Fatigue, a “foggy” mind, and irritability are all signs you’re not getting enough sleep—and neither might your sleeping partner from your continuous snoring. You might have a common form of sleep-related breathing disorder (SRBD) known as obstructive sleep apnea.
Sleep apnea occurs when the airway becomes obstructed (usually by the tongue), resulting in a lack of oxygen. The body rouses from sleep just enough to correct the obstruction. This can occur and interrupt deep sleep several times a night, causing the aforementioned problems as well as personality changes, high blood pressure or increased stomach acid reflux. If the problem persists, sleep apnea could also become a long-term factor in the development of heart disease, diabetes or other serious conditions.
Fortunately, we can do something about it. While some may require more invasive intervention, most cases of sleep apnea can be alleviated through continuous positive airway pressure (CPAP) therapy. In this therapy, an electrical pump supplies pressurized air into a face mask worn while sleeping. The increased air pressure helps to keep the airway open.
For some patients, however, CPAP can cause discomfort like claustrophobia, nasal congestion and dryness. If that’s a concern for you, you might want to consider an oral appliance provided by your dentist.
Customized to your own individual mouth contours, this appliance is usually a two-part hinged device that draws the lower jaw and the tongue forward to open the airway. Easily adjustable, these appliances are usually more comfortable to wear than a CPAP and don’t require electricity or have the attendant noise of a CPAP pump.
They do, however, have a few drawbacks: they can disrupt saliva flow, causing either too much or too little; they may result in some morning soreness; and they can stimulate unnecessary tooth or jaw movements. For most, though, these side effects are minor compared to a better night’s sleep.
If you suspect you may have some form of SRBD, you’ll need to have it confirmed through a physical examination and possibly sleep lab testing. If it is sleep apnea, your physician and dentist can work together to help you find the right therapy to regain the benefits of a good night’s sleep.
If you would like more information on sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”
After several treatment sessions your periodontal (gum) disease is under control. But, while we may have won this battle, the war rages on. To keep an infection from re-occurring we'll have to remain on guard.
Gum disease begins and thrives on a thin film of bacteria and food particles on tooth surfaces called plaque. The infection usually begins as gingivitis, which causes the gums to become red and swollen (inflamed). Untreated it can develop into periodontitis, a more advanced form that progresses deeper into the gum tissues resulting in bone loss.
To treat the disease, we must remove all the plaque and calculus (hardened plaque deposits) we can find no matter how deeply they've penetrated below the gum line. Since the deeper it extends the more likely surgical techniques may be necessary to consider, it's better to catch the disease in its earliest stages when plaque can be removed with hand instruments or ultrasonic equipment.
The appropriate treatment technique can effectively stop and even reverse gum disease's effects — but it won't change your susceptibility. Constant vigilance is the best way to significantly reduce your risk of another episode. In this case, our prevention goal is the same as in treatment: remove plaque.
It begins with you learning and applying effective brushing and flossing techniques, and being consistent with these habits every day. As your dentist, we play a role too: we may need to see you as often as every few weeks or quarter to perform meticulous cleaning above and below the gum line. We may also perform procedures on your gums to make it easier to maintain them and your teeth, including correcting root surface irregularities that can accumulate plaque.
Our aim is to reduce the chances of another infection as much as possible. "Fighting the good fight" calls for attention, diligence and effort — but the reward is continuing good health for your teeth and gums.
If you would like more information on continuing dental care after gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Cleanings.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
People with missing teeth have more replacement options than ever before, including the ever popular but often more expensive dental implant. But there has also been an expansion of choice on the more affordable side of dental restorations. The flexible removable partial denture (RPD) is one such choice.
Though RPDs have been around for some time, the newer flexible RPD offers some advantages over the more rigid traditional RPD. They’re made of a kind of nylon that’s pliable but also strong and durable. This material is thermoplastic, meaning when heated it can be injected into molds based on a patient’s individual mouth to form an accurate denture base. The gum-colored base can also be formed to cover any receded areas of the gums, which can greatly improve smile appearance.
Older versions of RPDs are made of rigid acrylic plastic that stay in place in the mouth with metal clasps that attach to remaining teeth. The flexible RPD, on the other hand, is secured with finger-like nylon extensions that fit and hold in the natural teeth’s concavities near the gum line. This, along with its relatively light weight, offers a more comfortable fit.
But aside from these benefits, flexible RPDs do have a few drawbacks. Although fracture-resistant, they’re not easy to repair or reline to readjust the fit to accommodate mouth changes. They can stain (though not as much as a traditional RPD), so they require diligent cleaning and maintenance.
We consider the whole category of RPDs as “temporary” restorations, meaning they’re intended as a transitional phase between tooth loss and a permanent restoration like a natural tooth-supported fixed bridge or dental implants. For some, however, the flexible RPD might be a more long-term solution. As mentioned before, to extend their life as much as possible they should be removed daily and cleaned thoroughly. And like any form of denture, they should not be worn overnight.
In either case, flexible RPDs offer an effective way to restore not only dental function diminished by missing teeth but an improved appearance as well. With careful maintenance, they could serve you well for some time to come.
If you would like more information on flexible partial dentures, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”
At no other time in a person’s life will their teeth and mouth change as rapidly as it will between infancy and adolescence. In this short span an entire set of teeth will emerge and then gradually disappear as a second permanent set takes its place.
While the process may seem chaotic, there is a natural order to it. Knowing what to expect will help ease any undue concerns you may have about your child's experience.
The first primary teeth begin to appear (erupt) in sequence depending on their type. The first are usually the lower central incisors in the very front that erupt around 6-10 months, followed then by the rest of the incisors, first molars and canines (the “eye” teeth). The last to erupt are the primary second molars in the very back of the mouth just before age 3. A similar sequence occurs when they’re lost — the central incisors loosen and fall out around 6-7 years; the second molars are the last to go at 10-12 years.
A little “chaos” is normal — but only a little. Because of the tremendous changes in the mouth, primary teeth may appear to be going in every direction with noticeable spaces between front teeth. While this is usually not a great concern, it’s still possible future malocclusions (bad bites) may be developing. To monitor this effectively you should begin regular checkups around the child’s first birthday — our trained professional eye can determine if an issue has arisen that should be treated.
Protecting primary teeth from tooth decay is another high priority. There’s a temptation to discount the damage decay may do to these teeth because “they’re going to be lost anyway.” But besides their functional role, primary teeth also help guide the developing permanent teeth to erupt in the right position. Losing a primary tooth prematurely might then cause the permanent one to come in misaligned. Preventing tooth decay with daily oral hygiene and regular office visits and cleanings (with possible sealant protection) is a priority. And should decay occur, it’s equally important to preserve the tooth for as long as possible for the sake of the succeeding tooth.
Your child’s rapid dental development is part of their journey into adulthood. Keeping a watchful eye on the process and practicing good dental care will ensure this part of the journey is uneventful.
If you would like more information on the process of dental development in children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dentistry & Oral Health for Children.”
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