The Breathe Away learning group will meet the first Tuesday of each month, for 12 months, beginning in January. During each interactive 90-minute session the group will discuss the assigned module. There are additional BONUS “office hours” the third Tuesday of each month to facilitate open discussion and case review. All sessions are scheduled for 6 pm Pacific/ 7 pm Mountain/ 8 pm Central/ 9 pm Eastern time and will earn each participant 1.5 CE credits.
The investment to join is $3,600 annually.
Only 24 spaces, first come, first served.
Interested in becoming a member of the Breathe Away learning group?
Apply Below to be added to the wait list. (No payment due at this time)
Hello! I’m Dr. Steve Carstensen.
I’ve been providing patients with oral devices for sleep breathing disorders for more than 25 years, and have been actively teaching this subject to dentists for over 12 years in lectures, study clubs, and writing. My passion is to help narrow the gap between what is known and what is practiced, so all instruction is tied to how it benefits the patient in a dedicated clinician’s office.
My general restorative practice spanned 32 years – and five years into that practice, I began attending the Pankey Institute where I learned about whole-person health care. An early mentor there, Dr. Keith Thornton, is a pioneer in dental sleep medicine so he brought along interested dentists like me with him as he influenced our profession.
My writing partner Dr. Ken Berley and I published The Clinician’s Handbook for Dental Sleep Medicine in 2019, with a second edition in the works for 2023.
I lead the American Dental Association’s Children’s Airway Initiative as we strive to make dentists the primary care physicians of airway performance in kids younger than 6.
WHAT WE ARE COVERING IN THE BREATHE AWAY LEARNING GROUP
MODULE 1 - Dental Sleep Medicine and the Opportunity to make an Impact
Dentists are not trained in the medical field of sleep medicine. This module will introduce learners to the basic physiology and terminology necessary to study the subject and incorporate it into their dental practices. There is a global need for people to breathe better and sleep better, with multiple providers needed to address all the concerns.
Module Learning Objectives:
- Understand common language associated with sleep and breathing
- The pathophysiology of sleep related breathing disorders
- The means of diagnosis and the workflow from unaware to treatment
- Appreciate the epidemiology of poor breathing and the medical consequences associated with it
MODULE 2 - Sleep and Breathing Disorders
This module will go into the details of breathing and airway support disorders. From anatomy to phenotypes to breathing habits, the respiratory system will be explored. Language for how to explain these specialized anatomy and functional details will be discussed so clinicians can easily communicate with their patients.
Module Learning Objectives:
- The anatomy and function of the upper airway from the nares to the alveoli will become more familiar
- The effects of poor breathing on sleep stages and consequences of interruptions during each phase
- Understanding endotypes will give clinicians better ways to decide on which therapy will have the best chance of success
MODULE 3 - Dental Sleep Medicine Protocols and Practice
Who makes the rules for what we can do? How does the ethical, practical dentist decide what they are comfortable with for working with colleagues and achieving health outcomes for their patients? What are initial steps to take?
Module Learning Objectives:
- Introducing screeners to the dental practice
- Choosing a workflow
- Discuss policy statements
- The effectiveness equation
- What does current literature say about OAT vs. CPAP?
MODULE 4 - Integrating a Medical Service into a Dental Practice
Dentists are not as well-trained in documenting encounters as medical colleagues. This module will detail what needs to be recorded for each patient visit. We will talk about software and office responsibilities to ensure the clinician has what they need for ongoing care, communication with colleagues, and submission of claims to medical benefit programs.
Module Learning Objectives:
- An effective strategy for choosing a software program
- What specialized equipment needs are there?
- What imaging is required, recommended, or optimum?
- The nature of medical insurance plans will be discussed
- Specific information that must be documented in the signed medical record will be detailed
- The clinician will know what additional examination details must be added to the typical dental exam
MODULE 5 - Treatment Choices and Appliance Selection
Choosing the right therapy, including deciding which of the 125+ numbers of oral devices available, can be frustrating. This module will bring some clarity to the process through discussion of overall therapy goals and details of several popular oral devices. Member’s clinical experiences will be used to illuminate improvement strategies.
Module Learning Objectives:
- Name patient characteristics that influence treatment choices
- Be able to discuss details of various mandibular advancement devices
- Understand the use of professional interim devices
MODULE 6 - Getting Started on Therapy – Delivery of MAD
Helping people accommodate to therapy that may not be completely comfortable is about more than properly fitting a custom device. The process must include details, setting expectations, and dealing with inevitable side effects. Helping patients with combination therapy is a key element of success
Module Learning Objectives:
- Know what is needed to help people accommodate to OAT
- Creation of a custom AM Aligner and how to instruct use
- Combination therapies to improve success
- What happens if OAT is insufficient?
MODULE 7 - Complications of Therapy and Recovery Strategies
Not every patient will have negative results, but for those who do, what can be done? Should the dentist be concerned with long-term changes? Are they predictable? How does the team help the patient through short and long-term changes? Which other medical providers do you need to be able to call upon?
Module Learning Objectives:
- What are the most common unwanted side effects
- How to have some sense of likelihood they will occur
- Strategies to help patients manage their results
- Develop a list of colleagues to refer patients with specific problems
MODULE 8 - Evaluating Therapy
Most dental procedures do not cure breathing disorders. Ongoing management requires benchmarking for initial response and persistent resolution of the measurable issues. Patients need to understand their role in the process and clinicians will need to choose how their practice is going to assess the titration process as well as future monitoring.
Module Learning Objectives:
- Documentation of the initial problem
- Setting goals for therapy
- Assessment of resolution of initial signs and symptoms
- Strategy for ongoing management at consumer and professional levels
MODULE 9 - Nose Breathing and Other Strategies to Aid Success
While keeping the mandible forward has a positive effect on the tongue base and tissues of the upper airway, nose breathing is a key component of success. The rate and depth of breathing during the day can influence overall health and may improve sleep breathing as well, so members will learn basic techniques to improve breath control during this module. The nose is not just a choice of breathing route.
Module Learning Objectives:
- Understand some of the details of nose breathing benefits
- Know some simple ways to test your patients for nose breathing effectiveness
- Improve nasal breathing through specific exercises
- Be familiar with resources your patients can use to make things better
MODULE 10 - Legal Issues and Medical Benefit Strategies
Dentists must be careful in a changing, and unfamiliar, environment of legal definitions of practice. Sending claims to medical insurance companies brings with it some details that must be considered. In this module, most legal issues will be found to be benign. Medical benefits and managing claims is a complex issue – billing experts will be guest hosts to answer questions. This module is intended to include team members.
Module Learning Objectives:
- Understand legal constraints around current dental practice in this area
- Set up workflows to document necessary information for successful medical claims
- Set expectations for the medical claim process with patients and team.
MODULE 11 - Pediatric Airway Considerations
It is with our youngest population that dentists can have the most impact on overall health. Signs, symptoms, evaluation, treatment, and payment systems are completely different than for adults. This module introduces some of these key comparisons and outlines the dentist’s role in pediatric airway. Guest hosts from the world of children’s dentistry will share real-world experiences.
MODULE 12 - Adjunctive Therapies
No part of medicine can treat every breathing problem or airway support compromise. Dentists have a critical role to play, sometimes as quarterback for a team of physical therapists, speech pathologists, physicians, surgeons, orthodontists, and other key personnel.
Module Learning Objectives:
- Be familiar with what other providers can add to a successful treatment strategy
- Help patients accept combination therapy as the best chance for success, not as ‘yet another doctor to see’
- Know how to manage patients who choose to compromise by not engaging other providers
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