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CUSTOMIZED PRACTICE SOLUTIONS
Dr. Klauer also invested in building a team, working with nurse
practitioners, myofunctional therapists, orthodontists, sleep and ENT
rehab specialists, and musculoskeletal pain doctors. "If you're doing
a ton of ortho, you really do want a myofunctional therapist because
that'll be paramount in getting good results," he said. 
"Team training is huge. You need to spend money on professional
development, including practice management help, leadership
courses, and continuing education. I brought my team to a lot of sleep
and TMJ courses over the years to get them trained. Once you
have clinical training, you need to market to the community to attract
new patients."

independent practice with a different location that's 100% focused
on craniofacial pain and dental sleep medicine or just dental sleep
medicine if you choose." 
"One of the most profound things I remember hearing was
Dr. Jameson Spencer saying that dental sleep medicine is easy
if you're an expert of the TMJ. I think there's a lot of truth to that
because of the overlap of those two branches. We're seeing more
and more of that. Dental sleep medicine courses are in fact talking
about craniofacial pain, TMD, and the relationship between these."

Educating patients about sleep disorders
At Dr. Klauer's practice, he shows patients scans of what a normal
anatomy looks like compared to what their anatomy looks like. He
walks patients through the process of screening, diagnosis, and
personalized treatment plans. He then shares the scans with patients
so they understand what was diagnosed and what was performed. 
Collaborating with physicians to help patients
Building a presence in the sleep disorder sector involves
communicating with physicians, dentists, chiropractors, physical
therapists, and psychologists in the area to let them know this type of
practice is available to their patients. 
"Once you start to accept patients as referrals and you get your name
out there, you'll start to build relationships with physicians, but the
easiest way to get referrals is to send referrals out and they come
back," Dr. Klauer said. 
Incorporating to sleep medicine
Practitioners who are new to sleep disorders may choose to screen
patients and advise them to participate in a sleep study or talk to a
physician, or they may screen patients, refer some out, and then start
to offer treatment. "Once you've had ample training, you can have
patients come back to discuss what an oral therapy appliance looks
like, discuss the risk indications, and get an order from the physician
or sleep physician to fabricate the oral appliance," advises Dr. Klauer. 
"Once you start dabbling in sleep disorders, what we most commonly
see is practitioners starting to offer more of this in their practice. It's a
good idea to dedicate half days or particular days to this, because it's
such a dynamic mental shift to go from performing general dentistry
to the types of conversations we have around sleep and pain. It's
hard to go back and forth."
Some practitioners create a different entity within their practice, so
that patients have a bit of a different experience than when they come
in to get their teeth cleaned or to get a filling. "You might consider
creating a separate brand," Dr. Klauer advises. "It can be under the
same roof and share overhead but typically has different staff, its own
phone system, and so forth. At some point you may form a separate,

Clinical case examples
Below are some recent case examples:
Ivan was a dental patient who presented complaining that his teeth
were grinding off. The scan showed a mild obstructive sleep apnea.
Ivan got his nose fixed, and the ENT sleep physician provided an order
to fabricate a new oral appliance. Dr. Klauer then performed a follow
up sleep study to see how Ivan was doing. He is now in a stable
position with no TMJ issues and is sleeping well. Five years later,
Ivan has lost weight and his master hypertrophy is decreasing as well. 
Rocco is a healthy 37-year old who presented with TMJ problems. He
wanted to be able to relax his mouth and jaw and not feel so tense
all the time. He had been through multiple orthotics with multiple
different dentists and seven different appliances over the years. He
had dizziness, anxiety, muscle spasms, and was tired. 
What bothered him most was that he had an open bite, so he
didn't know where to bite. Dr. Klauer performed an evaluation and
recommended that Rocco receive a diagnostic sleep study and see
an ear, nose and throat physician for his nasal valve issues and his
deviated nasal septum. The treatment plan involved starting with
myofunctional therapy to help keep the tongue in the roof of the
mouth and help treat that lateral open bite.
Dr. Klauer was able to get the jaw pain under control and Rocco then
went ahead and got braces. After discovering that Rocco had mild
sleep apnea, Dr. Klauer started treating the jaw joint dysfunction
using myobrace and myofunctional therapy. In eight weeks, Rocco
started to see his bite closing and within roughly three months, the
bite was reestablished as normal. 
After Rocco got his nose fixed, he still had some sleep apnea, so Dr.
Klauer devised an oral appliance for him. This helped Rocco's bite
feel better, and actually improved his posture, which also alleviated
his neck pain. 
Conclusion
"Our goal is to offer a stellar patient experience," said Dr. Klauer.
"These are the type of results you can get with patients - taking away
significant pain and improving their breathing. You can see pretty
significant changes."

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2020 - 2021 Orthodontic Specialty Catalog

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