Joseph Grimaudo, DMD, uses multiple channels to alert others that symptoms like snoring and gasping during sleep may be signs of a treatable health condition.
Interview by Yoona Ha
After some false starts into dental sleep medicine, Joseph Grimaudo, DMD, a dentist practicing at All Smiles Tampa Bay, has hit his stride in helping patients with obstructive sleep apnea (OSA) get treatment. He now helps raise awareness among other healthcare providers about OSA and about oral appliance therapy as a treatment option for some patients.
Here, Grimaudo shares his experience. The transcript has been lightly edited for clarity and style.
Walk us through your journey of becoming a dentist who takes an interdisciplinary approach to treat OSA patients in collaboration with sleep specialists.
JG: I have an interesting story of how I arrived at a practice focused on treating patients with sleep apnea using oral appliance therapy. I graduated from dental school in 2006, worked as an associate dentist for a few years, and then opened my own dental practice in 2009. Early on I realized the impact sleep apnea had on patients’ overall health and their dentition.
I took a sleep medicine course through the Dawson Institute and attempted to begin treating patients. Unfortunately, I hit numerous roadblocks in billing insurance, working with physicians, getting patients to accept treatment, and all the other issues many dentists face when trying to incorporate sleep medicine into their practice. For several years we would educate patients on their potential issues with sleep-related breathing disorders and refer them to their physicians.
In 2014, my life was changed forever. I received a flu vaccination and within two weeks I was diagnosed with transverse myelitis, swelling in the spinal cord that left me paralyzed from the waist down. I was unable to walk, feel my legs, and suffered from other issues associated with my parasympathetic nervous system. I worked extremely hard to learn to walk again and was determined to achieve the maximum rehabilitation possible. I had no idea if I would ever be able to work again.
As I began my rehabilitation, it became obvious that I would not be able to perform clinical dental procedures again. As I realized this, I became more interested in dental sleep medicine. I took courses through Dental Sleep Solutions with Gy Yatros, DMD. I learned how to properly screen for sleep-related breathing disorders, work with physicians to get patients tested, explain issues associated with sleep-related breathing disorder/OSA, perform scans on patients for impressions, deliver appliances, and perform follow-up care while working with the patient’s physician to treat their OSA.
You are participating in SomnoMed’s medical initiative. What is it, and why does it matter?
JG: The medical initiative came at a perfect time in my dental practice. I was comfortable in treating and billing patients after my training with Dr Yatros and Dental Sleep Solutions. Following our time in quarantine due to COVID, I was planning to market my practice, specifically working with physicians. Drs Yatros and Drake of Dental Sleep Solutions do a phenomenal job of teaching their members how to deal to physicians, but I was hesitant to get the ball rolling.
The medical initiative launched by SomnoMed focuses on helping dentists contact and educate physicians on the effectiveness of oral appliance therapy. It supports developing these relationships through providing educational materials to the physician’s practice, supporting social interactions, and providing guidance in marketing. This initiative helped me develop the confidence I needed to apply the lessons learned from Dr Yatros and Dr Drake.
Would you describe some approaches you’ve taken to really promote awareness of sleep apnea, and how dentists can play a powerful role in treatment?
JG: As far as dentists playing a powerful role in treatment, all those providing oral appliance therapy know how effective it is and how we are changing patients’ lives. For me, promoting awareness all begins in believing in the impact I have on people’s lives. I am always talking about the importance of quality sleep and the negative impact of snoring and sleep apnea. When I am with friends, at my children’s schools or activities, at church, in the grocery store, I am listening and educating people on these issues when the topic arises.
I have met with physicians, health care providers, and their office teams to educate them on the efficacy of oral appliance therapy. My sleep champion, Carla, reaches out regularly to referring doctors and potential referrals to set up meetings or phone conversations. I participate in health fairs, when possible, to reach out to the public.
We have made appliances for our office team, physicians, and their office team at no cost to allow them to experience how well the treatment works.
What are some of the biggest challenges and opportunities you see when raising awareness for sleep apnea?
JG: The two biggest challenges we are currently facing are COVID-19 and managing time to market. Many physicians are hesitant to meet due to the rising numbers. We have worked around this by contacting offices over the phone, sending emails to physicians, and arranging virtual meetings.
We have also increased the number of patients we are seeing and that has limited our time to market. We are currently refining our policies and interviewing for new team members to overcome this issue and allow us to continue to grow.
How can folks contribute, support, or be a part of your initiative to improve sleep apnea awareness?
JG: Everyone is familiar with the quote, “If you love what you do, you will never work a day in your life.” Dentists play a powerful role in treatment, especially those providing oral appliance therapy know how effective it is and how we are changing patients’ lives. This fulfilling feeling leads to passion, and that passion will enable you to make others aware of sleep apnea, its harmful effects, and the benefits of treatment. Being aware of the symptoms: snoring, daytime sleepiness, poor sleep quality, etc, allows you to notice when someone may be suffering from a sleep-related breathing disorder.
Most people think the symptoms are normal. When you talk with someone suffering, let them know these aren’t normal and should be evaluated.
Two other points I would like to bring up: One, it is essential to work with your medical colleagues. I have been blessed to have some amazing physicians, including ENTs, and physical therapists who I work with.
The second is the importance of your team. Invest in your team. Educate and encourage them. Provide treatment for them to experience oral appliance therapy. Take care of their loved ones who are suffering from snoring or sleep apnea. They should be your biggest supporters in raising awareness of sleep apnea.
Yoona Ha is a freelance writer and healthcare public relations professional.