I am a full-time practicing dentist in Massachusetts and went through a period of burnout, regret, and resentment toward dentistry. It took years but during the long climb back to getting back to enjoying dentistry, I learned a lot about burnout, what causes it, and how to avoid it. I recently pulled this hard-won wisdom into my book, The Stress-Free Dentist: Overcome Burnout and Start Loving Dentistry Again. I don’t want any other dentist to have to go through what I did. But if they are, then I have a few encouraging words for you because trust me, I’ve been there and back. YOU CAN DO THIS.
There are many reasons burnout in dentistry exists. Some of the big ones are:
- The overwhelming amount of debt or overhead
- Lack of HR and business training
- The day-to-day exhausting nature of the profession
It’s important to remember to not give in to the false belief that dentistry is just a stressful profession and there is nothing you can do, or that this is the profession I chose and I’ll just have to deal with the stress until I retire. No. This is no way to live and this mentality is unsustainable for a 40-year career.
There are concrete steps you can take to relieve pressure in these areas. For instance, one way to conquer this false belief is to invest in yourself, learn to deliver a new treatment or technology, and introduce it into your practice. Adding these new modalities, especially high-value services such as guided implant dentistry, sleep and airway treatment, 3-D printing, impression-less digital scanners, and/or clear aligners can create what I call the three R’s: Return on investment, Re-energize your staff, and practice, and Reinvent yourself.
This will be the Second of a five-part series focusing on how one can rejuvenate their careers and overcome or avoid burnout in dentistry by adding some of these high-value treatments and technologies.
Part one focused on adding guided implantology to your practice.
For this installment, we’ll focus on adding sleep apnea and airway treatment for the dental office.
And now for something completely different…
Want to make a difference in your patients’ lives but are tired of doing the same old thing? Are you stuck in the hamster wheel of dentistry? Fillings, crowns, bridges, extractions, endo, removable prosthetics, and so on. Rinse and repeat? Looking for a new treatment to add? Maybe something that isn’t back-breaking work like the #15-DO composite I did the other day.
Well, give your practice, career, and back a boost by adding sleep and airway. Forget about just saving teeth, save some lives as well.
What is sleep apnea anyway?
The repetitive collapse of the upper airway (back of the throat) during sleep. Episodes of partial airway collapse for at least 10 seconds can result in a significant blood oxygen level drop, a brain awakening, or both. None of that is good.
How prevalent is sleep apnea?
I have heard that there can be up to 10-30% of your patients who may have suffered from some level of sleep apnea or an airway issue. So, if you think about practicing with 1000 active patients, then there may be at least 100 that have some level of sleep apnea.
What are the biggest issues with untreated Sleep Apnea?
Untreated sleep apnea has been associated with more risk of a stroke, arrhythmias, heart attack, weight gain, type 2 diabetes, GERD, Alzheimer’s, etc.
Some patients may not even know they have sleep apnea. Some patients aren’t even asked while at their PCP and only inquired about it because their spouse gave them an ultimatum due to the snoring, they had a scare while driving, or they just feel so fatigued throughout the day.
Hesitations and barriers
What’s holding you back from successfully adding sleep apnea and airway to your practice? For me, some of the biggest barriers were the thought of trying to navigate medical insurance coding and reimbursement, the fear of the treatment not helping the patient, or not knowing where I can go for guidance if I need help. Plus, we had no training in dental school and a lot of this may be new for the staff, as well.
Patients may also have been coming to you for a while and you never asked them. Sleep and airway just seemed like a treatment that was too difficult for me to add to my practice. So, to get started, we have to get ourselves, the staff, and our patients educated.
Use 3rd party companies to remove some of these barriers.
Like I mentioned earlier, I learned 0.0% of sleep apnea and airway in dental school. However, there are a lot of companies out there that can help you with training, screening, sleep studies, medical diagnosis, treatment, and follow-up care. Sleep studies used to be done in a clinic or sleep lab but a lot of this can now be done remotely with home sleep studies and/or online consultations. There are also services that will help with the medical insurance coding aspect and options to engage with peer support groups.
Sleep apnea treatments in the dental office
The mouth is the gateway to the body. So, let’s put our doctor pants on and save some lives. Continuous Positiva Airway Pressure or CPAP is considered the gold standard for treatment. However, there can be low compliance, maintenance, or recall issues with the CPAP. If the patient isn’t using it or keeping it clean, then it’s not helping at all.
Another option is where the dentist comes in to play and that is with a dental mouthpiece for mild to moderate sleep apnea. These dental devices tend to have a higher compliance rate and the cleaning and maintenance is much easier.
A mandibular advancement device brings the tongue forward indirectly. Primary lip closure at rest to prevent mouth breathing is also crucial.
Training, training, training, and more training. Like most new modalities you are adding, you need to be properly trained before treating your patients. Don’t jump in without getting fully educated, and more importantly, without knowing your limitations.
Start with your staff and their family, or even yourself. Have everyone fill out the proper questionnaires and sleep studies and you may be surprised at how many of them or even yourself suffer from some level of sleep apnea. I did, and low and behold, guess who had a mild case of sleep apnea? This guy. This isn’t just an adult issue, either. Some children may also suffer from a lack of air during sleep.
Feel the energy
After you have treated a few patients with successful outcomes, you may feel the positive energy seeping into the rest of the office culture. Don’t make it a secret that you are changing people’s lives. Tell the staff and share in the successes. Patients may tell you how they feel better, have more energy, are back in bed with their partner, and feel healthier.
We as dentists see patients at least twice a year and have the ability to be involved with early sleep apnea signs or symptoms. Getting assessed early could be one of the best things someone can do for their health.
And, hey, one of those patients could be you. Ask me how I know.
ENJOY GOING TO WORK EVERY DAY
Life is too short to dread going to work every day. For me, taking things slow, not straying out of my comfort zone, and adding new treatment modalities such as sleep and airway to my practice has decreased those Sunday night blues.
Although I am just getting started with sleep and airway treatment, I can see it as being one of the least stressful, more enjoyable, and financially rewarding treatments I provide on a weekly basis.
For me, being able to control my stress levels by making choices and having a positive impact on patients has relieved my burnout in dentistry. If you can feel yourself losing joy in dentistry and wishing you could change your past, there’s hope.
Find some tools that make you happy and expand your practice and your options. Once you find your groove, dentistry is a great life, but it can take a while to get there. With new treatment modalities and keeping up with the latest technology, you can start loving your job again.
ABOUT THE AUTHOR
Dr. Eric Block is a full-time practicing dentist in Acton, Massachusetts. He’s also a husband and father of two kids. He is on a mission to help dental professionals across the country overcome burnout and anxiety.