Over the past months we’ve looked at the first three parts of S.E.T.U.P.—Screen, Educate, and Test. This month we’ll look closely at how sleep medicine dentists can (1) help patients understand the risks of their sleep breathing disorder and the reason why we, as dentists, are intervening for their health, and (2) help your team understand and implement the best game plan for patient conversations about sleep health.

Understanding: The Patient Perspective

At this point, we’ve seen a study or gotten the patient tested. If the patient is complying with a physician’s recommended treatment, we must congratulate him or her, but also be wary of the fact that there may be a level of unjustified shame associated with noncompliance. It does happen. Furthermore, even the patient who wears a CPAP every night may wish to know there are alternatives. Our goal is not to convert patients to oral appliances, but to meet them where they are and determine whether you can help them stay healthy.

For the patient who is not being treated, the sleep apnea dentist should spend some time on case presentation. Prior to case presentation, highlight the sleep study details you’ll use to discuss targeted points that will make it more understandable. Some patients are confused by this area of crossover from the medical world.  It’s not as common in the medical world to spend time to discuss the details.  Make a point to put your role in the proper context early on. You are not sharing your own opinions, but recommendations that come from a board-certified sleep physician.

Before you sit down with the patient, take the data and put it into patient-friendly terms. What can you say to foment understanding? Our role is to translate and interpret their sleep study, as a service to them and their health. If the patient views us as a concerned ally, we have a greater chance of helping.

Discussing the Study

When you sit down with patients to discuss their sleep study, remember that you must meet them where they are. If he or she is already motivated to make a change—sleeping in a separate room from his spouse, for example—help him understand that treatment can improve his marriage. If the patient is in poor overall health and complains of low energy, espouse the benefits of better sleep on all the body systems.

The patient who has just done his sleep study may need a bit more information on the implications of letting apnea go untreated than one who has already seen a physician. The patient who is not complying with his doctor’s advice may need gentle reassurances that it’s okay to admit if it’s not working out.

Explain to the patients how many times they choke and suffocate during the night. Cite their degree of oxygen desaturation why it is dangerous. You will need more than just positive diagnosis of OSA to make the study data meaningful. You have to make it personal, and you can never assume these details were ever adequately explained by a physician.

Ultimately, your job as a sleep apnea dentist is to convey why treatment is important and the consequences of doing nothing. Keep the message straightforward:

• Sleep apnea is serious.
• Sleep apnea is progressive.
• Sleep apnea does not go away.
• Sleep apnea is life threatening and life shortening

Helping the patient understand what is truly at risk requires education, but it also requires compassion and reminding the patient why his or her health is worth preserving. Help patients understand how it will improve their lives and they’ll be more open when you present a treatment.

Understanding: Putting Together Your Team

Understanding is also a critical piece of getting your team operating in a way that routinely helps you identify at-risk patients and get them the help they need. The sleep apnea dentist cannot do it alone.

You must be intentional about every member of your team understanding the role they play. Identifying at-risk patients, case presentation, documentation, diagnosis—everyone needs to know how it’s going to work and what they can do.

Not only should everyone on your team be given at least a basic education on sleep health and sleep disorders, signs and symptoms, but they should also understand how each team member may be able to initiate conversations with patients. This should be planned and orchestrated with everyone in the same room, so no layer of interaction is neglected.

As a group, discuss:

• What questions will go on the new patient questionnaire?
• What questions will be asked in the hygiene chair?
• What other patient interactions may present opportunities for engagement?
• What red flags warrant repeated attempts at connecting, and how should they be handled?

Team members do not need to always follow scripts, but you should take the time to role-play scenarios for maximum patient engagement and education.

When you take the time to build understanding in your team, you give them the confidence and the know-how to function as an efficient cog in your system for identifying and helping at-risk patients. With a strong team, no patient will fall through the cracks.

Next Month

Next month, we will look at the final step: Present. If you aren’t putting time into case presentation you are missing a valuable opportunity. We’ll show you how to maximize this step for the health of your at-risk patients.