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ACSDD Consortium by Michael J. Krahe, PhD, and Jennifer A.E. Krahe, PhD(c)

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by Michael J. Krahe, PhD, and Jennifer A.E. Krahe, PhD(c)

Healthcare in the United States is undergoing a dramatic transformation. Prevailing national and international healthcare policy, reform and initiatives are demonstrating that care is no longer based solely on practitioners' perspectives, but instead is the result of dialogue between patients and practitioners. Central to this dialogue is the navigation of both the scientific evidence and the needs of the patient and family. Taking into account diverse expectations of care, this patientcentric dialogue requires extensive teamwork and an approach to health and healing from a multidisciplinary perspective. This multidisciplinary perspective considers the patient and the patient's family an integral part of the healthcare team.

This re-envisioning of care demonstrates that there is increased interest in engaging patients and their families as part of the healthcare team, and ensuring that care is safe, patient-centric, evidence-based and cost-effective while focusing on prevention.

What Can Dentists Do to Be Part of This Transformation?

Dentists can begin to explore dental sleep medicine. Dental sleep medicine is the medical/dental identification and management of sleep breathing disorders like snoring and obstructive sleep apnea (OSA) with oral appliance therapy. Approximately one-third of your patients over age 15 are at risk for a sleep breathing disorder1 and, according to the American Academy of Pediatrics, between 10-15 percent of the pediatric population. Of those suffering from a sleep breathing disorder, 80-90 percent remain undiagnosed.2 Virtually every system of the body is affected by sleep breathing disorders, from the neurologic and cardiovascular systems to the metabolic and reproductive systems.

Why Dental Sleep Medicine?

Dental sleep medicine with oral appliance therapy is noninvasive, non-pharmacologic and very well tolerated by patients. It requires close collaboration between the physician who diagnoses the sleep breathing disorder and the dentist who treats it. Other relevant healthcare practitioners who treat the patient are also involved, such as nurse practitioners, ENTs, chiropractors, nutritionists and many others.

The gold standard of treatment for these conditions was continuous positive airway pressure (CPAP) up until 2006. However, as the research concentrates more on patient-centric, evidence-based options that take the preferences of the patient into consideration, this has changed. According to the 2005 Practice Parameters for Dental Sleep Medicine,3 oral appliances are now indicated for patients with mild to moderate sleep breathing disorders, and those with severe sleep breathing disorders who elect not to use CPAP.

Dentists must join this new collaborative, patient-centric and evidence-based model of Dental Sleep Medicine, as an increasing number of patients are electing to treat their sleep breathing disorder via oral appliance therapy. This collaboration requires a different perspective - one that is multidisciplinary, scholarly and rigorous.

The Academy of Clinical Sleep Disorders Disciplines (ACSDD)

The Academy of Clinical Sleep Disorders Disciplines (ACSDD) has been created to help dentists participate in this transformation of healthcare, and to join the burgeoning field of Dental Sleep Medicine with both scholarly rigor and clinical practicality.

The ACSDD is the only academy in the national and international Dental Sleep Medicine arena that is truly multidisciplinary. It brings together not only dentists and physicians but all relevant healthcare practitioners who are part of the multidisciplinary healthcare team. In keeping with the prevailing national and international policies that mark healthcare's transformation, the ACSDD invites everyone to the table, including the patient. More information can be found at www.ACSDD.org.

Overview of Issues Facing Dentists Who Practice Dental Sleep Medicine

Patient-centric healthcare perspectives welcome dental sleep medicine, and the literature supports this modality's efficacy. However, the reality is that dentists practicing dental sleep medicine continue to experience an uphill battle. The literature shows that research takes 17 years to reach practice (Morris, 2011), particularly when it comes to healthcare. The ACSDD is closing that gap.

Dentists are struggling to build referral networks that ensure collaboration with physicians to treat the condition, to work within a medical model, to bill medical insurance, and to successfully communicate to the medical community and the public what they bring to the treatment of sleep breathing disorders. The ACSDD is helping dentists meet these challenges head-on with an innovative and realistic solution that's the first of its kind in dental sleep medicine: The Consortium for Dental Sleep Medicine.

Why the ACSDD Started the Consortium

The Consortium was created because ACSDD members were expressing their frustration with the lack of advocacy for dentists practicing dental sleep medicine. Widespread splintering within the field of dental sleep medicine, in-fighting, politics, hidden agendas and an inability to follow through on what was promised was truncating any progress that dentists hoped to make, and frustrating everyone who tried.

Because the ACSDD exists first and foremost to meet its members' needs, starting a Consortium initiative was an easy choice for the organization to make.

Numerous organizations have been invited to partner with the ACSDD under the umbrella of the Consortium, but todate, no other organization has stepped forward, despite these organizations' repeated assertions that something must be done. The ACSDD's invitation is always open to all dental groups and organizations to contact the ACSDD to join their voices with others to support and advocate for those practicing dental sleep medicine. Together we can make a difference, but only if other organizations put their differences aside and agree instead to make their assertions a reality.

What is the Consortium?

The Consortium is a grass-roots initiative overseen by the ACSDD and run by its members to bring advocacy and change for dentists doing dental sleep medicine. There are three initiatives and each initiative is led by a team leader (currently all ACSDD members) and has a corresponding volunteer group helping with the initiative. These three groups have been working for about nine months on the initiatives:
  1. Educate the Public - led by Dr. Mark Paschen (mdpaschen@acsdd.org)
  2. Educate the Insurance and Federal Payors - led by Dr. Ellen Crean (epcrean@acsdd.org)
  3. Educate the Medical Community - led by Dr. Melody Barron (mabarron@ acsdd.org)
The Educate the Public initiative recently completed a public service announcement (PSA) through SleepBetter TV (www.sleepbetter.tv), the ACSDD's 24-hour Internet news channel. To find out more about how to embed, e-mail or link to the PSA, call the ACSDD at 480- 575-7100. The PSA is free and available to use as you wish to educate your patients on sleep breathing disorders and dental sleep medicine.

The ACSDD membership has recently enlisted the assistance of Arizona Congressman/Dentist Dr. Paul Gosar as an advocate for our Consortium. Dr. Gosar has been practicing dentistry for 25 years and is very familiar with oral appliances and the many issues facing dentists doing Dental Sleep Medicine. Dr. Gosar can open many doors for our initiative on Capitol Hill. Moreover, Dr. Gosar is very active in promoting prevention and wellness versus the current model that concentrates solely on treating diseases. The ACSDD was honored to have him at the last ACSDD conference in Scottsdale, Arizona, as our keynote speaker. The standing ovation he received from the membership was a testament to his stance on health, dentistry and government. The ACSDD is currently working with him to plan next steps.

Additionally, the ACSDD has formalized a collaborative relationship with the Atlanta School of Sleep Medicine, one of the premier sleep medicine educational institutions in the nation (www.sleepschool.com). The Atlanta School, as it's widely known in the field, educates and trains physicians, sleep technologists, advanced practice nurses, physician assistants and other industry professionals in the field of sleep medicine. The ACSDD and the Atlanta School are proud to announce that they will be holding a joint conference September 27 and 28, 2013, in Scottsdale, Arizona. Dentists, physicians, nurse practitioners, physician's assistants and others will be in attendance - a truly multidisciplinary experience. For more information or to register contact the ACSDD at 480-575-7100.

You are invited to join our efforts to advocate for the dentists practicing dental sleep medicine. If you wish to be a part of one of the initiatives, simply send an e-mail message to the dentist listed above who is overseeing it. If you have any questions, visit www.acsdd.org or call Dr. Krahe directly at 814-881-7020.

References
  1. 1. Michael J. Krahe, PhD and Jennifer A.E. Krahe, PhD(c)
  2. Finkle et al., 2009; Young et al., 1993
  3. Kushida et al., 2006

Author Bios
Dr. Michael Krahe is the founder and executive director of the Academy of Clinical Sleep Disorders Disciplines and serves as a leadership and strategy mentor with Transformational Alliances, LLC, an interdisciplinary dental sleep medicine education and practice collaborative that is the first of its kind in the field. He is a former C-level executive in a Fortune 400 Company, in which he focused on leadership, strategic planning and technological innovation. He resides in Carefree, Arizona.

Jennifer Krahe, a PhD candidate, is founder and owner of S3: Sleep Science Simplified. She resides in Phoenix, Arizona.
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