1. Treating Bruxism and OSA within a single continuum of care The Missing Piece Bruxism & OSA

2. Obstructive Sleep Apnea is a condition that presents in the Dental office as Bruxism Bruxism PatientDentistDDME Dental Lab 2 Sleep dentist can identify the root cause of the patients Bruxism and begin treatment in consultation with the dental lab. Often before the tooth structures have begun to show wear and damage.

3. Copyright 20113 Medical diagnosis by a Board Certified Sleep Physician Scored by a Registered technologist Placing the missing Piece DDME Online practice parameters, seminars and the Medical\Dental approach - ABI™ 3 simple markers to identify the potential bruxism patient caused by apnea Work closely with your DTI lab Separate Your Practice from the Pack by Becoming a DDME Online Partner OSA and Bruxism, a preventative approach ABI™ Bruxism OSA ABI™ Bruxism OSA Identify the patient Diagnosis Oral Appliance Build Your Practice

4. Copyright 20114 What Would Itimar\Watermark Do ? DDME Online sent this patient to a sleep specialist for an attended, in lab full PSG study.

5. 5 Embletta\SGS - Really

6. Copyright 20116 Bruxism OSA Report Sample

7. Copyright 20117 Electrode placement

8. Copyright 20118 Leads into the T3 monitor

9. Copyright 20119 Setting up the software

10. 10 Bruxism w\o apnea

11. 11 Bruxism with apnea

12. Value Proposition for the Dentist Copyright 201012 BMI Neck Circumference Epworth 30% of your Patients Home test per day 1 Average case fee from Medicare $2,000.00 Revenue per week $8,000.00 Revenue/year based on 44 week schedule $352,000.00

13. -One out of every 5 patients that enter the dental office has undiagnosed and/or untreated Sleep Apnea. -If left untreated the patient is at risk of developing High Blood Pressure, Heart Attack, Diabetes, increase in Mortality and any number of other associated co- morbidities. -Sleep Apnea consists of two main types Obstructive and Central. Obstructive is when the muscles of the airway relax and the airway closes. Central is when the patients brain does not send signals to the breathing muscles asking for a breath - Obstructive Apnea is classified by severity. Mild, Moderate and Severe -AASM guidelines governing the use of oral appliances state -“Diagnosis 3.1.1 The presence or absence of OSA………… The severity of sleep related respiratory problems must be established in order to make an appropriate treatment decision”. ” -3.3.3 Although not as efficacious as CPAP, oral appliances are indicated for use in patients with mild to moderate OSA who prefer OAs to CPAP, or who do not respond to CPAP, are not appropriate candidates for CPAP, or who fail treatment attempts with CPAP or treatment with behavioral measures such as weight loss or sleep position change. “ -.-.-.-. Copyright 201113 OSA prevalence

14. Sleep Apnea Therapeutic Revenue domestic US 2005- 2015 YearRevenue in $ Millions Growth rate % 2005775.1 2006909.417.3 20071066.617.3 20081248.417 20091452.516.3 20101684.115.9 20111941.515.3 20122229.714.8 20132551.214.4 20142905.413.9 20153289.313.2 Copyright 201114 Sleep Therapy Business CPAP compliance in Mild to moderate patients is less than 50% according to some studies. Projected growth rate for Oral Appliance therapy should match CPAP therapy

15. Identify the OSA Candidate These 3 markers are highly indicative of the presence of obstructive sleep apnea, the number one cause of Bruxism Epworth Score Above 9 is positive BMI Body Mass Index Neck Size Above average circumference Copyright 201115

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17. 17 Questions? We are happy to help you!

18. QUICK FACT A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. QUICK FACT A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. A content placeholder. Use for text, graphics, tables and graphs. You can change this text or delete it. 18Copyright 2011 A Two Column Page Layout

19. Smart Art Page Layout This chart utilizes Smart Art which is feature in PowerPoint 2007 or higher. If you wish to make charts like this and don’t have PPT 2007, we have provided the graphical elements to help you build this yourself. Topic 1Topic 2Topic 3Topic 4 Copyright 201119