Sleep Apnea Management
Do you have patients who struggle to comply with PAP therapy?
Our office has a special interest in oral appliance therapy, an effective alternative treatment to PAP for obstructive sleep apnea sufferers.
As the recommended treatment for sleep apnea, PAP has many benefits for the patient who is willing and able to use it in a compliant manner. However, you may also have seen that, for some, complying with PAP is a challenge. These patients may be coming back to your office looking for advice and recommendations on alternative treatments. Oral appliance therapy is a proven, effective treatment option for mild to moderate OSA.
Oral appliance therapy is supported by AASM practice parameters and clinical guidelines.
As a member of the American Academy of Dental Sleep Medicine (AADSM), the only national, non-profit society dedicated exclusively to the practice of dental sleep medicine, Dr. Richard Vermillion has a strong working knowledge of both the medicine behind obstructive sleep apnea and the dental options available. His expertise can complement and enhance your patient care; Dr. Vermillion can:
- Custom fit FDA-approved oral appliances for your patients and make adjustments to ensure proper fit and maximum effectiveness
- Provide oral appliances not only as standalone therapies, but also for use in conjunction with PAP, to give your patients a myriad of personalized treatment solutions
- Our office is an approved Medicare DME supplier for a custom fabricated oral appliances (E0486)
Our office is dedicated to helping patients accept therapy, improve medical outcomes and increase compliance regardless of treatment choice. Dr. Vermillion would welcome the opportunity to discuss oral appliance therapy with you in more detail. Please contact our office at your convenience.
Who is a candidate for oral appliance therapy?
A patient needs to have a healthy and stable dentition with at least eight teeth per arch to retain the appliance; for the appliance to be a covered as a durable medical equipment benefit under Medicare and be considered for coverage by private insurance the following criteria need to be met:
The Medicare LCD Determination for Oral Appliances for Obstructive Sleep Apnea:
A custom fabricated mandibular advancement oral appliance (E0486) used to treat obstructive sleep apnea (OSA) is covered if criteria A – D are met.
A. The beneficiary has a face-to-face clinical evaluation by the treating physician prior to the sleep test to assess the beneficiary for OSA testing.
B. The beneficiary has a Medicare-covered sleep test that meets one of the following criteria (1-3):
1. The AHI or RDI is greater than or equal to 15 events per hour with a minimum of 30 events; or
2. The AHI or RDI is greater than or equal to 5 and less than or equal to 14 events per hour with a minimum of 10 events and documentation of:
a. Excessive daytime sleepiness, impaired cognition, mood disorders, or insomnia; or
b. Hypertension, ischemic heart disease, or history of stroke; or,
3. If the AHI>30 or the RDI >30 and meets either of the following (a or b):
a. The beneficiary is not able to tolerate a PAP device; or,
b. The treating physician determines that the use of a PAP device is contraindicated
C. The device is ordered by the treating physician following review of the report of the sleep test.
D. The device is provided and billed for by a licensed dentist.