I recently visited the site Gergen’s website and realized they do sleep medicine. I spoke to David Gergen about the advancement in sleep medicine. I wasn’t surprised to find out David Gergen worked hand in hand with the Icon’s the founders of dental sleep medicine  Dr. Ricketts and Dr Spiegel.

During our conversation David answered all my questions plus more. This is why the ASBA has such and advantage. Not only does David have first-hand working knowledge of sleep medicine  he is still manufacturing appliances himself to make sure the Gergen’s quality remains  highest in the anywhere.

David not only gave me the confidence I needed to start offering sleep medicine, he also held my hand through the entire process. Sleep medicine in itself is another animal and they didn’t go over it  in dental school. I am writing this letter as pure gratitude to David Gergen and his incredible in-depth knowledge that he shared willingly. He also sent Phonetic Bite Dr Ricketts developed back in 80’s

Dr. Ricketts believed in taking a bite while the jaw naturally comes off the eminence. He originally did this using a numbering system. This is used to find the vertical and A.P

To find the vertical position have the patient sit straight up and count from 55-75. Make sure they count evenly and steady. You will be watching for their maximum vertical opening. Fives, eights, and nines are most common.

I learned along the way finding the A.P. distance using words was adopted. Originally the number 66 was used, but didn’t always work. Alternatively, the words Mississippi, Ohio, the “f” sound, is the most effective. When “n” is added, as in shun, it often gives the most protrusive position as well as the most vertical in a natural eminence.

Using these techniques will give you a high success rate in catching a proper phonetic sleep bite while keeping the jaw in a natural state.

I highly suggest you join the ASBA and use Gergen Ortho for all Sleep and Ortho work

Orthodontic is a long-term investment and retainers turn to be the only method that keeps your teeth from going back to the original state. Ligaments and tissues of your mouth require some time to adjust to your teeth’s new position, and because ligaments are elastic in nature, they have a tendency to return to their older form, simultaneously taking the teeth along with them. Retainers work very well in maintaining the new position of the teeth and hence, we at Gergen’s Orthodontic Lab strongly recommend our patients to wear it after their orthodontic treatment.

On removal of braces, your orthodontist will automatically give you guidance on when and how to wear a retainer. While some of you might be asked to wear your retainer around the clock during the initial months, others might get the freedom to wear them at night only. But this entirely depends upon your case and amending the wearing routine should never be taken into account without consulting an orthodontist.

Delving deeper into the realm of retainers, Hawley retainers came into existence initially and are, therefore, known to be one of the oldest and most common types of the same. A combination of plastic and metal are used to prepare them and their primary goal is to stabilize your teeth’s position while the bone around them hardens. Hawley retainers are fragile and demand care as well as attention. They, however, are the best in the market place when it comes to retaining “literally” and can be removed as per convenience. Below mentioned are a few perks of using Hawley retainers:

• The style of the retainer is adjustable as well as removable. This makes it easy to customize to the patient’s needs.
• If the patient has not been able to wear the retainer regularly with commitment, then the orthodontic expert holds the ability to adjust this type of retainer easily.
• It’s a lot more durable in comparison to other types. And can be repaired upon breakage, unlike others which do not always hold the capacity of undergoing a repair and ultimately get replaced, only.
• Just like braces, Hawley retainers are available in an assortment of colors. One has the freedom to choose.

You need to brush your Hawley retainer twice a day to remove residual plaque. For additional refreshing, you can soak it in a mixture of antiseptic mouthwash and water.

Seeking help from Gergen’s Orthodontic Lab is a great way of retaining your beautiful smile for a lifetime. Contact us today to begin your new journey to a perfect smile. 

Over the previous decade, there’s been a critical ascent in awareness pertaining to obstructive sleep apnea (OSA) along with the risks involved in the same.

In the event that the sheer number of people affected by this condition isn’t sufficiently alarming, it might come as a stun that even a portion of the top proficient competitors in the country who are respected on magazine covers and displayed on TV, experience the ill effects of sleep apnea. NFL players are hard hit by this condition, in particular.

What comes across as shock is the fact that a lot of present and previous NFL players do not even have the foggiest idea that they are living with this genuine issue. On the contrary, in cases where players know they have this problem too aren’t effectively seeking any treatment. One of the reasons behind not taking up treatment is that they are not aware of the options accessible to them. Most of them do not even know about the CPAP masks or oral appliances and even if they do, they find it extremely difficult to use them on a nightly basis.

What keeps these cases from getting diagnosed?

Regardless of the expanding knowledge and awareness about sleep apnea as of late, confusion about it still persists. In particular, there’s an absence of comprehension about the signs and warnings of the same. Wheezing, snoring, morning sickness and daytime sluggishness are the most common examples of sleep apnea that may appear to be innocuous in daily life. These, howbeit, at the same time come across as warning signals which should not be ignored at any cost. Regularly, this is the situation with people who live alone, as wheezing or rehashed stops in breathing may go undetected.

Problems caused by sleep apnea generally include:

1- Daytime sluggishness

2- Migraines

3- Irritation

4-Hormonal problems

5- Relationship issues

6- Drowsy driving habits

7- Fluctuating mood swings

8- Acute or mild depression

For NFL players with sleep apnea, these impacts can have negative results on the field as well, for example,

1- Postponed response times

2- Absence of vitality

3- Lack of concentration

4- Low energy

Beyond instant consequences, there are various other health risks that come handy with sleep apnea, if it is not treated properly at the right time. Some of these long-term issues include irregular heartbeat, blood pressure problems, risk of dementia, stroke and heart attack. Sleep apnea in worse cases may also result in sudden and early deaths. Gergens is open and   is the leading manufacture of the oral appliances contact us today.

There has been a great deal of inquiry concerning the security of utilizing CPAP machines in case you have been tested positive for coronavirus or are in danger of getting it. As every community and industry is looking for ways to support their society members through this emergency, we need to ensure you have the most updated information about the effect of COVID-19 on adults and children suffering from sleep apnea.

Can Sleep Apnea Make You Highly Susceptible to Coronavirus?

There is no immediate association between having rest apnea and having a higher danger of getting coronavirus. People with a higher chance of getting infected by this virus incorporate individuals who recently developed sleep apnea or those whose conditions are exacerbated by rest apnea. These categories usually consist of smokers, individuals with blood pressure issues, hypertension, and breathing issues such as COPD and asthma.

On the off chance that you moderate or just mild sleep apnea, or in case you have extremely obstructive sleep apnea and cannot endure or continue proceeding with what you have been provided with, consult your specialist immediately to know what can be done amidst this situation.
Oral appliance therapy, in general, is the most effective treatment available for this problem and the chances of it causing you any trouble during this time is very rare. However, in case of discomfort and inconvenience, removal of all these appliances should be looked forward to immediately until further instructions of the doctor.

If you are interested in learning more about oral appliance therapy for sleep apnea, contact us today

http://gergensortho.com/

David Gergen, one of the original masterminds of Dental Sleep Medicine is back in the industry as he re-launches himself into the industry of Dental Sleep Medicine. As the President of Pro Player Health Alliance, he is seen as one of the nationally idolize and respected as a dental lab technician who has been at the top of the game for 30 years now.  In 1986 Columbus Dental selected David Gergen “The Finest Orthodontic Technician in the Country” this man has been applauded numerous times by many other institutes and in his journey as a professional.

Gergen’s Orthodontic laboratory is one of the largest research centers in country. From its beginning in 1984. Gergen’s currently employees 85 experts, the focal objective of this research center is to fortify the Sleep Health Profession by surrounding a dental and clinical multi-disciplinary approach to manage sleep medicine and overall health. The lab has broad involvement in sleep apnea devices. Gergen’s orthodontic lab is, biggest fabricator of the Herbst sleep appliance, which is broadly viewed as the most sturdy and successful oral machine for sleep. Back in 2004, David Gergen was awarded The National Leadership for Arizona Small Businessman, won it again in 2006! Gergen’s Orthodontic Lab has already positioned the Herbst as the premier oral appliance for snoring and sleep apnea. Also, David Gergen and his laboratory are endorsing the new VIVO’S appliance!

To know more, visit the website.

Address of the company

1745 W. Deer Valley Road
Building 1, Suite 112
Phoenix, AZ 85027
AZ Phone: 623-879-6066

More than 40 former NFL players woke up early on Saturday, November 16, 2019 in an attempt to create a positive pathway for their health as opposed to responding to problems that may occur in the future. This was possible thanks to Living Heart Foundation (LHF) and the NFLPA’s Professional Athletes Foundation (PAF) health assessment at Anaheim Regional Medical Center where the retired athletes attended and went through several screening stations that used the latest techniques in identifying potential concerns.

Sleep is becoming more of a focal point in health each year, but not just how much sleep you get or at what times; the airway and what happens (or doesn’t happen) during sleep is now under the microscope.Every LHF/PAF health assessment for the former players contains an obstructive sleep apnea station that is overseen by Pro Player Health Aliance (PPHA) who chooses local highly qualified and experienced dental professionals who are American Sleep and Breathing Academy (ASBA) diplomates to conduct the screening for sleep disordered breathing. Dr. Bradley Eli, Dr. Alex Kalmanovich and Dr. Dian Olah we’re selected for this event and received spectacular feedback from the players.

Once former players complete a brief Epworth Sleepiness and STOP-BANG form to establish their risk for sleep disordered breathing, they have the option to accept a home sleep test (HST) which is administered by Ez Sleep Home Sleep Testing on site. Ez Sleep has 24/7 patient support, instructional videos/papers and a return shipping label for every patient who is tested. The results are interpreted by a board certified sleep physician who provides a diagnosis and treatment options.

Depending on the outcome of the HST report, the players are able to receive treatment with a CPAP or oral appliance therapy. Oral appliances are exclusively fabricated by Gergen’s Sleep Appliance Lab and sent back to the treating doctor in under two weeks. The PAF OSA program has effectively changed the lives of hundreds of former players who are now able to receive a better night’s sleep.

If you are interested in learning more about the OSA program, ASBA Diplomacy, PPHA, Ez Sleep In-Home Testing or Gergen’s Sleep Appliance Lab, please email skylar@myasba.com.

During OSA episodes, shallow or paused breathing can lead to reduced blood oxygen saturation, which is measured as an apnea hypopnea index (AHI) during sleep tests. Physicians agree that a high AHI degrades organ function over time, which can eventually contribute to premature death. Reduced energy during the day is another obvious result of poor sleep. Those with high AHI numbers are literally waking up several times per hour, making restorative sleep impossible. The goal of sleep apnea treatment is to reduce the AHI number to single digits, or even zero.

For current players, sleep apnea can translate into poor performance on the field, and a less healthy body. “Consider that NFL players seek out every edge they can to capitalize on what amounts to short and lucrative careers,” says David Gergen, CEO of the American Sleep and Breathing Academy (ASBA). “Proper sleep, and avoiding OSA, should be top of mind for current NFL players who are looking to improve their health and better their performance on the field.”

Meanwhile, many former players who used to throw around their weight to great effect on the field, are often obese after retirement and have avery high incidence of sleep apnea.

“When a player’s athletic career ends, the level of exercise is reduced dramatically while caloric intake often remains high,” adds Andre Collins, Executive Director of the Professional Athletes Foundation and NFLPA Director of Former Players Services. “This could lead to obesity, along with other serious comorbidities.”

Much like the growing awareness surrounding brain trauma and its effects, the problem of poor sleep is gaining traction in the public eye. The NFLPA’s Professional Athletes Foundation, The Living Heart Foundation and Pro Player Health Alliance [PPHA]) work together with former NFL players to make the problems associated with poor sleep known to the public.

Players are eager to talk about OSA because they see the benefits of oral appliance therapy (OAT),

The goal is toeducate former player members and their families with the knowledge needed to tackle this tough subject and live the healthiest life possible.”

Super Bowl Champion and All Pro offensive lineman, Derek Kennard, went a long way toward living a healthier life when OSA treatment lowered his AHI from 72 to 2. He used some of the extra energy from radically improved slumber to work out more often, eventually losing a whopping 145 pounds.

All pro and two-time MVP runner up, Roy Green, who started at wide receiver most of his career and for a few years started on both sides of the ball, had three heart attacks and two strokes before being treated with an oral appliance for OSA. Since beginning the treatment, he has had no further heart attacks or strokes. With an AHI that went from 32 to 7 since using the Herbst Appliance, the 60-year-old Green says he feels better than he has in decades.

Green and Gergen have spread the word about OSA through Pro Player Health Alliance, holding free public awareness events in cities across the United States. Green’s extensive connections, along with his involvement in PPHA, has brought hundreds of former players, to try much-needed OSA treatment.

Players who take their health to heart should not overlook the vital component of proper sleep in a healthy lifestyle. If you are interested in learning more about the sleep program, contact the PAF’s Laura Stefanow at 800.372.2000.

The forgotten topic
If there is a topic in orthodontics that is chronically ignored and sometimes abused, I think most of us would agree, it is retention.

In fact, if you try to track down all of the articles written on retention since the specialty’s formation back in the early 1900s, it would only number a couple of hundred, while other aspects of orthodontics have been discussed nearly ad nauseam.

But retention—should we be ignoring this important part of treatment like this?

I know, nothing makes for a more frustrating day like several college students home for the holidays with lost or broken retainers and several rotated teeth, no responsible parents in sight, and a crowded waiting room. Some practice consultants advocate not seeing these patients ever again!

Is that a way to build a practice dependent on new patients replacing the ones that are treated? I dare say not!

It’s no secret that once the bill has been paid, the teeth are straight and a patient gets retainers, there’s not a lot more for an orthodontist to do. But as the model of orthodontic care continues to evolve, I propose that there will be the standalone practices where the orthodontist visits on a daily basis in an established practice and the corporate model, which addresses that population of patients in retention. And, frankly, those of us wishing to control the business may want to keep these patients coming back.

Reason for ignoring the issue
Ever since a classic article written in the ’80s by Little and others, we have been aware of the fact that teeth do continue to move, no matter how they are treated. I always smirk when I hear speakers brag about their results and insinuate that because of their specific treatment approach, the teeth that they have aligned will maintain themselves.

In an article entitled “Retention, Retainers May Be Forever,” the modern-day challenges of keeping teeth straight are discussed by Parker. This clever clinician documents various patients in retention and comes to the conclusion that if there is something in orthodontics that is unpredictable, it is maintaining straight teeth.

He admits to the fact that even the patients with the least problems in the beginning are often the most difficult to maintain.

Counting down

I have identified what I believe are the four elements of biology responsible for successful tooth movement. These same biological principles responsible for the process of orthodontic care are also responsible for relapse. They are the:

• process of tooth eruption
• growth of the patient
• function and position of the temporomandibular joint
• influence of facial muscles and airway.

For instance, consider the following factors as they relate to retention:

Contacts that slip or that were never perfectly aligned can lead to crowding. This would include teeth not positioned within the supporting bone.

Continued growth of the patient can place varying forces on the face musculature and alter the occlusion, which can cause crowding.

A changing TMJ can also alter the occlusal loading, resulting in teeth without opposition—leading to drifting.

Of course, digit habits lead to muscle imbalance, which once again places forces on the teeth probably stronger than the forces that we utilize to straighten the teeth.

All of these things point to a very simple question with very complex answers: What’s an orthodontist to do?

As advocated by Parker, explaining to patients that retention may be forever is our only choice.²Although it would be nice to have the magic treatment mechanics that ensure 100 percent success, this just isn’t the reality of today’s treatment options. All that we can do until that day comes is to work on increasing our retention batting average.

Our practice has devised a simple, cost-effective and ease-of-compliance system that we feel handles the majority of retention issues. We call it “the countdown to deband.”

As we approach the last several months of active care, the patient is advised that he or she will soon have the appliances removed and enter the retention phase.

A panoramic X-ray is made and appointments are scheduled for re-bracketing if necessary, and a couple more visits to detail and finish. During each of the next appointments, some posterior braces are removed, the occlusion is adjusted and settled, and final elastics are prescribed if necessary.

Retainer types
As we enter this period, the patient is given retainer options, depending on our suggestions.

We include—as a standard—vacuum or pressure-formed clear retainers as suggested by Rowland and others,³ because of this method’s scientific support. Also, we are able to manufacture them in the office quickly and affordably.

One of the options, for an additional fee, is a bonded lower and upper retainer, but only when the hygiene and occlusion permit. This option, suggested and supported by Zachrisson,⁴ has been proven to maintain tooth alignment as long as the set is intact.

For others, we suggest the retention product from Invisalign, Vivera, which gives the patient four sets of retainers.

With new scanning technology, most of these can be made in advance of the final debanding appointment, allowing for no time between removal of the appliance and the delivery of the retainer.

Many say that these options should be included in the original fee and, to some extent, I agree. However, patient compliance and treatment results vary, as do costs and materials. Having options at the conclusion of treatment allows for some financial adjustments, as well as the ability to take advantage of new technology, such as scanning and colored acrylics.

There are multiple types of retainers with many clasp designs. It’s often difficult for middle and high school kids to comply with wearing these types of retainers.

Final thoughts
Our philosophy continues to be that wearing a retainer—of whatever type—is what’s most important. The type is not relevant.

Retainers are delivered and we insist on full-time wear for three months, followed by nights only after that.

Third molars are discussed and their removal suggested in most situations, even though the science is still inconclusive on that topic.

The comment we make to patients is that it is better to have them removed on the patient’s schedule, rather than the third molar’s schedule.

These days, we offer bleaching, suggest bonding of small laterals by selected dentists, and enroll siblings.

The topic of retention may be ignored in the literature, but definitely not in our practice.

References

1. Little, R.M., An evaluation of changes in mandibular anterior alignment from 10 to 20 years postretention AJO/DO 1988;93:423-8
2. Parker, W.S. Retention, Retainers may be forever AJO/DO 2007;95:505-13
3. Rowland,H., The effectiveness of Hawley and vacuum-formed retainers: A single-center randomized controlled trial: AJO/DO 2007: 132:730-37
4. Zachrisson, B.U., Long Term experience with direct bonded retainers: Update and clinical advice JCO 2007 XLI Number 12 728-37

Dr. Daniel Grob graduated from Marquette University, where he received all of his dental, orthodontic and prosthodontic education. He was also honored with numerous awards, including the OKU honorary dental fraternity, as well as the ASN honorary Jesuit fraternity. Grob received the American Society of Dentistry for Children senior student award for his exemplary work with young patients.

• How can the dental practice identify patients at risk of sleep apnea
• How can the dental practice qualify patients with sleep apnea for the services I provide
• What are the techniques and tools required for the dentist to treat the patients obstructive sleep apnea (OSA)
• How can the dental office get paid for the treatment provided

It seems that as the field grows the number of answers to the above questions become more difficult to get. David Gergen has often lamented the lack of objective non vendor sponsored training. Many of the weekend courses that are offered around the country sell out of date equipment or simply do not stick to the literature. The American Sleep and Breathing academy is focused on evidence based, non commercial team training and is on record as the fastest growing sleep academy in the country. Read the material below and I will see you at the meeting in April.

SLEEP AND WELLNESS ANNUAL CONFERENCE, THE HOUR IS GETTING LATE!

Dr. Erin Elliott

April 15-16, Scottsdale, AZ. It is time to register for the most engaging sleep meeting of the year. In under 30 days the American Sleep and Breathing Academy ‘ASBA’ will host its sixth annual Sleep & Wellness conference; each meeting larger than the year prior.

The ASBA is the first inclusive sleep academy, meaning we want all of our members to be certified by us as competent providers and practicing in the medical model. The Academy is home to the most successful dentists practicing sleep in the country. At our annual conference you will have an opportunity to hear from industry powerhouses such as Dr. Erin Elliott, the current ASBA President, who was not even on the sleep radar four years ago, however in a short time, has become one of the most recognizable Dentists in the industry.

The conference will feature Dr. Rod Willey, the single most successful dentist in the industry, who still holds the national record for billing 106 cases in a single month; the head of a 3.5 million dollar a year, stand alone, sleep practice. Rod is going to give you a step by step cook book for success. Congressman Marty Russo who will be speaking on how oral appliance reimbursement is increasing with the U.S Government while C-PAP reimbursement has been decreased by another 25%. More importantly, he will be discussing what this means for the industry. Attendees will have the opportunity to meet David Gergen, who is putting dentists with NFL greats around the country for treatment of OSA. Just last month, Gergen’s public awareness event, in Phoenix, AZ, was attended by over 3000 people to learn about treatment of OSA. The office made over 260 appointments. In addition to these VIP guests that you’re able to learn from, chronic care management opportunities will be presented by Dr. Miller. All this is only available to members of the ASBA.

Dr. Kent Smith

Dr. Kent Smith who, at one time, paid $180,000 a year on radio marketing ads to generate 20 patients a month. Kent’s new philosophy is to use chronic care, and an integrated system with medical specialists in his area, to generate over 30 appliances a month. This frees up time and resources to allow Kent to take lavish vacations to Italy and enjoy more time with his family while the practice continues to grow. Kent will share his valuable insights on the success of a dental practice at the ASBA meeting. While all this may seem overwhelming for any greenhorn in the industry, fortunately the annual meeting has something for you as well. There will be staff training for intro to sleep, medical billing, and one on one time with doctors for intro to sleep. Doctors who, just three years ago, were in your shoes and are now making an honest and rewarding living with ASBA training.

Dr. Kevin Mueller will teach you how to restore a sleep case, how to take a proper sleep bite and, through restorative dentistry, eliminate
the need for oral appliances. His revolutionary process and successful outcomes have made Kevin one of the top sleep doctors in the world. This is a rare opportunity for you to learn from a true expert in the industry. His 30 years of experience personally trained by Dr. Robert Rickets and Dr. Ed Spiegel puts Kevin a whole other league.

What makes the ASBA different? 

The ASBA is truly the cream of the crop when it comes to Sleep Apnea Training.  Our 700+ ASBA members are all being walked thru the process step by step to ensure they are ALL seeing a large number of oral appliance patients per month. How do we ensure this happens? The ASBA has study clubs that meet every other month. This helps to ensure that our members are learning from the most successful sleep dentists in the country. To be a mentor at one of these study clubs, you must have, at least, a 1.5 million dollar per year sleep practice. Having the opportunity to learn from these mentors at these study clubs helps to maximize your success.

Chronic Care Management: what is it? 

For a dentist, it’s an opportunity to bring something to the physicians where they can have residual income and a built in mechanism for oral appliance therapy.

ASBA Diplomat status

As a member, you have an opportunity for diplomacy with the ASBA. The credentialing doctors are Paul Van Walleghem, Professor Peter Chase of the University Pacific, and Professor Kevin Mueller of Midwestern University.

“Truth is, there are not enough competent providers of Dental Sleep Medicine in this country, and the ASBA is correcting that problem. The ASBA is an academy for the most experienced sleep doctors as well as the greenhorns in the industry” – Paul Van Walleghem DDS, FAGD, DABDSM, DASBA

More information regarding criteria and testing can be found HERE 

Book your rooms for the annual meeting as soon as possible to lock in the $184 rate. The date is fast approaching and rooms are going quickly. They will double in price in the next few weeks. Links to book your room as well as to the ASBA website are:

ASBA site:

http://www.americansleepandbreathingacademy.com

Registration Members $395 non Members $895 :

https://www.cvent.com/events/sleep-wellness-2016-the-premier-conference-for-sleep-health-professionals/registration-ba1b385e27b042e7aa98a865e3c4e9da.aspx