Impact of Medicare Ruling

 

There is a new Medicare ruling coming down the pipe that may put dentistry at the forefront of sleep medicine.  There is no other profession in existence that is better equipped to deal with the airway as a Dentist.  The training and education of the Dentist has been on the head and neck so this is just a natural extension of dentistry.  We are able to manipulate the jaw, the tongue, and all the major contributors to the sleep disorder breathing.  It is something that is we have been trained for to start and now we are able to bring it to bear on this concern.  Medicare is starting to see this and understand the role of Dentist and thereby the new ruling validates the Dentist’s role in this sleeping disorder.  If this ruling turns out to be the final ruling it will have profound impacts and ripples through this entire sleep medicine community both in the dentistry and medical side of things.  With this ruling, home unattended sleep study will be an accepted diagnostic modality thereby enabling Dentist to diagnose sleep disorder breathing without using a sleep lab.  This will have profound the effect on medical doctors who have started all the sleep labs around the country and who have decided to avoid utilizing Dentist in their treatment plan.  However, the medical doctors who have been wise enough to seek out a Dentist to work with their team may be able to survive. The future is just starting and it will be interesting to follow the progress of these aspects of dental sleep medicine in the future.

 

God Bless,

Dr. Ron Prehn

Dr. Keith Thornton’s Contribution

 

There are some new Medicare rulings that are being released as I pen this blog.  It will address the fact that Medicare will pay for the oral appliances as well as home unattended sleep studies.  This is a shocking and incredibly significant ruling if this ends up to be Medicare’s final position on this matter.  The ruling will propel the dental sleep profession into the forefront of dentistry as it starts to deal with all the aspects of sleep as it relates to oral disease as a whole and the deterioration of dental apparatus through time.  I will write more on this later.  At this point, I need to pay homage to Dr. Keith Thornton, who has been on the forefront of this profession since the beginning.  He has spent his career for the last 25 years in trying to obtain this type of status for the dental sleep profession.  He has worked diligently with lawmakers, with policy makers, with Medicare, insurance companies, and other industry professionals in order to convince them of the essential role of the Dentist in treating sleep disorders.  The Dentist is well equipped to deal with every aspect of sleep disorder breathing at the base of the diagnosis up to every aspect of the care of the airway.  This is what Dentists were trained to do from the very beginning and now we have been able to bring every aspect of our profession to bear on this critical problem in society and hopefully many patients will not only have their lives saved, but also have their entire general health improved.

 

Dr. Thornton is to be commended for all his hours and years of work that he has not had any pay for, nor has he had the recognition he deserves.  He is not only the inventor of one of the best mandibular advancement appliances for sleep medicine, but also the father of Dental Sleep medicine in my mind.  So, I dedicate the future of the dental sleep profession to Dr. Keith Thornton.  Thank you Dr. Thornton for all you have done for not only the profession, but for all the patients that will have better overall health and the lives you have saved, for your lifetime efforts.  I look forward to your continued contribution to the profession as we dive into all the different aspects of sleep disorder breathing as it affects the general dental health of all our patients.

 

God Bless,

Dr. Ron Prehn

Diplomate of the American Board of Orofacial Pain

Diplomate of the American Board of Dental Sleep Medicine  

 

Hebrew and Facial Pain

  

I have had the incredible opportunity to attend seminary at Dallas Theological Seminary.  I am near the end of my work for a masters of the Theology degree and all I have remaining at this time is to learn the language of Hebrew.  As I am learning this language, I find it fascinating by the versatility of this language.  When I learned Greek, every word had an exact definition and endings were very accurate as to how are they used in vocabulary and grammar.  Hebrew on the other hand is very fluent and very versatile.  One word may have many different meanings, often at times four or five meanings.  Therefore, it is from a western point of view a very difficult language to learn.  However, from the Semitic mind, this language fits the way the mind works.

 

The meaning of a Hebrew word is entirely contextual.  Context determinants the meaning not just the nuances, but the actual meaning of the word.  Therefore, a word cannot stand on its own, has no meaning until it is put into a context of a thought in sentences or paragraph.

 

When it comes to pain, the same principle applies.  Pain without context is almost unimaginable.  There is always a context to pain. Pain is in the context of anxiety or an experience or a physical harm or punishment or many other things that frame the context of the pain.  If the context of a painful event is in a life-threatening situation, the mind often times puts the pain aside and ignores it completely.  However, if the pain is in the context of secondary gain where the person would receive sympathy and attention, then the pain becomes highly exaggerated and center of the patient’s life.  I often see this in mothers who are raising children.  They very often put their pain aside because their children are of high priority than they themselves.  They have contextualized the pain and put it in a place of low priority.

 

Therefore as I am learning Hebrew and its vocabulary, I am reminded how people contextualize pain and that as a treating medical professional that we have to understand the context in order to understand the patient’s pain.  Then we are able to address the pain and to treat it properly.

 

God Bless,

Dr. Ron Prehn