Why don’t doctors refer to dentists?
Through: Teresa DeNike
There is growing evidence in the scientific literature that oral health is related to the well-being of the rest of the body.
A link has been found between poor sleep and periodontitis, with a shocking 36% increase in patients with chronic sleep loss; sleep apnea. Sleep apnea is a condition that dentists are qualified to treat using oral appliance therapy.
It has also been linked to bruxism, temporomandibular disorder, and Alzheimer’s disease; Periodontitis can be linked to cardiovascular disease and diabetes, and there are many other links.
In fact, 3 out of 4 doctors considered oral appliance therapy administered by dentists to be a suitable alternative to CPAP as a treatment for sleep apnea. Yet relatively few doctors refer to dentists for treatment of problems related to oral health.
But why? And how can we start building bridges?
Why Doctors Don’t Refer to Dentists: Interview Results
To trust
The majority of doctors we interviewed said the main reason they didn’t refer patients to dentists was simply trust.
Connecting with people outside your area of work is difficult and trusting someone enough to make a referral can take months or years of collaboration experience. While dentists are the most qualified professionals to administer certain treatments, it can be challenging for a doctor to find someone who is reliable.
Changing this would require a shift in the way dentists and doctors work together.
Of all the doctors we interviewed, all those who work with dentists said that communication was imperative during every step of the process.
Furthermore, the responsibility lies with the dentist when it comes to promoting cooperation. Many doctors may not seriously consider referring to dentists as an option because in their view a dentist is rarely the most qualified person – perhaps never, apart from the specific problems of teeth and oral health. This is of course not true.
Dentists are advised to screen for sleep apnea and provide treatment by major medical agencies.
But dentists need to make doctors aware of this, not just by providing this information and
discuss collaboration, but by supporting their role with consistently good work that a physician
can trust.
Insurance
The other major hurdle for doctors seeking to refer patients to dentists is insurance. Oral device therapy is billed by medical insurance, not the dentist.
There are some horror stories about paperwork, denials and a range of reimbursement rates, and it can be a nightmare for both the doctor and the dentist.
There are a few options.
You can hire an outside medical biller to take care of the paperwork.
Or you can just set a flat rate and not take out insurance – keep it honest, but remember that this is a life-changing device and you have every right to price it appropriately. Also be sure to make a down payment for the work as it can take several weeks for the medical insurance to be processed.
Whatever the reason, there is a clear and unfortunate lack of referrals from doctors to dentists – and the impetus is up to dentists to bridge that gap by communicating and raising awareness of their skills.
Summarized
However, there is some movement towards more positive partnerships. dr. Keith Matheny, a sleep physician, told us he:
“A very efficient, successful (and profitable) collaboration with a sleep dentist.”
…in his own medical practice.
When doctors and dentists build bridges, the results are great for both parties – so consider contacting a local doctor!
photo by Cedric Fauntleroy