# Episode 2 — Bringing Airway and Myo Into Your Practice as a Team **Length target:** 13–15 minutes (~2,300 words) **Publish:** Launch day (drop with Ep 1 + 3) --- ## Show notes You're curious about airway — so how do you actually bring it into a practice as a shared project, not a solo crusade? In Episode 2, Kirsten walks through the exact 4-step rollout she coaches teams through: how to open the conversation with the doctor, how to add screening without disrupting the schedule, how to handle billing and coding, and how to talk with patients and parents in a way that builds trust. This is a workflow any hygienist (hy-JEE-nist), doctor, or assistant can lead. **In this episode:** - (00:00) Why this works best as a team project, led by whoever's ready - (03:30) The 4-step practice rollout - (06:00) Step 1: Opening the conversation with the team - (08:15) Step 2: Adding screening without disrupting the schedule - (10:30) Step 3: Billing & coding the time - (12:15) Step 4: The parent / patient conversation script **Resources mentioned:** - 1-Hour CE Course (full screening workflow + scripts) → optimizedairway.com/ce-course (PODCAST20) - OAE Certification (the full clinical pathway) → optimizedairway.com/oae-certification --- ## Script Welcome back to Optimized Airway. I'm Kirsten Trevisonn, and this is Episode 2. This one's for whoever's listening — hygienist (hy-JEE-nist), dentist, orthodontist, assistant, therapist. Last week we talked about why airway shows up in so many different chairs, and the small signs that are easy to catch once you know to look for them. This week is the how. This is the episode I wish someone had handed me the day I finished my myo (MY-oh) training. Knowing the material is one thing. Bringing it into a practice as a shared project — something the whole team builds together — is a different skill, and it's one worth learning well. [BREATH] So let's talk about it. The question I get most often — in my DMs, at conferences, from hygienists and doctors both — is some version of, "I love this. Where do I even start? How do I bring this to my team?" And here's the good news: in my experience coaching hundreds of teams through this rollout, most doctors are genuinely curious. Most say, "Interesting, tell me more." A lot of them say, "Wait, I've been noticing this too, I just didn't have a name for it." Airway is newer territory for a lot of curricula, dental and hygiene school alike. So it makes sense that a practice might not have a formal workflow for it yet — not because anyone dropped the ball, but because the evidence has moved faster than the training pipeline. That's exactly the gap this rollout is meant to close. [BREATH] The framework has four steps. Team. Schedule. Billing. Patient. In that order, because each step sets up the next. Done well, this can be running in a practice within about 60 days — and it works best when the doctor is the one championing it, with the hygienist, assistant, or therapist bringing the clinical detail. **Step one: opening the conversation with your team.** Here's what tends not to work: catching the doctor between patients on a Tuesday afternoon with a big, undefined ask. That conversation usually goes nowhere, not because the doctor doesn't care, but because they're task-switching between three ops and you've handed them something without any structure. Instead, ask for 15 minutes at the next team meeting, or grab coffee before the Monday huddle. Bring one printed page. Three sentences on what airway-related dysfunction can look like in a patient population — sleep-disordered breathing, TMJ discomfort, ortho relapse, pediatric behavior changes. Three sentences on what a screening could look like — a 90-second visual check folded into the existing recall. One sentence on what it adds to the practice: a chance to catch things earlier, strengthen referrals, and offer patients a fuller picture of their care. Then close by proposing a small, easy yes. Not "let's build a whole program" — that's a big ask for one meeting. Instead: "Would the team be open to me piloting this screening for 30 days, and then we look together at what we found?" Most doctors say yes to that, because there's no cost and no disruption. Once you have that yes, the data does a lot of the rest of the talking. Doctors, like most clinicians, respond well to pattern recognition. If you can bring one or two examples from the existing patient list where the airway story is clear in hindsight, the conversation gets a lot easier — you're speaking the same clinical language. [BREATH] **Step two: adding screening without disrupting the schedule.** This is the practical question everyone asks. "I have 45 minutes with an adult and 30 with a kid — where does this fit?" The answer: you're not adding new minutes. You're using the minutes you already have a little differently. The screening itself takes about 90 seconds. It's a quick triage, not a full clinical workup — a handful of high-yield observations woven into the greeting, the medical history review, and getting the patient settled. Here's the flow. While walking the patient back: how are they breathing right now, what's their posture like, is the tongue visible at rest, is the lower lip chapped or everted. Four observations, about ten seconds. Then, folded into the medical history you're already taking, two added questions. For an adult: "How's your sleep been — are you waking up rested?" For a child, to the parent: "Does she snore, mouth-breathe at night, or wake up a lot?" And: "Any headaches, jaw pain, or clenching you've noticed?" That's the whole screening. If everything's negative, the appointment continues as normal. If a couple of things come back positive, note it in the chart and bring it up gently at the end of the visit — more on that in step four. Ninety seconds, not twenty extra minutes. After doing it a few dozen times, it becomes as automatic as anything else in the appointment. [BREATH] **Step three: billing and coding the time.** This one sounds more complicated than it is. The 90-second screening itself isn't billed separately — it's part of the recall, the same way an oral cancer screening is absorbed into a standard visit. It's simply part of a thorough exam. Where billing becomes its own conversation is if the screening turns up findings and the patient wants a full myofunctional evaluation. That's typically a separate 60–90 minute appointment, usually private pay. In Canada, many practices charge between $175 and $250 for that evaluation; in the US it tends to run $150–$300 depending on region. It's not an insurance code — it's a specialized service the patient pays for directly, similar to physiotherapy. Some extended health plans do reimburse under general therapy codes, so it's worth checking, but building the model around the value of the service tends to hold up better than building it around reimbursement. One more practical note: check your provincial or state scope of practice before billing for standalone myo services. In most Canadian provinces and US states, hygienists can deliver myofunctional (MY-oh-funk-shun-ul) therapy under their existing license, particularly education and neuromuscular retraining components — but scope varies. A couple of hours reviewing your regulatory college's site before the first invoice saves a lot of back-and-forth later. If your jurisdiction requires a doctor's referral or supervision, build the workflow around that from day one — it's a structural detail, not a barrier. [BREATH] **Step four: the parent and patient conversation.** This step is what makes the whole rollout land well. You can be clinically right about everything, but if the conversation feels alarming or judgmental, the patient tunes out. The rule: lead with observation, not diagnosis. Don't open with "sleep apnea" or any clinical label. It's observation, then a question, then an invitation — never an accusation. Here's a version of the script, close to verbatim. For a parent: "Before you head out — I noticed a couple of things today I want to flag, just so you have the information. Emma's breathing through her mouth quite a bit while resting, and her tongue sits a little low. Sometimes those things are connected to sleep quality. Have you noticed any snoring, mouth-breathing at night, or restlessness?" Notice what that does. It names the observation, invites the parent in, and doesn't diagnose anything. Often the answer comes back, "Actually yes, she snores a lot, we've wondered about it." Now there's a real conversation, and you can offer: "There's a workup we can do here that looks at what's happening functionally, and depending on what we find, we might loop in your pediatrician or an ENT. Want me to book that in?" For an adult, it's nearly the same, self-directed: "I noticed a few things today, and I'd like to ask a couple of questions — not to alarm you, just to get the full picture. Are you waking up rested? Does anyone mention snoring? Any morning headaches or jaw tension?" Observation, question, invitation. No fear, no jargon. Once it's memorized, it takes about 45 seconds to deliver, and it opens the door to real conversations far more often than people expect. [BREATH] So there's the whole rollout. Team. Schedule. Billing. Patient. It's not a moonshot — it's a 60-day project any team can run without new equipment or a disrupted schedule, with everyone contributing the piece they see best. Homework this week is just step one. Book the 15-minute conversation. Print the one-pager. Propose the small yes. If you want the one-pager template, the full 90-second screening protocol, and the parent-conversation script — with coding notes for Canada and the US — it's all in the 1-Hour CE Course at optimizedairway.com/ce-course. Use code PODCAST20 for 20% off. Next week, in Episode 3, we're talking about what this path opens up professionally — for hygienists, for assistants, and for doctors who want to grow their own scope. Follow the show so you don't miss it. I'm Kirsten Trevisonn, this has been Optimized Airway, and I'll see you next Tuesday. Take care of yourselves out there.