Patient Safety, Inc.
Speaker Spotlight: Dr. Steve Carstensen
Speaker Spotlight is a new feature on our blog! We will be interviewing experts in the field and learning more about what they do. First up, we talked to Dr. Steve Carstensen.
In 1996, Dr. Carstensen achieved Fellowship in the Academy of General Dentists in recognition of over 3000 hours of advanced education in dentistry, with an increasing amount of time in both practice and classwork devoted to sleep medicine. In 2006, he achieved Certification by the American Board of Dental Sleep Medicine.
Dr. Carstensen has been a key player in laying the groundwork for dentists now practicing dental sleep medicine and airway-centered therapy. As a volunteer leader for the American Dental Association, he was a Program Chairman and General Chairman for the Annual Session, the biggest educational event the Association sponsors. Dr. Carstensen also has an active history with the American Academy of Dental Sleep Medicine; he has been a Board Member, Secretary, Treasurer, and President-Elect.
Dr. Carstensen has also co-authored the recently published book, The Clinician's Handbook for Dental Sleep Medicine.
A lifelong educator himself, Dr. Carstensen is currently the Sleep Education Director for both Pankey Institute and Spear Education, recognized as among the finest places for dentists to further their education.
Dr. Carstensen recalls how he came to enter the field of dental sleep medicine, how his practice has evolved, and where he focuses his efforts today:
"It was in 1989, during my second week at the Pankey Institute that I met Dr. Keith Thornton, our lead faculty member for the week. He and I bonded right away, and as he became a leader in early dental therapy for sleep-related breathing disorders, he brought his friends along, including me. I’ve been treating sleepy patients since the middle 1990s – in 2007, I decided to move my education emphasis towards training dentists how they, too can be important providers of these critical services. With training at Pankey, the Pride Institute for practice management, UCLA, and uncountable hours in class and keeping up with the literature, I try to focus dental teams on how they can make practical changes to office systems to engage as many people in their practice as possible. In 2019, my writing partner Dr. Ken Berley and I published ‘The Clinician’s Handbook for Dental Sleep Medicine’ with practical advice for every dental office."
Here is a fun tidbit that people may not know about him:
"Several friends were talking, and a question arose:
With limited time left, how would you spend it?
One great friend said he would find a group and try to teach them something. While I admire greatly that thought and share its sentiment, I’d be at home with a fine vinyl record cued up on my turntable, listening to great music like the Tedeschi Trucks Band, Larkin Poe, or Alison Krauss. I couldn’t care less about cars, but I have a pretty nice hi-fi."
We asked Dr. Carstensen to comment on the state of the field, and where he sees an opportunity for dentists incorporating dental sleep medicine in their practice:
"The subject of sleep-related breathing disorders (SRBD) is, of course to me, fascinating. Forty or so years ago as physicians were learning about the ‘new’ disease and inventing ways to treat it, technology and limited understanding yielded what looks today like simplistic ways of labeling and treating the disease. Apnea-Hypopnea Index (AHI) became the standard definition, CPAP the common therapy. In the past few years, as better technology and more sophisticated science have emerged, the physician who created AHI decried its usefulness and the inventor of CPAP ‘can’t believe we still use that thing.’ Both AHI and CPAP remain useful, just not the only parameters – now we think of not only other ways of describing the patient’s problems and therapy choices, but take into account the age of the patient and many other precise phenotypes that indicate other clinical decisions.
An aspect of this thinking is who should be diagnosing, or at least, who should be deploying diagnostic instruments for those at risk of SRBD? With over a billion people estimated to suffer worldwide, tens of millions in the US, there simply are not enough board-certified sleep physicians to significantly impact those numbers. Dentists are the only workforce in medicine with the capacity to make a difference, so we are increasingly becoming more involved with moving people from undiagnosed-at-risk to diagnosed-in-therapy. This is a rapidly changing environment and the interested dentist must remain engaged and nimble to be a helpful member of the medical team. The American Dental Association (ADA) has a policy statement supporting a dental role in SRBD, which gives great validity to expanding the scope of our practices.
For children, it is even more exciting for dentists, as we are the only part of medicine that can affect the growth and development of the craniofacial-respiratory complex in growing children. As we learn to recognize signs of deficiencies as early in life as possible and employ therapies we already know how to do, dentists can have more impact on the health of people than they have ever had before. There is a lot of work going on by passionate professionals across all aspects of dentistry and pediatric medicine to support this effort, again, the ADA is championing the dentist’s role."
Where you can learn more from Dr. Carstensen:
"My favorite teaching week every year is at Pankey Institute, where we gather a small number of professionals and the leading experts in our field for a week of intensive learning and practical education. This year, we are combining in one building two courses, The Sleep Course at Pankey, for dentists interested in learning about sleep and appliance therapy, and The Advanced Airway Course, for those dentists experienced in the basics and want to know more about many aspects of how they can make a difference. September 20 – 24 will be a special time in Key Biscayne. www.pankey.org