Monday – Thursday:
8:00 am – 5:00 pm
Friday:
8:00 am – 12:00 pm
405/321-8030
FAQs (Frequently Asked Questions)
About Our Office
Do I need a referral to schedule an appointment for a new patient examination?
When are treatment options discussed?
How does the office handle insurance coverage?
Why can’t you accept direct insurance assignment?
Who can I contact if I have an insurance concern or complaint?
1. Do I need a referral to schedule an appointment for a new patient examination?
You may make an appointment any time by simply contacting our office. Many of our patients are referred to us for diagnosis and treatment of TMD and sleep-disordered breathing by their general dentist, family physician or other medical specialist (e.g., ENT, neurologist, otorhinolaryngolgist, etc.). However, a referral is not required.
*Note: If you are insured by an HMO, you may find it beneficial to obtain a referral from your primary care physician. This is because HMOs require a referral in order for patients to submit claims for the cost of any covered benefits.
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2. When are treatment options discussed?
We are committed to providing quality care that gets results. Following a thorough examination by the doctors, treatment options will be presented. Treatment plans are developed based on a specific diagnosis and desired outcomes. Until you have been thoroughly evaluated by our office, we cannot determine your treatment plan or the cost of your treatment because our fees are based on the severity and complexity of each case.
Following discussion of your treatment options and your treatment plan, a financial/insurance consultation will be conducted. During your financial/insurance consultation, we will outline treatment fees for the first six (6) months of your treatment and review payment options with you. This is why we recommend that you bring anyone involved in making healthcare and financial decisions with you to your first appointment.
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3. How does the office handle insurance coverage?
TMD: TMD is a medical condition; however, it is unusual for treatment to be covered fully by medical and/or dental insurance plans. This explains, in part, why we are a “fee for service” practice and why our patients (or their parents/legal guardians) are solely responsible for payment of all fees. That said, we WILL provide you with all of the documentation you need to file with your insurance company, so that you have the best possible chance of coverage. We WILL also answer questions and provide information in response to questions from your insurance company to assist you in obtaining any/all insurance benefits to which you may be entitled.
SLEEP: Dental sleep medicine treatment of snoring and obstructive sleep apnea may be covered by your insurance plan, especially if you have completed a diagnostic polysomnographic (sleep) study, which must be prescribed by a physician. If you are a CPAP user, we can provide you with a CPAP Intolerance Affidavit. This document is allowing increasing numbers of our patients to successfully seek benefits from their insurance providers.
*Note: If you wish to obtain an estimate of your potential insurance reimbursement prior to the start of treatment, we can prepare a predetermination notice immediately following your initial examination. However, we have found that some medical insurance companies will not respond to a predetermination. Each patient is urged, therefore, to follow up with his or her insurance company directly and keep detailed records of all communications.
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4. Why can’t you accept direct insurance assignment?
As dental professionals, our responsibility is to deliver consistently excellent care that gets results. We do not develop treatment plans based on what your insurance company will reimburse or deems “usual and customary.” Instead, our relationship is with you: our patient. As a patient, you have a relationship with your insurance company. We will provide you with an insurance claim form at the end of each visit to our office, so that you can seek maximum benefits directly from your dental and/or medical insurance providers. However, we cannot accept insurance assignment because:
- Benefits information is inconsistent
- Insurance companies frequently exclude treatment of temporomandibular disorders and,
- There are extreme delays in receipt of monies (despite Oklahoma state law, which requires payment within 30 days)
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5.Who can I contact if I have an insurance concern or complaint?
In addition to communicating directly with your employer (if you are covered by an employer-sponsored health plan) and your insurance company, Oklahoma residents may also wish to express their concerns to the Oklahoma State Insurance Commissioner.
Written complaints should be addressed as follows:
State Insurance Commissioner
1901 North Walnut
Oklahoma City, OK 73105
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About TMD/TMJ
When my treatment is completed, will I be cured?
Can I postpone or delay my treatment?
Why do I have to uncross my legs for you to mark and balance my appliance?
Will I have to wear my appliance forever?
Do I have to eat with my appliance?
Why is it important to do self-care at home while I’m undergoing treatment?
Since I’ve been wearing my appliance, my teeth don’t touch like they used to. Is this normal?
1. When my treatment is completed, will I be cured?
There are 40+ different types of TMD. Some can be cured; others can be managed. For all TMD patients, the first stage of treatment involves controlling TMJ-related pain and dysfunction for a period of time sufficient to determine stability. The second stage involves EITHER correcting the problem (if it can respond to a cure) OR managing it.
Our goal is to make each and every patient independent of us. And we prefer the least invasive, most simplistic approach possible to achieve maximum improvement and enhance your quality of life.
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2. Can I postpone or delay my treatment?
TMD is often progressive. The earlier it is diagnosed, the greater the likelihood TMD can be treated conservatively, relatively inexpensively, and without surgery! Early treatment of TMD can also help to prevent further damage to your jaw joint and its related structures.
Only you can make the decision that is right for you. To do so, we want you to know that waiting to begin treatment can have serious consequences, particularly if you are experiencing intermittent or continuous clicking and/or occasional locking. Once therapy has begun, delaying or canceling scheduled appointments can also compromise the success of your treatment.
Before making any decision to postpone or delay treatment, we strongly urge you to discuss the risks and benefits with a qualified dentist or another trusted healthcare provider.
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3. Why do I have to uncross my legs for you to mark and balance my appliance?
There are more than 2-dozen appliances available to treat TMD. To achieve maximum improvement, each appliance must be carefully customized and precision fit for each patient. When you cross your legs, it turns your pelvis, which, in turn, unbalances your entire skeletal and muscle alignment. To mark and balance your appliance correctly, your posture must be proper. (This is also why they ask you to uncross your legs whenever you get your hair cut!).
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4. Will I have to wear my appliance forever?
There is often no single cause of TMD and no two patients are alike. Our goal is to wean patients off daytime appliances rather than having to wear them indefinitely. However, any decision to reduce or eliminate the use of a daytime appliance can only be made after 6-months of active treatment has been completed.
We generally suggest that patients wear their nighttime appliance “forever,” as a precautionary measure to prevent symptoms from reoccurring. This is because we all clench and grind our teeth to some extent when we sleep, which can put 2x – 3x the normal amount of pressure on your TMJ. Think of using your nighttime appliance like wearing a knee brace or taping your ankle when you play a sport. You do it to add stability and safeguard against further injury.
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5. Do I have to eat with my appliance?
The answer depends on the stability of your TMJ and the type of appliance that has been prescribed for you. More specifically:
If you are using a repositioner so that we can stabilize your joint and can control dysfunction, the answer is “Yes.” Chewing puts tremendous stress on your TMJ, so it’s important to wear your appliance whenever you eat. It may take a few days for you to get used it. However, eating with your repositioning appliance in place is critical to a successful outcome at this stage of your treatment.
If you are using a deprogrammer to manage your TMD, the answer is “No.” You should not eat with a deprogramming appliance in place.
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6. Why is it important to do self-care at home while I’m undergoing treatment?
Patients spend significantly more time away from our office than they do with us. That’s why the diet and exercises we outline for our patients under “self-care” are so important.
Self-care is an essential part of rehabilitating your jaw joint (just as it would be if you needed to rehabilitate your knee, your ankle or any other joint in your body). Through self-care, you’ll learn about things you can things you can do (and things you should avoid) throughout your normal day to facilitate “healing.” More specifically, self-care will help to enhance the effectiveness of therapies you receive at our office, so that you can regain mobility of a compromised jaw joint and restore full range of motion.
Self-care also helps to establish a “healing and wellness pattern,” which will pave the way for you to manage your TMJ-related pain and dysfunction -- and sustain the results of treatment once completed – without having to continue to visit our office.
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7. Since I’ve been wearing my appliance, my teeth don’t touch like they used to. Is this normal?
Yes, that is very normal but it’s only temporary. The reason it happens is because of the changes in your jaw position that take place during treatment. In brief, your appliance teaches your muscles to close your jaw in a new position – a position that may not be aligned with your bite. After you complete your treatment, we will slowly reduce the amount of time you use your day appliance and your bite will return to normal. In some cases, orthodontics may be needed but this is not true for the vast majority of our patients.
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Why is sleep so important?
Who is at risk of developing a sleep disorder?
How many hours of sleep should I get each night?
Why should I consult a dentist about my sleep concerns?
What can I do to give myself the best chance of getting good, restful sleep?
If I snore, does that mean I have sleep apnea?
Can a dental sleep appliance stop snoring?
Can a dental appliance replace my CPAP machine?
Is there a connection between TMJ-related pain and my sleep disorder?
Will wearing a nighttime sleep appliance cause a TMJ problem?
How can I know for sure if I have a sleep disorder?
Sleep is more than a time out from daily activities. It is an active state, essential for physical and mental restoration. Individuals who do not get sufficient amounts of restful sleep each night put themselves at increased risk for hypertension, heart attack, stroke, diabetes, plus workplace accidents and injuries. In addition, the National Highway Traffic Safety Administration (NHTSA) conservatively estimates that 100,000 police-reported crashes are the direct result of driver fatigue each year. This results in an estimated 1,500 deaths, 71,000 injuries and $12.5 billion in monetary losses. The good news is that much can be done, through technology and advances in dental sleep medicine, to enable patients who suffer from sleep disorders find relief.
2. Who is at risk of developing a sleep disorder?
Men suffer most often from non-restful sleep. In addition, according to both the National Institutes of Health and the American Academy of Family Practice, the rates of obstructive sleep apnea (OSA) and other airway-related sleep disorders are 2x-4x higher after the age of 50.
Since the health of women and children may also be affected by sleep-disordered breathing problems, we urge anyone who does not wake in the morning feeling rested and relaxed after a full night’s sleep to discuss their sleep concerns with their family physician, a dentist with expertise in dental sleep medicine or another trusted health provider.
More than 40 million Americans consult their physicians about sleep complaints each year, making sleep-related problems the THIRD most common complaint heard in the physician’s office (behind colds and headaches).
3. How many hours of sleep should I get each night?
Sleep is as important as diet and exercise to good health. Despite this, there appears to be an epidemic of daytime sleepiness in this country. In fact, recent National Sleep Foundation (NSF) polls have shown that more than one-third of Americans say that they are so sleepy during the day that it interferes with their daytime activities a few days a month. Don’t be one of them!
Age Group |
Recommended Amount |
Nightly Average |
Infants (3-11 months old) |
14-15 hours |
12.7 hours |
Toddlers (12-35 months old) |
12-14 hours |
11.7 hours |
Preschoolers (3-5 years old) |
11-13 hours |
10.4 hours |
School-aged Children |
10-11 hours |
9.5 hours |
Parents/caregivers |
7-9 hours |
6.8 hours |
*Source: National Sleep Foundation, 2004 Sleep in America Poll
4. Why should I consult a dentist about my sleep concerns?
Mild to moderate sleep apnea patients are among largest groups of patients that are not screened. However, dentists with advanced training in dental sleep medicine can be patients’ first-line of defense against the potentially devastating cardiovascular, neurologic and interpersonal consequences of undiagnosed and untreated sleep-disordered breathing problems.
In our office, we use a state-of-the-art pharyngometer/rhinometer to measure your airway volume, determine whether or not your airway collapses, and evaluate your nasal turbinates (small, bony structures covered by mucous membranes that protrude into the nasal airway and help to warm, humidify and cleanse air as it is inhaled and before it reaches the lungs). Enlarged turbinates and nasal congestion can contribute to headaches and sleep disorders such as snoring and obstructive sleep apnea, as the nasal airway is the normal breathing route during sleep.
In addition to screening for sleep disorders, qualified dentists can provide dental sleep medicine therapies to patients that suffer from snoring, sleep apnea and other sleep-disordered breathing problems. These therapies can often enable sleep patients to find effective alternative or adjunct therapies to traditional treatments for sleep disorders, including CPAP or surgery.
5. What can I do to give myself the best chance of getting good, restful sleep?
In addition to making time for sleep, here are some sleep tips from the National Sleep Foundation (NSF) that may help you improve the quality of your sleep:
- Maintain a regular bed and wake time schedule including weekends.
- Establish a regular, relaxing bedtime routine such as soaking in a hot bath or hot tub and then reading a book or listening to music.
- Create a sleep-conducive environment that is dark, quiet, cool and comfortable.
- Sleep on your side, on a comfortable mattress and pillows.
- Use your bedroom only for sleep and sex, and take work materials, computers and televisions out of your sleeping environment.
- Finish eating at least 2-3 hours before your regular bedtime.
- Exercise regularly and complete your workout routine at least a few hours before bedtime.
- Avoid nicotine (e.g., cigarettes, tobacco products). Used close to bedtime, nicotine can lead to poor sleep.
- Avoid caffeine (e.g., coffee, tea, soft drinks, chocolate) close to bedtime. It can keep you awake.
- Avoid alcohol close to bedtime. It can lead to disrupted sleep later in the night.
6. If I snore, does that mean I have obstructive sleep apnea?
Snoring is no laughing matter. Although often depicted comically, snoring should be taken seriously. It can disrupt your sleep as well as your partner’s sleep. Snoring can also lead to sleep apnea by changing the structure of tissues. However, not everyone who snores has sleep apnea.
If you’ve been told that you snore, or you suffer from excessive daytime sleepiness or shortness of breath upon awakening, consult your doctor. Today, patients with mild to moderate sleep apnea are among the largest groups of patients not screened. That said, the only way to determine with certainty if you have sleep apnea is by referral to an overnight sleep lab for a diagnostic polysomnographic (sleep) study. We are happy to you with names of sleep physicians and sleep labs that we work with upon request.
7. Can a dental appliance stop snoring?
For simple snoring and mild to moderate obstructive sleep apnea (OSA), oral appliance therapy is an excellent alternative to CPAP and/or surgery. Both the American Academy of Sleep Medicine and the Academy of Dental Sleep Medicine endorse it.
When they are well made and used as directed by a qualified health professional, dental sleep appliances can put an end to snoring in the majority of patients. However, the success of these splint-like devices for any given patient cannot be determined without a complete dental sleep examination.
In our practice, we use six (6) different FDA-approved oral appliances to successfully treat snoring as well as other types of sleep-disordered breathing problems. To achieve maximum results, each of these splint-like devices must be customized and precision-fit to each patient. One size does not fit all, which is why you should be evaluated and treated for snoring by a dentist with advanced training and expertise in dental sleep medicine.
8. Can a dental sleep appliance replace my CPAP machine?
At their annual meeting in 1995, the American Sleep Disorders Association adopted a resolution, which formally accepted dental appliance therapy for treatment of snoring and mild sleep apnea. They also extended the recommendation to include dental appliance therapy for treatment of moderate and severe cases of sleep apnea. This is especially encouraging news, since nationally only 45% of patients using CPAP machines continue to use them.
We cannot determine with certainty whether or not you are a candidate for dental sleep appliance without a comprehensive sleep evaluation by our office. However, we can tell you that increasing numbers of patients are successfully using oral sleep appliances as both alternatives and adjuncts to standard therapies, including CPAP and surgery.
9. Is there a connection between my TMJ-related pain and my sleep-disordered breathing problem?
We cannot answer this question without your being fully evaluated by one of our doctors. However, we do know that development of your airway can be diminished by improper development of your jaws and/or an inability to breath through your nose. This explains, in brief, why we carefully examine the airway of every patient we see as a routine part of every new patient examination.
10. Will wearing a nighttime sleep appliance cause a TMJ problem?
No! Nighttime repositioning devices that are properly customized to help maintain your airway during sleep rarely ever cause TMD problems. The same is true of appliances that are worn to prevent “bruxism” (that is, grinding of your teeth during sleep).
If you are experiencing jaw-joint pain or dysfunction and you are using a nighttime sleep appliance, we recommend that you make an appointment to see a dentist with expertise in TMD, craniofacial pain and dental sleep medicine immediately.
11. How can I know for sure if I have a sleep disorder?
The only way to determine with certainty if you have sleep apnea is by getting a referral from your physician to an overnight sleep lab for a diagnostic polysomnographic (sleep) study. We are happy to assist you in that process by providing you with names of sleep physicians and sleep labs that we work with upon request.