Kenneth A. Mogell, DMD, DABDSM, helps many people on Medicare treat their sleep apnea with oral appliances.
By Chaunie Brusie, RN, BSN | Photography by Briggitte Pascual
People who are typically afraid of going to the dentist can enter a Florida Dental Sleep Disorders location without their usual fears being triggered. The practice’s four locations—in Boca Raton, Vero Beach, Jupiter, and Melbourne—deliberately showcase an environment that resembles that of a medical physician’s office more than a traditional dental office. The Melbourne and Vero locations lack even ceiling and chair dental lights and are markedly void of drills. After their first visit, patients can also confirm that they did not receive a free toothbrush or floss on their way out the door.
Florida Dental Sleep Disorders doesn’t need general dentistry equipment because it is a fully dental sleep practice—and a bustling one at that. Its founder Kenneth A. Mogell, DMD, DABDSM, easily sees upwards of 100 patients a week, about 80% of whom are insured by Medicare. “We truly do make a difference in people’s lives beyond just filling a cavity,” Mogell says. “We change peoples’ lives and that’s really a powerful thing for a dentist.”
Changing Lives While Changing Careers
Mogell didn’t start his healthcare career with the goal of becoming a dental sleep medicine practitioner, or even a dentist at all. He began interacting with patients in a different way—as a nurse.
After graduating from nursing school in the late 1970s, Mogell struggled to find his place in a role filled by few men at the time. So, after three years of working as a nurse and with the encouragement of friends, he applied to dental school. Fortunately, he found the transition to a different type of patient care a seamless one. “As a nurse, I’d been in every orifice, so that was helpful,” he quips.
There would be another transition later, albeit a much more gradual one, as Mogell found his niche offering dental sleep medicine services exclusively. He became interested in dental sleep after noticing a significant number of patients at his dental practice presenting with temporomandibular joint problems. While discussing his observation with other dentists, they mentioned dental sleep medicine. At the time, Mogell had “absolutely zero idea what they were talking about,” he says today, but his interest had been piqued.
Mogell was motivated by a desire to be intentional about creating a niche practice. He had entered dental cosmetics early on and been successful in carving a niche in that field. Dental sleep medicine, then, felt like a “natural extension” of his practice.
After attending an educational course with his then-dental hygienist, now director of marketing, Katherine Danias, Mogell slowly began integrating dental sleep medicine into his practice, starting with offering just one afternoon a week. He says, “We saw the potential in the field to not only expand our practice but to take care of patients on a different level.” With Danias’ help, he later expanded dental sleep services into a full day a week. Two years ago, Mogell was able to go full-time with his dental sleep services (and no longer offers other types of dentistry).
David Schwartz, DDS, DABDSM, president of the American Academy of Dental Sleep Medicine (AADSM), credits Mogell’s success to his willingness to learn and build relationships with people who could help him along the way.
“Dr Mogell honed his dental sleep skills, met the right people, and did the hard work to learn about sleep medicine and become credentialed in it,” Schwartz says. “He then learned about dental sleep medicine from those that had already experienced the uphill effort to be successful in dental sleep medicine.”
Mogell cultivated a habit of building relationships as the foundation of his growing dental sleep practice. That is, building relationships of trust with his patients and communicative and collaborative relationships with physicians.
He started by raising awareness about dental sleep medicine for both doctors and patients alike. “Our biggest challenge is that people don’t know we exist,” he says. “Patients will say, ‘Why didn’t anyone tell me this was a viable option to treat my apnea?’”
As a dentist, Mogell can treat his patients for sleep apnea, but he can’t diagnose the sleep disorder. So he relies on the bidirectional relationship between his office and the offices of physicians. “I’m a lieutenant of the ship and the physician is the captain,” he laughs.
The need for communication and collaboration means that Mogell’s work is an ongoing lesson in developing a trust-based relationship. After all, patients will come back to his office frequently as their oral appliance is designed and fitted, return for fine-turning and assessment every 3 months, then see him annually.
“We’re developing the relationship and the confidence with the physicians so they know we can be successful in managing their oral appliances on an ongoing basis,” he says. And while that’s an aspect of his practice that presents the most challenges, it’s also one of the most rewarding. “I find the medical-level work intellectually satisfying and I enjoy the relationship building with both patients and physicians,” he says.
Because most of his patients are age 65 or older and Mogell does medical-level work (obstructive sleep apnea therapies are covered under medical, not dental, insurance), most of Mogell’s procedures are processed through Medicare.
“Getting involved in Medicare early opened a lot of doors because of the combination of the number of patients in this area on Medicare, with the fact that no one was doing what I did,” Mogell says. “It allowed me to get a lot of experience and was paramount to my practice in getting new people involved.”
He encourages anyone new to the field to enroll in Medicare right away because it creates a natural access point for new patients, and, unlike some private insurers, Medicare does not require preauthorization for oral appliances for sleep apnea. The only challenges he has encountered with Medicare is ensuring that oral appliances are categorized as durable medical equipment, as well as the potential drawback of payout being different based on geographic location. But, in his view, commercial insurance can be much more involved and restrictive.
Sharing His Expertise
Mogell has dedicated himself to educating other dentists and advancing awareness in the dental sleep medicine space. He frequently speaks on practice management and business growth. His advice for dentists interested in getting involved in dental sleep is to turn to professional organizations, such as the AADSM and the American Sleep and Breathing Academy (ASBA), as well as look for local classes.
ASBA president Kent Smith, DDS, DABDSM, founder of Sleep Dallas and 21st Century Sleep Seminars, says, “We’re all on the same side in our efforts to save lives, heal relationships, and extend careers. Collaboration through integrated meetings, whether they be in person or virtually held, can go a long way to showing that we are much more alike than different. If we keep the patient first, everyone ‘wins,’ if there must be victors in this field.”
Smith adds that Mogell’s dedication to advancing the field of dental sleep medicine and building relationships between physicians and dentists is clear. “He has consistently striven to improve the field of sleep medicine,” Smith says. “His passion to uncover the undiagnosed and to treat the disenfranchised is evident in every conversation we have had in the last decade.”
AADSM’s Schwartz says, “Dr Mogell has been a fantastic colleague who is not only not afraid to share his experiences but also willing to share the new things he has learned from others along the way. He has been a supporter of the academy as well as a tremendous friend to me and the academy where he volunteers, lectures, and serves as a role of mentor.”
Both dentists speak to Mogell’s willingness to volunteer, mentor, and lend a helping hand, whether that be in discussing innovations in the field or serving as co-chair of the “emerging concepts” course being offered December 4 and 5, 2021, through the AADSM.
At the end of the day, Mogell simply sees himself as a man who is lucky to do a job he loves and continue to build relationships with his patients and others around him.
“I work hard, but I really like what I do,” Mogell says. “I have no problem getting up and coming to work, and I am so blessed with what I have and I’m so grateful for the people around me, from my staff to my peers. I’ve got some great role models and I wouldn’t be where I am without them.”
Chaunie Brusie, RN, BSN, is a content creator specializing in health, medical, parenting, finance, and travel. This is her first article for Sleep Review.