Friday, August 31, 2012

Medicare and Tricare coverage for oral appliances

Medicare, Tricare and other government insurances should cover oral appliances but that does not mean it will be easy. Medicare requires dentists form a DME, then pays poorly, See question from Eduardo received 8/31/12

Question from Eduardo: Why has my dentist taken so long to see if I can get an oral appliance for sleep apnea and snoring. Also I need to know if most of your Dentist take medicare and Tricare for life, I need to get something going.The doctor I have is taking too long I aplied back in May 2012 and still nothing

Dr Shapira response: Unfortunately while covered by medicare most docs won't take it. Medicare requires that an the dentist has a DME and choice of appliances is very limited. I do not accept medicare and have opted out and medicare patients pay my fee. My office is near great lake navak base but tricare has never paid for an appliance.

The good news is that CPAP is very successful if you can tolerate it. If not you must be proactive with Tricare and/or medicare that they find you a provider.

My suggestion is just to pay out of pocket if you can afford it otherwise get on CPAP while waiting for approval.

The good news about untreated sleep apnea is that it can kill you......the bad news is that it can cause a stroke!


There are several questions when it comes to Medicare coverage. First is whether medicare can afford to take on the cost of oral appliances considering the majority of seniors have some sleep disordered breathing. The requirement that dentists form DME's for each office is ridiculous, expensive and cumbersome. The proper approach is for Medicare to contract with Medicare approved labs that make appliances for sleep apnea and to pay the lab cost directly to the manufacturer. The dentist professional fee should be governed by standard Medicare B pay codes and fees. The alternative is that dentists opt out and patients make private arrangements for professional services.

Medicare should cover appliance manufacturers for the appliance based on specific appliances. My personal feelings is that there should be a minimal qualification of the dentist to have medicare cover the lab costs. A good idea might be to use diplomate status in the AADSM. Dentists who do not meet requirements would just do private contracts for the full amount. The dentist would not need to participate in Medicare but could if they desired.

Labs would have to meet Medicare standards for coverage, a difficult to define and ever changing target. Because labs serve thousands of dentists it would be financially effective.

It should be clearly understood that medicare would limit the number of appliance types.

In Illinois, Southern Wisconsin I personally treat patients with medicare after an opt out is signed. Patients who opt out of medicare can use the appliance of their choosing but must pay for it themselves.

Tuesday, August 21, 2012

Study Suggests Sleep Apnea May be Extremely Underdiagnosed Among Women

Perhaps because regular snoring is its most common symptom, sleep apnea is often perceived as a problem that is greater among men. But an ever-growing array of evidence demonstrates that sleep apnea is a dangerous problem that does not discriminate by gender, age or race.

A recent study conducted by researchers at Uppsala and Umea University—the findings of which were published in the European Respiratory Journal—indicates that women experience obstructive sleep apnea (OSA) at rates nearly as high as those of males. In a study of 400 women from a sample of 10,000 women between the ages of 20 and 70, approximately half suffered from symptoms of obstructive sleep apnea.

In findings echoed by other sleep apnea studies, the research showed a higher rate of OSA among those with hypertension or who were obese.

Sleep apnea is already thought to go undiagnosed in millions of people. The study suggests the problem of undiagnosed sleep apnea may be especially great with women.

If you or your partner suffers from chronic snoring and other sleep apnea symptoms, it’s important to undergo an evaluation by a qualified sleep dentist. The field of dental sleep medicine offers a number of safe, comfortable and effective treatment options for OSA and other types of sleep disorders.

Please contact to locate a dentist near you who specializes in sleep apnea diagnosis and treatment.

Tuesday, August 7, 2012

What is Dental Sleep Medicine, and How can a Dentist Treat My Sleep Apnea?

Dental sleep medicine is a specialized field of dentistry focused on diagnosing and treating the cause of snoring, which is often related to the dangerous condition known as obstructive sleep apnea (OSA).

Although many people occasionally snore, for tens of millions of Americans snoring is just one of the symptoms of OSA. While snoring alone is not necessarily harmful, sleep apnea can increase your risks for severe medical problems including heart attack, stroke, hypertension and cardiac arrhythmia among other conditions.

Dental sleep medicine addresses the cause of sleep apnea and treats it in an individualized manner. Sleep apnea treatment has long utilized continuous positive airway pressure (CPAP) machines; yet many patients find these devices uncomfortable and cumbersome, and discontinue their use.

Thanks to advances in technology and a deeper understanding of the airway blockages associated with obstructive sleep apnea, many patients who suffer from OSA find success with oral appliances. Oral appliances can effectively treat many cases of sleep apnea by stabilizing your jaw and tongue to help you maintain an open airflow during sleep.

Oral appliances are custom made for your individual bite condition, and they hold the jaw and tongue forward while allowing you to keep your jaw properly aligned as you sleep.

If you would like to learn more about sleep apnea diagnosis and treatment, please contact to locate a qualified sleep dentist near you.

Thursday, August 2, 2012

The Life-Threatening Dangers of Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a common and life-threatening sleep disorder thought to affect more than 20 million Americans. Yet its dangers are only beginning to be understood by the public at large.

OSA can affect children and adults regardless of gender or race. Recent public awareness campaigns backed by clinical research and an increasing number of treatment options available through the growing field of dental sleep medicine have helped educate people about the potential risks of OSA and other forms of sleep apnea as well as the importance of early diagnosis and treatment.

If not treated, obstructive sleep apnea can increase your risk for:

  • Heart attack
  • Stroke
  • Hypertension
  • Cardiac arrhythmia
  • Diabetes
  • Depression
  • Impotence
  • Anxiety disorders
  • Gastric reflux
  • Fibromyalgia

Some recent studies also suggest a link between sleep apnea and a risk for developing certain forms of cancer.

If you or your partner experiences nightly loud snoring or other sleep apnea symptoms, a qualified sleep dentist may be able to diagnose your condition and recommend a custom sleep apnea treatment. Continuous positive airway pressure (CPAP) devices are just one treatment option; for many patients, oral appliances are a comfortable and effective way of correcting the airway blockage that leads to OSA.

If you would like to learn more about sleep apnea assessment and treatment, please contact to locate a dentist near you who specializes in sleep apnea diagnosis and treatment.

Wednesday, August 1, 2012

Sleep Apnea Symptoms Beyond Snoring

Loud, chronic snoring is the most common symptom of sleep apnea, but most people who suffer from obstructive sleep apnea (OSA) and other forms of this dangerous sleep disorder also experience other symptoms. And snoring alone does not mean you have sleep apnea.

With an increasing number of sleep apnea diagnostic tools and treatment options available through the growing field of dental sleep medicine, it’s important to schedule a consultation with an experienced sleep dentist near you if you or a loved one snores regularly and also has any of the following symptoms:

  • Recurring daytime drowsiness
  • Morning headaches
  • Sudden weight gain
  • Difficulty focusing/memory problems
  • Regular morning dry mouth
  • Recurring sore throats
  • Depression
  • Mood swings
  • Waking up choking/gasping for breath
  • Decreased sex drive

Left untreated, OSA and other types of sleep apnea can increase your risk for developing severe health problems, including hypertension, stroke, cardiac arrhythmia, diabetes and fibromyalgia among others. Fortunately, there are a number of comfortable and effective sleep apnea treatments available.

Although continuous positive airway pressure (CPAP) devices have long been the standby for treating sleep apnea, many patients benefit from custom-made oral appliances similar to mouthguards that allow you to maintain an open airway as you sleep.

If you would like to learn more about sleep apnea diagnosis and treatment, please contact to locate a qualified sleep dentist near you.