your combined number of apneas, hypopneas, and RERAs per hour of sleep

HEART RATE

Flow limited breathing without a snore

Central Sleep Apnea: Central sleep apnea occurs because your brain doesn't send proper signals to the muscles that control your breathing.

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• Sleep apneaindicator (SAI)

• Measure of SDB based on oscillations in cardiac intervals – based on CVHR during unstable breathing (tidal volume fluctuations). Bradycardia followed by tachycardia, over & over.

• Periodicity• CSA events, also "pain"

If the CSA events are >50% of theOSA events, need MRI to rule outChiari malformation

An exceptional feature of the sleepimage analysis is its capacity to easily distinguish bettwen SDB types.

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Red colored peaks indicated CSA

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CASESVivos does not have an appliance to treat

children diagnosed with Sleep Disordered Breathing. Any use of the Vivos Appliances used off label from the FDA Cleared and or Registered indication for use is the responsibility of the treating dentist clinical discretion, not the teachings nor guidelines of Vivos Therapeutics, Inc.

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Systemic links

Getting to their "why"

"How do you get them to understand that they need it?"

Diagnosing the problem, treating the root cause


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HOW MANY "YES" RESPONSES EQUAL SLEEP TEST?

TAKE AWAY POINTS:1) SLEEP QUESTIONNAIRE2) MENTAL SUMMARY LIST

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BE AN EXPERT

• It's IMPERATIVE that YOU understand the treatment options (be multi-modal)

• Establish systems in your practice to educate your patients!

• Patient education meeting


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The Breathing WellnessMovementTHANK YOU FOR LISTENING!

NEW TEETH DENTAL SOLUTIONSDR KALLI HALE, DDS, [email protected]


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mailto:[email protected]

sleep dentistry: no one’s ever explained it like that before

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