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industry Ortho Tribune U.S. Edition | NESO & PCSO 2016 10 Screening for a new revenue source that sets you apart By Dr. Chris Farrell, BDS, CEO and founder of Myofunctional Research Co. (MRC) M ost dental profes- sionals, by now, should be well aware of the rapid changes altering the dental playing field. Themarket-drivenchanges,suchascorpo- ratization of the industry and oversupply of new dental graduates, have been well highlighted in professional publications, and despite an increase in the frequency of dental caries, particularly in young children, after decades of decreasing in- cidence, the dental profession, unlike its medical counterpart, relies on the ability to treat just a handful of diseases. In previous articles, I wrote about the opportunities to widen our income base beyond the traditional that this chang- ing dental landscape offers and explained how these opportunities are available now. Sleep Disordered Breathing (SDB) — and the serious effect it can have on a patient’s health and well-being — has recently gained attention and emerged as a new special interest. The disorder is recognized as being a result of the same upper airway and neuromuscular dysfunction causing malocclusion. For dental practitioners willing to grasp new opportunities, the ability to treat SDB and TMJ disorder rep- resents a new revenue source. The first step toward tapping into this new revenue source is to realize that each day more business walks out of your prac- tice than is actually treated there. Virtu- ally all growing children have a develop- ing malocclusion, and early treatment or, where possible, prevention is sought after by parents. Additionally, 35 percent of adults expe- rience chronic pain as a result of TMJ dis- order, and treatment is rarely offered. Fur- thermore, there is a high incidence of SDB among both children and adults, which is 80 percent undiagnosed. The potential increase in practice capacity is significant if these patients could be recognized and offered treatment. Therefore, the second step is develop- ing the knowledge and ability to screen for these issues, which can be as simple as asking some questions. This can be achieved by setting aside one day each week to focus on consultations to identi- fy these issues, which other dental prac- titioners may have never evaluated. For kids: Myofunctional orthodontic evaluation (MOE), 5-15 years Malocclusion is evident in children from the time the primary dentition is present and onto the mixed dentition. Rather than genetics, the causes of the malocclusion are incorrect growth and development. The MOE identifies the causative factors of malocclusion, which, as is the case with mouth breathing, can lead to chronic health issues later in life. Therefore, it is the duty of care of the dental profession to at least identify these developmental issues in children and offer treatment options to their parents when available. Even in a practice that predomi- nantly treats adult patients, if those adults are parents, they will naturally take an interest in any health issues concerning their children. For adults: TMJ disorder screening procedure TMJ disorder is one area of the dental pro- fession where tertiary education is lacking, with many academics considering it too complex an issue. Additionally, in order to avoid acknowledging the detrimental effects mandibular advancement devices (MADs) have on the occlusion and TMJ, many sleep dentistry practitioners make no mention of the TMJ during diagnosis. Screening for TMJ disorder is made easy when the patients use a visual index to pinpoint to the practitioner what symp- toms they are experiencing. This has the potential to identify a vast number of pa- tients who have TMJ disorder, and because it is easily treatable in adults, and more severe issues can be avoided by treating early in childhood, existing patients can be offered solutions for issues that were previously unidentified. In addition to opening a potential new source of income, identifying these patients and developing an effective, evidence-based treatment plan provides a great service. For many dentists today, it is easy to be- moan a lack of patients while taking little action, except spending hard-earned in- come on advertising while offering the same service as colleagues. However, for practitioners who are focused on succeed- ing, the ability to effectively screen exist- ing as well as new patients for SDB or TMJ disorder provides a means of differentiat- ing from competitors. Furthermore, by packaging habit cor- rection, arch expansion, airway correction and dental alignment into cohesive treat- ments, Myobrace® and myOSA® systems, available from Myofunctional Research Co. (MRC), are able to address the aetiologi- cal factors interfering with craniofacial growth and causing malocclusion as well as SDB and TMJ. These systems, which were developed during the past 25 years and use a struc- turedapproachthatintegratespatientcon- sultation,evaluation,diagnosis,treatment, education, clinical management and health goals, can enable dental profes- sionals to treat more children earlier than previously possible, increase patient flow, diversify treatment by offering so- lutions for SDB and improve practice ef- ficiency. In addition to providing financial ben- efit by enabling the practitioner to deliver high-quality biologically based treat- ments at a low cost, MRC’s systems provide a means of meeting an increasing demand for early orthodontic treatment. Once potential patients have been iden- tified through the screening methods out- lined above, MRC’s myofunctional treat- ment systems are easily implemented into the practice. The treatment process begins with evaluation, education and treatment planning, which is completed via a series of optimized stages. Implementing the Myobrace and myOSA systems into your practice • Parent/patient education: The first con- sultation with parent/patient begins with MRC’s intuitively guided patient educa- tion presentation. This explains the causes of upper airway and neuromuscular dys- function leading to SDB, malocclusion and TMJ disorder in children as well as adults. The presentation outlines to the parent/patient how myofunctional treatment is not just another means of straightening teeth or habit correction; rather, it is a complete treatment mo- Myofunctional Orthodontic Evaluation (MOE) identifies the causative factors of malocclusion. Photo/Provided by MRC dality aimed at improving the patient’s overall health and development. • Evaluation: As part of the first con- sultation with the parent/patient, a Myo- functional Orthodontic Evaluation (MOE) identifies areas that require focus (i.e., breathing dysfunction, incorrect myo- functional habits or nutrition). The pa- tient’s myofunctional habits should be analysed to provide context for the evalu- ation of the malocclusion, SDB and TMJ disorder. • Record taking: In preparation of the case presentation and treatment plan, intra- and extra-oral photographs are then taken along with impressions for study models. Additional videos of the patient’s function can be taken using a video camera or mobile tablet. Patients are referred for an OPG and ceph X-rays as required, ensuring parent consent is recorded in the case notes. • Case presentation: Through the use of visual aids the parent/patient is pro- vided with a clear understanding of the issue as well as the proposed corrective action. The patient’s photographic records should be displayed on a monitor, utilis- ing the patient education presentation as a support tool to help explain treatment parameters. Treatment options and refer- rals are also discussed and in some cases, a referral to another health specialist may be required, which offers the opportunity for collaboration with other health profes- sionals. • The treatment plan: This makes up part of the case presentation and con- firms in writing: the patient’s evaluation, established health goals, proposed treat- ment, including approximate timing and fee structure. Once the parent or patient has accept- ed the treatment plan, an appointment is scheduled and treatment using the Myobrace or myOSA system can begin. Treatment involves the use of a series of intra-oral myofunctional appliances, spe- cifically designed to re-train the oral mus- culature, develop the arch-form and align the teeth. In combination with the appli- ances, the fully automated patient educa- tion and activity program, the Myobrace Activities™ app, is an integral part of the treatment system. A changing professional landscape as well as a new focus on evidence-based bio- logically focused treatment means that, for practitioners still reliant on the me- chanical excellence of the past, profitabili- ty is diminishing. However, the good news for forward-thinking dental professionals focused on 21st-century, evidence-based dental and health care, the opportunity to improve their patient’s health and well- being as well as operate a profitable prac- tice is available. To learn more about MRC’s patient education programs and to begin imple- menting the Myobrace and myOSA treat- ment systems, visit the courses section at myoresearch.com.