Prices for oral appliances?

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Prices for oral appliances?

Postby dknapp » Wed Sep 27, 2006 11:57 am

I visited a dentist recently for a consultation on getting an oral appliance, as I was not having a good experience with CPAP. Basically, I was far more tired in the morning, had sore throats from dryness even with online humidifier, pressure escaping from mouth even with strap, etc. I was disappointed to discover that the fee was $2,500 for the first year with a recurring cost of $1,800 per year for the Thornton Adjustable Positioner (TAP) device. According to him, they need to be replaced after about a year. This would really burn a hole in my budget. Absolutly no help from my medical insurance (MDIPA/MAMSI) either. So, I would like some price info on various other devices and some feedback on how well they work. I have mild-to-moderate OSA and snoring.
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prices for oral appliances

Postby tom zohlmann » Thu Sep 28, 2006 12:13 am

to dknapp- Do you have your sleep study reports. If not you need to ask for them. You are entitled to them. You say you have mild to moderate apnea. Do you know what position you are having apneas (please look at your report before you discuss this with your doctor), your AHI and Min Oxygen. The reason I ask as it is not out there that many sufferers have their apneas while in the supine position. Do not assume that this will be told to you. The dentist is selling oral and the bulk of sleep centers sell machines. The surgeon sells surgery. The thing is the treatments all work for most but cpap is probably the best. It is the gold standard. The one missing solution for some sufferers that is not being assessed or discussed anymore is positioning. When I reviewed the condition on University, ASAA and other websites they do mention it. They all say sew a tennis ball in the back of your pjs. which hurts when you roll back on it and it really is not comfortable to do. I mean it really is painful to sleep with I know I tried it 2 nights. (Deleted per posting guidelines re commercial postings)

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TAP costs

Postby schurst » Sun Oct 01, 2006 4:22 am

I have been getting quotes from Dentists in towns as far as 3-4 hrs drive from my city.
My town has 750,000 people and no Dentist that does TAP!
I am finding a wide range in prices and it seems that the Drs. that have done them before
dont seem to really know allot about them!
For example they may not know about TAP 2 or the new TAP-T.

I wonder how important it is to get experience with this work?
Maybe a local dentist could do the job just as well by following the directions?
Maybe an experienced Dentist might be able to look at your features and be able
to tell by past patients results if your particular size/shape got good results or not?

If you use the right code you can file on you medical insurance possibly.
I am looking into this now with my insurer
It looks like a catch might be even if a local dentist does the work he will still be out of network
because no Dentists are listed as a provider on a medical plan?
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Postby paulyofpa » Tue Feb 20, 2007 5:11 pm

My TAP-T cost me under 700,
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Postby Leland » Mon May 14, 2007 2:09 pm

TAP costs
I just got a quote from my dentist for the TAP appliance (says it is the latest improved model) of $700. He's not done but one other of these, but the other patient reports excellent results and "passed" the test using it.
Since I'm eligible for Medicare, the dentist recommended I ask for a prescription from my EENT Dr., that he can them fill, and apparently Medicare covers a substantial part of the cost. This approach might ease the difficulty some are having with their medical insurance carriers. They don't come much tougher than Medicare! :-)
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Apnea Oldtimer

Postby jbjr » Mon May 14, 2007 3:24 pm

I have been diagnosed with obstructive Apnea since 1985. I have had tonsils, uvula, upper palate removed, and 3 septalplastys. Still have it. I have tried both CPAP & BIPAP, can't handle either. Only thing I haven't tried is a mouth piece, does anyone know how good/bad they are and where to get them or info on them. Of those of you who have had apnea for a while, have any of you lost your sense of smell. I lost mine about 7 yrs ago, now I can only smell occasionally and very little when I do. Can be dangerous when around chemicals like when doing yard work. Also am curious if anyone has seen improvement by losing weight, although I have seen in forum where that doesn't mean much. Thanks.
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Postby Don Harger » Sat Jan 05, 2008 5:58 pm

How do I locate a dentist fitting the Thornton Adjustable Positioner (TAP) in my geographical area? The Association websites show every dentist qualified to fit oral appliances but not specifically the TAP as recommended by my sleep physician.
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Postby Gipper » Thu Jan 17, 2008 12:57 am

Dan,

You can look on aimsleep.com and search for a dentist in your area. That is where I found the dentist that helped me out. My TAP 2 ran about $800 2 years ago. Hope this helps.

Gipper
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Postby melhajj » Thu Jan 17, 2008 10:08 am

Hi EVERYBODY, some questions for ALL OF YOU; i went to see my ENT he claims that the surgery he performs (to move the hyoid bone to the front, remove tonsils and uvula) has a success rate of 70%, reducing also the pressure you need for your cpap mask; the first time we saw him he said 30-60% which sound very discouraging; we asked also about the different oral appliances and he does not really know anything about it, but he says that they can also be succesfull at treating severe sleep apnea; that raises another question mark, since i have read that only HELPS to people with mild sleep apnea NOT SEVERE; we asked for nasal pillows to see if they are less annoying that the full cpap mask, any comments about these comments that i wrote? also, if any of you have UNITEDHEALTHCARE, what code have you used in order to approve an oral appliance? because until now unitedhealthcare has refused to approve the payment of an oral appliance, claiming that this is under a dental insurance, which i do disagree, since the problem is in the upper airways. i have been reading here that you mention the TAP oral appliance, any comments about it and also about the surgery results; just trying to figure out what other posibilities i have......... my ENT seems knowledgeable JUST ABOUT SURGERY but not about anything else; i also asked about playing the didgerodoo he says that it might help to strengthen theupper airways muscle but that does not help with the sleep apnea; just wondering if that is really true, i wonder if people playing a musical instrument also suffer from sleep apnea, any inputs? i have noticed also that this disease is an epidemic, you can ask ANYBODY, and you will find out that an amazing number people do have this problem or have not have a test to realize that he or she has it. wonder what is the cause of this disease: the food that we eat, full of preservatives, pesticides, hormones,etc? the polluted air? the water? the heavy weight? why are we suffering this disease? If you have the chance read the book ULTRALONGEVITY by dr. mark liponis, he treats patients and has lowered the CRP (c reactive protein, which is a heart enzyme predictor for heart attacks and stroke) which is usually elevated in people with sleep apnea; his treatment consists of some specific vitamins, tai chi, qijong, walking, etc. VERY INTERESTING FOR EVERYBODY WITH THIS DISEASE.
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Postby phorts » Sat Jan 19, 2008 11:23 am

My Dentist billed my plan to my insurance company at $3000 and broke it down to me like this:

$200 - Dental Exam (required before making device to ensure that I had a sound dental structure)
$600 - SilentNite device
$1700 - Somnomed MAS Device
$500 - Tongue Bulb

He only required me to pay him the $800 for the Exam and the SilentNite as sort of "Copay" in order to make the SilentNite device and get started. The reason he billed all 3 appliances under one bill is because, if insurance companies DO pay a portion of a device, they're only going to pay once. So he submits the entire "Plan" and, if they only cover a portion, then the rest can be setup as a payment plan where I only pay for the device(s) I use.

The "Plan" is that I get the SilentNite made to get started quickly and cheaply first to see if i could tolerate being protruded and second to see if it works for me. Also, if it does work and I can tolerate it, than it will serve as a good replacement device should I have problems w/ the Somnomed. One last thing was also that he highly suggests to have any dental work done before making these devices due to the change in teeth shape. If I had the device made and then had dental work, the device might no longer fit properly.

I chose to have the SilentNite made right now because I couldnt afford to wait, financially or physically and mentally, to have dental work done prior to getting the device made. I figure that i'll have the dental work done at some point and then have the SomnoMed made. But i'll be waiting until after my battle w/ the insurance company is over before doing any of this.

Hopefully, the SilentNite just WORKS.

The tongue bulb was thrown in there also just in case, god forbid, the other two devices are unsuccessful. Where i've already had UPPP and have battled w/ CPAP for years, this "plan" is really my last option.

I will say though, as Dr Kent Smith and others have said here. It is FAR more important to find a reputable doctor that works with a proven device than it is to shop around for the cheapest one. You are paying for a THERAPY, not a piece of plastic. Make SURE that EVERYTHING is included in the price that you pay. This includes ANY xrays they must take, exams, impressions, the device itself, follow up visits, Titrations, etc.

What I did was I read reviews of devices and contacted the manufacturer for a list of dentists in my area. For me there was only one choice, and I lucked out, because he's a great guy and his staff has been great too....

good luck and please post any questions you have in here, there are a log of knowledgeable and helpful people in here.
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Postby Kent Smith » Sun Jan 20, 2008 2:14 am

melhajj wrote:that raises another question mark, since i have read that only HELPS to people with mild sleep apnea NOT SEVERE

Statistically, appliances alone average a 50% reduction in AHI or RDI, so this is the reason some say it is for mild OSA. However, I have treated quite a few severe OSA sufferers to an AHI under 10, so it is certainly possible.

; we asked for nasal pillows to see if they are less annoying that the full cpap mask, any comments about these comments that i wrote?

It's always good to try different masks, and the nasal pillows seem to be the most comfortable for the average patient. There are recent studies (on rats) to show that these can cause inflammatory reactions in the nose, but they are still the easiest to tolerate.

also, if any of you have UNITEDHEALTHCARE, what code have you used in order to approve an oral appliance? because until now unitedhealthcare has refused to approve the payment of an oral appliance, claiming that this is under a dental insurance, which i do disagree, since the problem is in the upper airways.

I agree with you...this is a medical condition, and IF you have at least moderate sleep apnea, medical insurance at least SHOULD cover it. You also need to ask the dental office that will supply the appliance to give you the best code.

i have been reading here that you mention the TAP oral appliance, any comments about it and also about the surgery results; just trying to figure out what other posibilities i have.........

The TAP is a good appliance, as are most mandibular advancement devices. The MOST important thing is compliance. The best appliance is the one the patient will wear.

my ENT seems knowledgeable JUST ABOUT SURGERY but not about anything else; i also asked about playing the didgerodoo he says that it might help to strengthen theupper airways muscle but that does not help with the sleep apnea; just wondering if that is really true, i wonder if people playing a musical instrument also suffer from sleep apnea, any inputs?

I have a didgeridoo, and it would be a good thing for anyone with a breathing disorder to learn to play. It does strengthen the pharyngeal muscles, but my belief is that you must learn the circular breathing technique, or it won't help much. This takes much practice!

i have noticed also that this disease is an epidemic, you can ask ANYBODY, and you will find out that an amazing number people do have this problem or have not have a test to realize that he or she has it. wonder what is the cause of this disease: the food that we eat, full of preservatives, pesticides, hormones,etc? the polluted air? the water? the heavy weight? why are we suffering this disease?

Odd that you mention this. I have a peer-reviewed paper yet to be published entitled "Sleep Breathing Disorders - a 21st Century Epidemic". Yes, weight (with neck size being the biggest culprit) is the #1 factor, and this country is growing more obese every year. The statistics are amazing. After that, there's the allergy rise, more baby boomers with their tonsils, increase in sedative sleep aids being used, less sleep for everyone trying to burn candles at both ends, the "graying" of America, genetics and a growing number of insomniacs. Too much to discuss here, but by my calculation, by 2045, 100% of America will have OSA :-D

If you have the chance read the book ULTRALONGEVITY by dr. mark liponis, he treats patients and has lowered the CRP (c reactive protein, which is a heart enzyme predictor for heart attacks and stroke) which is usually elevated in people with sleep apnea; his treatment consists of some specific vitamins, tai chi, qijong, walking, etc. VERY INTERESTING FOR EVERYBODY WITH THIS DISEASE.


Lowering the CRP level is very important, so thanks for suggesting the book. Does he say to make sure your gums are healthy?
Kent Smith DDS, D-ABDSM
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